title: Neoadjuvant therapy changes the lymphocyte composition of tumor-draining lymph nodes in cervical carcinoma.
abstract: BACKGROUND
  The objective of the current study was to illustrate the influence of neoadjuvant therapy on the local immune response in patients with cervical carcinoma.
  
  
  METHODS
  Uninvolved tumor-draining lymph nodes (TDLN) (n=158 lymph nodes), including internal, external, and common iliac lymph nodes as well as obturator, presacral, and aortic lymph nodes from 15 nontreated (NT) patients, 4 chemotherapy (CT)-treated patients, and 19 chemoradiation (CR)-treated patients, were analyzed for lymphocyte subset distribution and for the proliferative response of T cells to polyclonal activation and interferon-gamma (IFN-gamma) production. Lymphocyte subsets in peripheral blood also were assessed.
  
  
  RESULTS
  TDLNs from CR-treated patients contained higher proportions of CD8+ cells and natural killer cells than NT and CT-treated patients (P values ranged from <0.05 to <0.01). TDLNs from CR-treated patients were enriched in activated-type CD4+ cells (HLA-DR+, CD134+, CD62L-, and CD25+ at an intermediate expression level; P values ranged from <0.05 to <0.01) and activated-type CD8+ cells (CD62L-, P<0.001) compared with NT patients. Concomitantly, there was a reduction in the proportion of naïve-type CD4+ and CD8+ cells (CD45RA+/CD62L+) (P<0.01 and <0.05, respectively). CR treatment increased the proportion of both CD4+ and CD8+ cells prone to produce IFN-gamma. All TDLNs contained suppressive CD4+ T regulatory (Treg) cells (CD25+ and CD152+ at a high expression level) whose frequency and suppressive activity was not influenced by the treatment. Therapy-induced changes in TDLN were mirrored only in part by respective alterations in peripheral blood.
  
  
  CONCLUSIONS
  To our knowledge, the current study is the first to show that neoadjuvant therapy produces an enhancing effect on the immune competency of TDLNs from patients with cervical carcinoma.
authors.affiliation: Unità Operativa Assistenziale di Ginecologia Oncologica, Istituto Di Ginecologia, Università Cattolica S Cuore, Rome, Italy. cytogyn@rm.unicatt.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Fattorossi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Battaglia
authors.forename: Gabriella
authors.initials: G
authors.lastname: Ferrandina
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Coronetta
authors.forename: Francesco
authors.initials: F
authors.lastname: Legge
authors.forename: Vanda
authors.initials: V
authors.lastname: Salutari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000276:immunology* / Q000532:radiotherapy / Q000601:surgery; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008198:Lymph Nodes / Q000276:immunology; D008214:Lymphocytes / Q000276:immunology* / Q000378:metabolism*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000276:immunology* / Q000532:radiotherapy / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin