Expression of PD‑L1 and CD4+ tumor‑infiltrating lymphocytes predict survival in head and neck squamous cell carcinoma

Fu,Ze-Ming; Zhang,De-Jun; Guo,Ying-Yuan; Han,Shuang; Guo,Fang; Bai,Jie; Wan,Yi-Ning; Guan,Guo-Fang; Sun,Ke-Wei; Yang,Na

doi:10.3892/mco.2022.2492

Expression of PD‑L1 and CD4+ tumor‑infiltrating lymphocytes predict survival in head and neck squamous cell carcinoma

Authors:
- Ze-Ming Fu
- De-Jun Zhang
- Ying-Yuan Guo
- Shuang Han
- Fang Guo
- Jie Bai
- Yi-Ning Wan
- Guo-Fang Guan
- Ke-Wei Sun
- Na Yang
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Affiliations: Department of Otolaryngology‑Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China, Department of Otolaryngology‑Head and Neck Surgery, Changchun Center Hospital, Changchun, Jilin 130041, P.R. China
Published online on: January 10, 2022 https://doi.org/10.3892/mco.2022.2492
Article Number: 59
Copyright: © Fu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The clinical efficacy of immune checkpoint blockade has been recently demonstrated in a variety of cancer types. The aim of the present study was to characterize the expression profile of tumor‑infiltrating lymphocytes (TILs) and programmed death‑ligand 1 (PD‑L1) in head and neck squamous carcinoma (HNSCC). A total of 63 patients with HNSCC were enrolled in the present study. CD3⁺ and CD4⁺ TILs and the expression of PD‑L1 were detected by immunohistochemistry. PD‑L1 mRNA levels were evaluated by reverse transcription‑quantitative PCR analysis. The association of TILs and PD‑L1 with patient clinicopathological characteristics was also assessed. CD3⁺ and CD4⁺ TILs were detected in 100% of the samples. CD3⁺ was the predominant subset of TILs. PD‑L1 was expressed in 53 of 61 (86%) patients when a score of ≥1 on tumor cells was considered positive and in 28 patients (45.2%) when a score of >5 on tumor cells was considered positive. PD‑L1 mRNA levels were determined to be significantly correlated with PD‑L1 protein expression. Survival analysis demonstrated that high CD4⁺ TILs were associated with improved overall survival (OS) and disease‑free survival (DFS), and furthermore, the association of high PD‑L1 expression with unfavorable OS and DFS was statistically significant. Multivariate analysis identified CD4⁺ TILs and PD‑L1 as prognostic markers for HNSCC. The results of the present study suggested that increased CD4⁺ TILs in HNSCC may be associated with improved outcomes, while high expression of PD‑L1 may indicate unfavorable OS and DFS; thus, these factors may serve as predictors of the response to immune checkpoint therapy.

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