Additionally, SPP1+ TAMs interact with cancer cells via the SPP1-CD44 signaling axis, an interaction that is more pronounced in high-grade squamous intraepithelial lesion (HSIL) and CC samples compared to low-grade squamous intraepithelial lesion (LSIL) samples.55 Here, CD44 is linked to squamous cell intraepithelial neoplasia.