Cervical Neoplasia: Papillomavirus Infection and Resistance to Anti Tumor Immunity

Abstract

This study aim to identify the expression of resistance to antitumor immunity on cellular and tissue alterations predictive of Human Papillomavirus infection as well as to establish the relationship between this resistance and the grades of Intraepithelial neoplasms of the cervix in patients from Lubumbashi and Kinshasa in the Democratic Republic of Congo. This is a study on cervical biopsies whose diagnosis of intraepithelial neoplasia was confirmed by a routine histopathological examination in two pathology laboratories in the Democratic Republic of Congo, or the laboratory of Lubumbashi and the LEBOMA laboratory of Kinshasa. The paraffin blocks were selected during a period from March 2017 to March 2020 at the laboratory of Lubumbashi and at the LEBOMA laboratory in Kinshasa. Laboratory manipulations were carried out at the molecular pathology unit of the LEBOMA Pathological Anatomy and Cytology Cabinet in Kinshasa. Papillomavirus infection was retained by the presence of predictive cellular and tissue alterations. The expression of PD-L1 signifies resistance to anti-tumor immunity. The following results were observed; A total of 50 cases of intraepithelial neoplasia were recorded in a set of 107 patients with cervical lesions, i.e. a frequency of 46.7%. The cytological and histological alterations predictive of papillomavirus infection were observed in the following proportions: For cytological changes; koilocytosis was present in 92%, bi-nucleation was observed in 24% and dyskeratosis was identified in 46%, ie 46, 12 and 23 cases, respectively, out of 50 cases of cervical neoplasia recorded. The proportions of histological alterations are presented as follows: 62% of papillomatosis, 86% of acanthosis, 54% of basal hyperplasia and 34% of intraepithelial capillaries, i.e. 31, 43, 27 and 17 cases out of respectively. The 50 cases of intraepithelial neoplasia of the cervix recorded. PD-L1 expression was observed in 16 cases out of all intraepithelial neoplasia, ie 32% of cases. PD-L1 is mainly expressed in high-grade intraepithelial neoplasias, i.e. 81.25% 95% CI=54.35-95.95 and those involving bi-nucleation (OR=26.66 95% CI=4, 63-153.57, Fisher exact, p<0.01), the intraepithelial capillaries or 37.5%; 95% CI=15.20-64.57. It emerges from this study the expression of PD-L1 is not uniform over all the cyto-histological alterations predictive of human papillomavirus infection during neoplasias. intraepithelial of the cervix, but it is much more expressed in high-grade intraepithelial neoplasias and in those comprising the predictive alterations of Papillomavirus infection like the bi-nucleation and the intraepithelial capillary.