Abstract:Objective To explore the differential expressions of toll like receptor 4 (TLR4) / nuclear factor κB (NF-κB)/inducible nitric oxide synthase (iNOS) pathway in cervical microenvironment in carcinogenesis of human papillomavirus (HPV)-related cervical squamous cell (CSCC), and its clinical significance in the progression of CSCC. Methods Sixty cases of HPV related women with normal cervix (CN), 51 cases of low-grade squamous intraepithelial lesions (LSIL), 60 cases of high-grade squamous intraepithelial lesions (HSIL) and 58 cases of CSCC confirmed pathologically in Shanxi Children's Hospital (Maternal and Child Health Hospital) were selected as the research objects. The expression levels of TLR4, NF-κB and iNOS protein were detected by immunohistochemical SP method. The demographic characteristics and cancer related factors of the subjects were collected. Results From CN group, LSIL group, HSIL group to CSCC group, the positive expression rates of TLR4(1.7%，17.6%，31.7%，55.2%), NF-κB (1.7%，11.8%，78.2%，89.7%) and iNOS (3.3%，11.8%，31.7%，70.7%)increased significantly, and the difference was statistically significant(P<0.01). With the progression of cervical lesions, the expression rates of TLR4 (trend χ²=32.900, P<0.01), NF-κB (trend χ²=48.340, P<0.01) and iNOS (trend χ²=47.862, P<0.01) gradually increased. Conclusion The activation of TLR4/NF-κB/iNOS pathway may promote the progression of cervical squamous intraepithelial lesions and the occurrence of CSCC.