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Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma

BACKGROUND: Prognostic factors aid in the stratification and treatment of cancer. This study evaluated prognostic importance of tumor infiltrating immune cell in patients with oral squamous cell carcinoma. METHODS: Profiles of infiltrating immune cells and clinicopathological data were available for...

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Autores principales: Fang, Juan, Li, Xiaoxu, Ma, Da, Liu, Xiangqi, Chen, Yichen, Wang, Yun, Lui, Vivian Wai Yan, Xia, Juan, Cheng, Bin, Wang, Zhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446725/
https://www.ncbi.nlm.nih.gov/pubmed/28549420
http://dx.doi.org/10.1186/s12885-017-3317-2
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author Fang, Juan
Li, Xiaoxu
Ma, Da
Liu, Xiangqi
Chen, Yichen
Wang, Yun
Lui, Vivian Wai Yan
Xia, Juan
Cheng, Bin
Wang, Zhi
author_facet Fang, Juan
Li, Xiaoxu
Ma, Da
Liu, Xiangqi
Chen, Yichen
Wang, Yun
Lui, Vivian Wai Yan
Xia, Juan
Cheng, Bin
Wang, Zhi
author_sort Fang, Juan
collection PubMed
description BACKGROUND: Prognostic factors aid in the stratification and treatment of cancer. This study evaluated prognostic importance of tumor infiltrating immune cell in patients with oral squamous cell carcinoma. METHODS: Profiles of infiltrating immune cells and clinicopathological data were available for 78 OSCC patients with a median follow-up of 48 months. The infiltrating intensity of CD8, CD4, T-bet, CD68 and CD57 positive cells were assessed by immunohistochemistry. Chi-square test was used to compare immune markers expression and clinicopathological parameters. Univariate and multivariate COX proportional hazard models were used to assess the prognostic discriminator power of immune cells. The predictive potential of immune cells for survival of OSCC patients was determined using ROC and AUC. RESULTS: The mean value of CD8, CD4, T-bet, CD68 and CD57 expression were 28.99, 62.06, 8.97, 21.25 and 15.75 cells per high-power field respectively. The patient cohort was separated into low and high expression groups by the mean value. Higher CD8 expression was associated with no regional lymph node metastasis (p = 0.033). Patients with more abundant stroma CD57(+) cells showed no metastasis into regional lymph node (p = 0.005), and early clinical stage (p = 0.016). The univariate COX regression analyses showed that no lymph node involvement (p < 0.001), early clinical stage (TNM staging I/II vs III/IV, p = 0.007), higher CD8 and CD57 expression (p < 0.001) were all positively correlated with longer overall survival. Multivariate COX regression analysis showed that no lymph node involvement (p = 0.008), higher CD8 (p = 0.03) and CD57 (p < 0.001) expression could be independent prognostic indicators of better survival. None of CD4, T-bet or CD68 was associated with survival in ether univariate or multivariate analysis. ROC and AUC showed that the predictive accuracy of CD8 and CD57 were all superior compared with TNM staging. CD57 (AUC = 0.868; 95% CI, 0.785–0.950) and CD8 (AUC = 0.784; 95% CI, 0.680–0.889) both provided high predictive accuracy, of which, CD57 was the best predictor. CONCLUSION: Tumor stroma CD57 and CD8 expression was associated with lymphnode status and independently predicts survival of OSCC patients. Our results suggest an active immune microenvironment in OSCC that may be targetable by immune drugs.
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spelling pubmed-54467252017-05-30 Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma Fang, Juan Li, Xiaoxu Ma, Da Liu, Xiangqi Chen, Yichen Wang, Yun Lui, Vivian Wai Yan Xia, Juan Cheng, Bin Wang, Zhi BMC Cancer Research Article BACKGROUND: Prognostic factors aid in the stratification and treatment of cancer. This study evaluated prognostic importance of tumor infiltrating immune cell in patients with oral squamous cell carcinoma. METHODS: Profiles of infiltrating immune cells and clinicopathological data were available for 78 OSCC patients with a median follow-up of 48 months. The infiltrating intensity of CD8, CD4, T-bet, CD68 and CD57 positive cells were assessed by immunohistochemistry. Chi-square test was used to compare immune markers expression and clinicopathological parameters. Univariate and multivariate COX proportional hazard models were used to assess the prognostic discriminator power of immune cells. The predictive potential of immune cells for survival of OSCC patients was determined using ROC and AUC. RESULTS: The mean value of CD8, CD4, T-bet, CD68 and CD57 expression were 28.99, 62.06, 8.97, 21.25 and 15.75 cells per high-power field respectively. The patient cohort was separated into low and high expression groups by the mean value. Higher CD8 expression was associated with no regional lymph node metastasis (p = 0.033). Patients with more abundant stroma CD57(+) cells showed no metastasis into regional lymph node (p = 0.005), and early clinical stage (p = 0.016). The univariate COX regression analyses showed that no lymph node involvement (p < 0.001), early clinical stage (TNM staging I/II vs III/IV, p = 0.007), higher CD8 and CD57 expression (p < 0.001) were all positively correlated with longer overall survival. Multivariate COX regression analysis showed that no lymph node involvement (p = 0.008), higher CD8 (p = 0.03) and CD57 (p < 0.001) expression could be independent prognostic indicators of better survival. None of CD4, T-bet or CD68 was associated with survival in ether univariate or multivariate analysis. ROC and AUC showed that the predictive accuracy of CD8 and CD57 were all superior compared with TNM staging. CD57 (AUC = 0.868; 95% CI, 0.785–0.950) and CD8 (AUC = 0.784; 95% CI, 0.680–0.889) both provided high predictive accuracy, of which, CD57 was the best predictor. CONCLUSION: Tumor stroma CD57 and CD8 expression was associated with lymphnode status and independently predicts survival of OSCC patients. Our results suggest an active immune microenvironment in OSCC that may be targetable by immune drugs. BioMed Central 2017-05-26 /pmc/articles/PMC5446725/ /pubmed/28549420 http://dx.doi.org/10.1186/s12885-017-3317-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Fang, Juan
Li, Xiaoxu
Ma, Da
Liu, Xiangqi
Chen, Yichen
Wang, Yun
Lui, Vivian Wai Yan
Xia, Juan
Cheng, Bin
Wang, Zhi
Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma
title Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma
title_full Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma
title_fullStr Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma
title_full_unstemmed Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma
title_short Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma
title_sort prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446725/
https://www.ncbi.nlm.nih.gov/pubmed/28549420
http://dx.doi.org/10.1186/s12885-017-3317-2
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