Characterization of the Immune Tumor Microenvironment and Its Association With Cervical Cancer Health Disparities [ID 1217]

INTRODUCTION: Cervical cancer disproportionately affects women from underserved populations. Non-Hispanic Black and Hispanic women are 60% and 20% more likely, respectively, to die from cervical cancer than non-Hispanic White women. Although disparities have largely been attributed to social determinants of health, evidence from other cancer types suggests ancestry and race may also influence cancer biology. However, the biology underlying cervical cancer disparities remains underexplored. METHODS: Clinicopathological characteristics were compared in a diverse cohort of cervical cancer patients treated at Johns Hopkins Medicine between 1995 and 2019 using R statistics. Surgically resected formalin-fixed paraffin-embedded tissues from Black and White women, matched on grade, age, and subtype, were selected from this cohort. Multiplex immunohistochemical staining targeted CD163 (M2 macrophages), tryptase (mast cells), CD66 (granulocyte activation), CD68 (pan-macrophages), and Pan-cytokeratin. Quantitative image analysis was performed using HALO software. Immune marker expression was correlated with FIGO stage and self-identified race. RESULTS: Quantitative analysis showed no significant differences in CD163+ M2 macrophage or tryptase+ mast cell expression by self-reported race. Squamous cell carcinoma predominated across samples, whereas adenocarcinoma was more frequent among White patients. Staging distributions showed Black patients more often diagnosed at advanced stages (IIIA–IVA), and White patients concentrated in earlier stages (IB1–IIA1). Exploratory cBioPortal analysis suggested racial differences in gene mutation profiles, warranting further study of genomic influences in the tumor immune microenvironment. CONCLUSIONS/IMPLICATIONS: Profiling the cervical tumor microenvironment could improve early detection and targeted interventions to reduce disparities. Future work will generate immunobiological data to guide clinical practice and enhance outcomes for patients.