Figure 4

Th17 counteracts the effect of IL6. Of the 27 immunological and 15 vascularization markers analysed, CD3, IL5, IL6, IL17A and VEGFA were most significantly correlated with the clinical outcome of cervical cancer patients. A ‘T cells’ response, indicating the presence of Th1, CTL and Treg cells and represented by blue cells, was correlated with improved prognosis. IL6 and VEGFA, the latter indicative of angiogenesis, were both correlated with poor prognosis. IL6, expressed by both tumour cells and infiltrating immune cells, may directly promote tumour growth, indicated by the interrupted arrow. High IL17 (Th17) and IL5 (Th2) expression were correlated with improved prognosis, specifically relative to IL6 expression. IL6 expression was also correlated with the absence of vaso-invasion, indicated by the blunted arrow on the tumour cell entering the vessel. We have also shown this correlation before for IL-17 protein expression [30], suggesting that the IL-6/IL-17 pathway may prevent tumour spread via the blood or lymphatic vasculature.