Cervical cancer, also known as carcinoma of uterine cervix, is a common gynecological malignancy. Human papillomavirus (HPV) is the main risk factor for the cervical cancer, which is mostly caused by smoking, premature sexual life and immune deficiency diseases [1]. Most patients may have no symptoms in the early stage, which is often found through screening. Contact bleeding and abnormal vaginal bleeding may occur in supplementary patients, and other tissues and organs will be invaded in the advanced cervical cancer [2]. Therefore, it is very important to predict early cervical cancer. Some studies have confirmed that patients with cervical cancer have different degrees of abnormal cellular immune function [3]. CD${}_4$+ refers to T lymphocytes with CD${}_4$+ T molecules on the surface. CD${}_8$+ is a leukocyte differentiation antigen and a subgroup of T cells [4]. CD${}_{20}$+ expresses and secretes immunoglobulin of B cells, and plays a regulatory role in the proliferation and differentiation of B cells. CD${}_{57}$+ mainly marks natural killer (NK) cells in lymphoid tissue [5]. At present, there are few studies on T lymphocytes, B lymphocytes and NK cells in predicting the effect of laparoscopic nerve-sparing radical hysterectomy (LNSRH) for early cervical cancer.

Cervical cancer is a common gynecological tumor, with a high incidence of carcinoma in situ at the age of 30–35 and invasive cancer at the age of 45–55 [7]. The disease types are mostly squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma, clear cell carcinoma, small cell carcinoma, etc. In most cases, cervical cancer is caused by a persistent infection from human papillomavirus (HPV) and developed through a series of precursor dysplastic lesions of the cervical epithelium (i.e., cervical dysplasia) [8]. Human immune dysfunction may lead to cervical cancer. Some studies have shown that the state of the patients immune function can be used to assess the curative effect and prognosis of cervical cancer [9].

The study found that cervical cancer group CD${}_4$+ was low and CD${}_8$+ was high in cervical cancer patients than control group. CD${}_4$+ was high and CD${}_8$+ was low on the postoperative 3 d than postoperative 1 d. CD${}_4$+ expression was positively correlated with FSFI and FACT-G scores, and CD${}_8$+ expression was negatively correlated with FSFI and FACT-G scores, CD${}_4$+ lymphocytes decreased, resulted in low immune function [10, 11, 12, 13]. CD${}_8$+ is a kind of cytotoxic T lymphocytes, which can kill human cells infected by viruses and can inhibit antibody synthesis [14, 15]. Indicated that lymphocyte immune function decreased with the development of the cervical cancer, but the T lymphocyte immune function improved after LNSRH. Suggested that LNSRH was beneficial to the recovery of cervical cancer patients, and T lymphocytes could be used as a clinical indicator of cervical cancer, which were in line with the previous literature reports. LNSRH could use to laparoscopic technique to preserve nerves on the basis of treatment. LNSRH has been proved to be associated with many benefits in the management of different gynecological cancers, in terms of reduced postoperative morbidity, improved recovery and reduced inpatient stay [16].

The study found CD${}_{20}$+ was highly expressed in patients with cervical cancer that compared with control group. Compared with postoperative 1 d, the expression of CD${}_{20}$+ was lower on the postoperative 3 d. The expression of CD${}_{20}$+ was negatively correlated with FSFI and FACT-G scores, indicated that B lymphocyte CD${}_{20}$+ participated in the occurrence and development of cervical cancer, CD${}_{20}$+ played a regulatory role in B cell differentiation and proliferation [17] and CD${}_{20}$+ was closely related to the cervical cancer which were in line with the previous literature reports [18, 19].

NK cells can secrete a variety of cytokines and plays a role in hematopoiesis and immune regulation [20]. CD${}_{57}$+ is expressed in neuroendocrine cells, derived tumors, and NK cells mainly marking lymphoid tissues [21]. The study found the expression of CD${}_{57}$+ was low in patients with cervical cancer that compared with control group. Compared with the postoperative 1 d, the expression of CD${}_{57}$+ was higher on the postoperative 3 d. The expression of CD${}_{57}$+ was positively correlated with FSFI and FACT-G scores, indicated that the NK cell immune function decreased with the development of the disease. However, the NK cell immune function gradually improved after LNSRH, suggested that LNSRH was conducive to the recovery of patients with cervical cancer.

The results of the study showed that the sensitivity of CD${}_4$+, CD${}_8$+, CD${}_{20}$+, and CD${}_{57}$+ in ROC were 63.33%, 66.67%, 73.33%, 70.00%, and 86.67% respectively, and the accuracy was 60.00%, 63.33%, 68.33%, 63.33%, and 70.00% respectively and sensitivity and accuracy both lower than the four combined tests, suggested that CD${}_4$+, CD${}_8$+, CD${}_{20}$+, and CD${}_{57}$+ had high detection value for early cervical cancer treated with LNSRH which was involved in the occurrence and development of cervical cancer. The CD${}_4$+, CD${}_8$+, CD${}_{20}$+, and CD${}_{57}$+ of patients after LNSRH were improved, and LNSRH was of high value in the treatment of early cervical cancer.

Among the limitations of the present study, we mention the retrospective design, the relatively small number of patients included. Interestingly, a recent analysis has confirmed that, in female with the International Federation of Gynecology and Obstetrics (FIGO) stage Ib1-IIa2 cervical adenocarcinoma (CA), there were no significant differences between LNSRH and open surgery in terms of disease-free survival and overall survival [22, 23]. So, further analyses of larger series are needed to better investigate the effect of LNSRH on the survival rate of early cervical cancer (ECC) patients. The main strengths of the current investigation were: FSFI, FACT-G scores were used to evaluate female sexual function and quality of life, the homogeneous and long-term (3-year) analysis of outcomes. The four combined test have good predictive value for the efficacy of LNSRH for early cervical cancer.

In conclusion, our study shows that LNSRH is a feasible, safe and effective procedure that conjugates adequate radicality with an improvement in post-operative functional outcomes. In the present study, we evaluated LNSRH is beneficial to the recovery of cervical cancer patients of life that were investigated. T, B, and NK lymphocytes combined test have good predictive value for the efficacy of LNSRH for early cervical cancer. Our data provide a reliable picture of the everyday clinical scenario in patients affected by early-stage as well as locally advanced cervical cancer. These data may serve as the basis for clinical counselling and future discussions on this relevant topic.

All data generated or analysed during this study are included in this published article.

Conception and design—LH; Administrative support—HZ; Provision of study materials or patients—LH; Data analysis and interpretation—LM; Manuscript writing—All authors; Final approval of manuscript—All authors. All authors read and approved the final manuscript.

All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki, and this study was approved by the Tianjin Fifth Central Hospital Ethics Committee (approval number: 20221110). I confirmed that informed consent was obtained from all patients and their families. I confirmed all methods were carried out in accordance with Helsinki declaration.

Not applicable.

This research received no external funding.

The authors declare no conflict of interest.