Cervical cancer has been found to have increased morbidity and mortality in women around the world. Despite complex treatment according to stratification, the risk of relapse is observed in up to 40% of patients

Purpose of the study: - Improving the result of early diagnosis of recurrence of cervical cancer stump after complex treatment, by determining the value of the immune response by immunohistochemical markers in combination with the results of complex research methods

Materials and methods: - The basis of the research work was a retrospective analysis of the results of the examination and complex treatment of 87 patients with cervical cancer who were treated and treated at the Republican Specialized Scientific and Practical Center of Oncology and Radiology of Uzbekistan, as well as in its Samarkand Regional Branch from 2012 to 2017. All patients underwent complex treatment of 4 courses of polychemotherapy according to the scheme fluorouracil + cisplatin, laparotomy, extended hysterectomy according to Wertheim type and combined radiation therapy of the small pelvis according to the BOX type.

All patients were divided into 2 groups. The first control group consisted of 32 (36.8%) patients with cervical cancer who underwent complex treatment in various sequences, without relapse for three years. The second group included 55 (63.2%) patients with the same diagnosis, but in whom, after complex treatment, an early relapse was detected at the preclinical stage.

Results: - In the study of intense infiltrate with lymphoid follicles, it was mainly observed with the degree of tumor differentiation G-3 and G-4, which amounted to 21 (80.7%) patients in the relapse group, while in the control group in 19 (61%) which significantly higher (p≤0.05). In group 1, negative expression was noted in highly and moderately differentiated tumors 9 (29%). With low and undifferentiated tumors, moderate and high expression of VEGF (50%) was noted, with further observation in these patients, locoregional recurrence was noted.

In the second group, where there was a relapse of the cervical stump by histological examination, high expression with G-4 was noted in 8 (30.7%), and with G-3 moderate expression in 6 (23%) cases. Low intensity was observed only in 1 (3.8%) G1.As can be seen in Table 4.2, negative expression during relapse, i.e. the absence of lymphoid

Conclusions: - Based on our research, differences in cellular immunity play a significant role. In patients without relapses, an increased cellular density of T3DM and T20 was observed, and in patients with relapses and severe course of the disease, low lymphoid density.

 We should note that in our study, the strongest predictor of prognosis is the number of CD3 + cells per mm 2.

Cervical cancer, relapse, combined radiation therapy

BELL M. C., EDWARDS R. P., PARTRIGE E. E., KUYKENDALL K., CONNER W., GORE H., TURBAT-HERRARA E., CROWLEYNOWICK P. A., CD8+ Tocytes are recruited to neoplastic cervix, J Clin Immunol, 2015, 15(3 ):130–136.

CHAO H. T., WANG P. H., TSENG L. Y., LAI C. R., CHIANG S. C., YUAN C. C., Lymphocyte-infiltrated FIGO Stage IIB squamous cell carcinoma of the cervix is a prominent factor for disease-free survival, Eur J Gynaecol Oncol, 1999, 20 (2):136–140.

MONNIER-BENOIT S., MAUNY F., RIETHMULLER D., GUERRINI J. S., CĂPÎLNA M., FÉLIX S., SEILLÈS E., MOUGIN C., PRÉTET J. L., Immunohistochemical analysis of CD4+ and CD8+ T-cells subsets in high risk human papillomavirusassociated pre-malignant and malignant lesions of the uterine cervix, Gynecol Oncol, 2016, 102(1):22–31.

NEDERGAARD B. S., NIELSEN K., NYENGAARD J. R., LADEKARL M., Stereologic estimation of the total numbers, the composition and the anatomic distribution of lymphocytes in cone biopsies from patients with stage I squamous cell carcinoma of the cervix uteri, APMIS, 2007 , 115(12):1321–1330.

NEDERGAARD B. S., LADEKARL M., THOMSEN H. F., NYEGAARD J. R., NIELSEN K., Low density of CD3+, CD4+ and CD8+ cells is associated with increased risk of relapse in squamous cell cervical cancer, Br J Cancer, 2017, 97(8 ):1135–1138.

NEDERGAARD B. S., LADEKARL M., NYENGAARD J. R., NIELSEN K., A comparative study of cellular immune response in patients with stage IB cervical squamous cell carcinoma. Low number of several immune cell subtypes are strongly associated with relapse of disease within 5 years, Gynecol Oncol, 2008, 108(1):106–111.