Resposta imunológica local nas lesões de baixo, alto grau e de carcinoma de colo uterino: estudo imunohistoquímico de leucócitos mononucleares residentes

Abstract

The câncer of is a neoplasia whose prevention, with previous diagnosis of pre-malignant intraephitelial lesions, presented a relevant decrease in occurrence. The researches have concentrated on infection by means of HPV, considered the most important co-factor in the genesis of lesions. There is stili a lot to be learned about interection between HPV and the individual. This research concentrates on the study of local immunologic response of several cervical proliferatives lesions, and is correlation whith the lesion intensity. 61 cases in ginecology Service of câncer Prevention Institute of the State of Ceará (Brazil) were assessed between 1996 and 1997. 15 of the patients presented low grade intraephitelial lesions (LGIL); 12 presented high grade intraephitelial lesions (HGIL) and 27 presented invadors carcinomas (Ca). The leukocytes populations, most specifically the macrophages and lymphocytes, were classified by means of monoclonals antiboryies the use of through tecnique of immunohistoquemistry. For this purpose, tracers CD20, CD43 and CD68 were used to identify, respectively, B cells, T cells and macrophages. A considerable difference between the average percent of CD20+ cell in LGIL and CD20+ cell in HGIL was found (p=0.0001), as well as HGIL and Ca invadors (p=0.0001). This observation suggests that the humoral respnse decreases in HGIL. I was observed that a Progressive increase of CD43+ cell occurred with the increase of the lesions's grade. There was also a relevant occurence of CD68+ cells in all lesions with considerable difference between the average percent of HGIL and Ca invadors (p=0.04). It was concluded that, according to the tracers analysis, in relation with the three lesions assessed, there is a decrease in the humoral response of HGIL represent by a reduced number of CD20+ cells, with the clear prevalence of CD43+ cells. It indicates higher involvement of HGIL with celullar response; and a significant enhancement of celullar response in the Ca invadors represented by the presence of grest amount of CD43+ cells, when compared to LGIL (p=0.01).