Journal article
Prognostic Role of Tumor-Infiltrating Lymphocytes in Oral Squamous Cell Carcinoma
BMC cancer, Vol.24(1), 766
06/26/2024
DOI: 10.1186/s12885-024-12539-5
PMCID: PMC11201865
PMID: 38926643
Abstract
Background
In oral squamous cell carcinoma (OSCC), the tumor-node-metastasis (TNM) staging system is a significant factor that influences prognosis and treatment decisions for OSCC patients. Unfortunately, TNM staging does not consistently predict patient prognosis and patients with identical clinicopathological characteristics may have vastly different survival outcomes. Host immunity plays an important role in tumor progression but is not included in the TNM staging system. Tumor-infiltrating lymphocytes (TILs) are part of the host immune response that recognizes tumor cells; and the presence of TILs has emerged as potential candidates for prognostic markers for many types of cancers. The present study aims to determine the association of T cell-specific markers (CD3, CD4, CD8, and FOXP3) with clinicopathological characteristics and survival outcomes in OSCC patients. The prognostic value of CD3, CD4, and CD8 will also be evaluated based on tumor stage.
Methods
Tissue microarrays were constructed containing 231 OSCC cases and analyzed by immunohistochemical staining for the expression of CD3, CD4, CD8, and FOXP3. The expression scores for each marker were correlated with clinicopathological parameters and survival outcomes. The prognostic impact of CD3, CD4 and CD8 were further analyzed based on tumor stage (early or advanced).
Results
CD3, CD4, and CD8 were found to be significantly associated with both overall survival and progression-free survival using univariate analysis. However, none of these markers were found to independently predict the survival outcomes of OSCC using multivariate analysis. Only conventional factors such as nodal status, tumor differentiation and perineural invasion (PNI) were independent predictors of survival outcomes, with nodal status being the strongest independent predictor. Additionally, low CD4 (but not CD3 or CD8) expression was found to identify early-stage OSCC patients with exceptionally poor prognosis which was similar to that of advanced staged OSCC patients.
Conclusions
TIL markers such as CD3, CD4, CD8, and FOXP3 can predict the survival outcomes of OSCC patients, but do not serve as independent prognostic markers as found with conventional factors (i.e. nodal status, tumor differentiation and PNI). CD4 expression may assist with risk stratification in early-stage OSCC patients which may influence treatment planning and decision making for early-stage OSCC patients.
Details
- Title: Subtitle
- Prognostic Role of Tumor-Infiltrating Lymphocytes in Oral Squamous Cell Carcinoma
- Creators
- Wattawan Wongpattaraworakul - University of IowaAllen Choi - University of IowaMarisa R. Buchakjian - University of IowaEmily A. Lanzel - University of IowaAnand Rajan KD - University of Iowa, PathologyAndrean L. Simons - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- BMC cancer, Vol.24(1), 766
- Publisher
- BioMed Central
- DOI
- 10.1186/s12885-024-12539-5
- PMID
- 38926643
- PMCID
- PMC11201865
- ISSN
- 1471-2407
- eISSN
- 1471-2407
- Language
- English
- Date published
- 06/26/2024
- Academic Unit
- Oral Pathology, Radiology and Medicine; Pathology; Pharmaceutical Sciences and Experimental Therapeutics; Surgery; Radiation Oncology; Otolaryngology
- Record Identifier
- 9984649059302771
Metrics
5 Record Views