Clinical significance of tumor-associated macrophage infiltration in supraglottic laryngeal carcinoma

Tumor-associated macrophages (TAMs) can elicit contrasting effects on tumor progression, depending on different tumor microenvironment. This study aimed to explore the correlation between TAM infiltration and clinicopathologic characteristics, metastasis, and prognosis of supraglottic laryngeal carcinoma. TAMs in intratumoral and peritumoral regions of 84 specimens of supraglottic laryngeal carcinoma tissues were detected by immunohistochemical staining with monoclonal CD68 antibody. The density of peritumoral CD68(+) TAMs in recurrence cases (9/11) and in dead cases (17/23) were significantly higher than those in non-recurrence cases (33/73) and in survival cases (25/61), with significant differences (P = 0.024 and 0.007, respectively). The Kaplan-Meier survival analysis showed a significant relationship between the infiltration of both intratumoral and peritumoral CD68(+) TAMs and the overall survival of patients. The 5-year survival rate was significantly lower in the group with a high density of intratumoral CD68(+) TAMs than in the group with a low density (39.6% vs. 82.5%, P < 0.05). Similarly, the 5-year survival rate was significantly lower in the group with a high density of peritumoral CD68(+) TAMs than in the group with a low density (50.6% vs. 73.1%, P < 0.05). Cox regression analysis revealed that T classification, distant metastasis, and intratumoral or peritumoral CD68(+) TAMs were independent factors for disease-free survival, whereas T classification and intratumoral CD68(+) TAMs were independent factors for overall survival. The results indicate that TAM infiltration in supraglottic laryngeal carcinoma can be used to predict metastasis and prognosis and is an independent factor for prognosis.