Objective To investigate the effect of inflammatory factors (IL-2, INF-γ, IL-10, TNF-α) and CD4⁺ and CD8⁺T cells in vaginal lavage in high-grade cervical squamous intraepithelial lesions (HSIL) and early cervical cancer (CC).

Methods To collect clinical data of HSIL (n=120) and early CC patients (n=44) after high-risk human papilloma virus (HR-HPV) infection. And healthy middle-aged women not infected with HR-HPV were randomly selected as control. The clinical data of the subjects in three groups were compared, inflammatory factors distribution and ratio of CD4⁺ and CD8⁺T cells in serum and vaginal lavage fluid were compared. Multivariate Logistic regression performed to analyze the influencing factors of HSIL progression to early CC, ROC and calibration plot were drawn to evaluate the model.

Results The difference was not statistically significant in serum IL-2, INF-γ, IL-10, TNF-α levels, CD4⁺T cell distribution, CD8⁺T cell distribution and CD4⁺/CD8⁺ ratio in subjects of control group, HSIL group and early CC group (P>0.05). The difference was statistically significant in the vaginal lavage levels of IL-2, INF-γ, IL-10, TNF-α levels, CD4⁺T cell distribution, CD8+T cell distribution and CD4⁺/CD8⁺ ratio (P<0.05), plus the level of HSIL patients was higher than that of control subjects (P<0.05). Logistic regression analysis showed that parity >2 (OR=3.119, 95%CI: 4.353～6.737) and the percentage of CD4⁺T cells in vaginal lavage fluid (OR=0.327, 95%CI: 0.188-0.478) in model 2 (P<0.001, AUC=0.908), CD4⁺/CD8⁺(OR=0.809, 95%CI: 0.356-1.868) (P<0.001, AUC=0.873) in model 3 has an independent influence on the development of HSIL to early CC; the difference is not significant (Z=1.5504, P=0.121) in ROC curves of the two models. CD4⁺/CD8⁺ ratio as only one indictor in Model 3 can be good prediction, and the calibration curve of this model is close to the standard curve.

Conclusions After HR-HPV infection, the systemic immune status does not participate in HSIL and HSIL progression to early CC, but the cervical local immune status is involved, in which CD4⁺/CD8⁺T cell ratio is an independent protective factor.