Immunohistochemical and ultrastructural study of Langerhans's cells in squamous cell carcinoma of the cervix

An Immunohistochemical Study on the Role of CD83+ Dendritic Cells (DCs) in Malignant and Benign Lesions of the Human Cervix

Background Dendritic cells (DCs) are a group of cells that mainly function as antigen-presenting cells in the human body. Proper knowledge and understanding of such cells in the human cervix would be beneficial for understanding the role of CD83+ cells in benign and malignant lesions of the cervix. Materials and methods This retrospective study was performed on cervical specimens. After processing, the CD83+ cells were counted for every 20 high-power fields. The average count per high power field (HPF) was then calculated. The CD83+ cell distributions in cervicitis, cervical dysplasia, and cervical carcinoma were then analyzed.  Results A total of 30 cervical specimens were studied. Of these, 16 were cervicitis and seven were squamous cell carcinoma. Vaginal bleeding was the most common presentation in 21 patients. The mean age was 44.7 years. The mean CD83+ DCs in benign lesions was 1.75 and in malignant tissues was 12.26 per HPF (P<0.001). The area under the curve suggested a 100% sensitivity and specificity of CD83 in distinguishing benign and malignant lesions. The receiver operating characteristic (ROC) curve indicated that the probability of malignancy is higher if the number of CD83+ DCS is more than 179.50/20 HPF. Conclusions Dendritic cells play a major role in the tumoricidal activities of the host cervical tissues. Malignant cervical tissue possesses a higher concentration of CD83+ DCs than benign ones, with 100% sensitivity and specificity. This research work on CD83+ DCs in the cervix would pave the way for further research on the immune functions of the human body.

An immunohistochemical study of CD1a and CD83-positive infiltrating dendritic cell density in cervical neoplasia

Cervical carcinoma is the second leading cancer in women in Malaysia, after breast cancer. Human papillomavirus (HPV) has been implicated in the development of dysplasia or cervical intraepithelial neoplasia and progression to squamous cell carcinoma. Because of the confinement of the human papillomavirus infection within the epithelial layer, the presence of dentritic cells or Langerhans cells in epithelial layer of the ectocervix is paramount in producing immune response. The mature dentritic cells express CD83 and high CD40/80/86, whereas the immature cells express CD1a and low CD40/80/86. By identifying CD1a and CD83, theoretically, both immature and mature dentritic cell populations can be studied. In view of the facts, we investigated the infiltrating cell density of mature and immature dentritic cells in cervical neoplasia.

Relationship between HIV viral load and Langerhans cells of the cervical epithelium

AIM

To determine the relationship between the density of cervical mucosa Langerhans cells, cervical histology, and HIV viral load.

METHODS

Eighty-four HIV-infected and 17 women at high risk for HIV had cervical biopsies assessed for squamous intraepithelial lesions and Langerhans cell density. Langerhans cells were identified using the S-100 immunohistochemical stain and were counted manually. Polymerase chain reaction assays were used to detect cervical human papillomavirus (HPV)-DNA. T-cell subsets were determined using immunofluorescent flow cytometry. Plasma HIV RNA levels were measured using a nucleic acid sequence-based amplification technique. The associations between cervical Langerhans cell density, cervical histology, CD4 counts, HIV viral loads, HPV-DNA detection, and smoking status were assessed using multivariate statistical models.

RESULTS

In multivariate analysis among women infected with HIV, the mean Langerhans cell density per high-powered field was 4.00 among women with no detectable plasma HIV-RNA, and 1.92 among those with detectable HIV-RNA (P = 0.01). The mean cervical Langerhans cell density was increased in women with high-grade squamous intraepithelial lesions compared with those with low-grade squamous intraepithelial lesions and normal/metaplastic histology (3.87 vs 2.11; P = 0.05). Neither HPV-DNA detection, smoking status, nor CD4 count was significantly associated with Langerhans cell density.

CONCLUSIONS

The decrease in cervical Langerhans cell density in women with detectable HIV-RNA suggests an impaired mucosal immune response to local infections, such as HPV. Conversely, HPV infection resulting in high-grade dysplasia might be associated with an enhanced local immune response.