Franz Leonardo, Alessandrini Lara, Fasanaro Elena, Gaudioso Piergiorgio, Carli Alessandro, Nicolai Piero, Marioni Gino
Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy.
Department of Medicine DIMED, University of Padova, Padova, Italy.
Ann Diagn Pathol. 2021 Feb;50:151657. doi: 10.1016/j.anndiagpath.2020.151657. Epub 2020 Nov 5.
In laryngeal carcinoma (LSCC), tumor immune microenvironment is attracting increasing interest, given the recent progresses in immunotherapy. Immune cells migrate to tumors as a result of a tumor antigen-induced immune reaction and cancer cells recruit immune regulatory cells to induce an immunosuppressive network, resulting in the escape from host immunity. This interaction reflects both on tumor microenvironment and systemic inflammatory status. Blood neutrophil-to-lymphocyte ratio (NLR), reflecting a highly pro-inflammatory status, has been related to worse oncological survival outcomes. The aim of this study was to analyze in LSCC the relationship between circulating inflammatory cells (also in terms of NLR) and tumor immune microenvironment histopathological features (programmed cell death ligand 1 [PD-L1] expression, and tumor-infiltrating lymphocytes [TILs]), also investigating their clinical-pathological and prognostic significance.
Blood pre-operative NLR, and, at pathology, PD-L1 (in terms of combined positive score [CPS]) and TILs were assessed on 60 consecutive cases of LSCC.
Blood NLR, neutrophils, and lymphocytes counts showed a significant value in predicting DFS and recurrence risk. Moreover, PD-L1 CPS ≥ 1 and TILs count rate ≥30% were associated with higher disease-free survival (DFS) and reduced recurrence risk. A logistic regression model found a significant positive association between increasing NLR values, and PD-L1 CPS < 1 and TILs count rate <30%.
Further studies are needed to better characterize the role of pre-operative blood NLR in association with PD-L1 expression and tumor immune microenvironment features as prognostic factors and markers of anti-tumor immune response in LSCCs, also with regard to the effectiveness of immunotherapeutic protocols.
鉴于免疫治疗的最新进展，喉癌（LSCC）中的肿瘤免疫微环境正吸引着越来越多的关注。免疫细胞因肿瘤抗原诱导的免疫反应而迁移至肿瘤，癌细胞招募免疫调节细胞以诱导免疫抑制网络，从而导致宿主免疫逃逸。这种相互作用反映在肿瘤微环境和全身炎症状态上。反映高度促炎状态的血液中性粒细胞与淋巴细胞比值（NLR）与较差的肿瘤学生存结果相关。本研究的目的是分析LSCC中循环炎症细胞（也包括NLR方面）与肿瘤免疫微环境组织病理学特征（程序性细胞死亡配体1 [PD-L1]表达和肿瘤浸润淋巴细胞[TILs]）之间的关系，并研究它们的临床病理和预后意义。
对60例连续的LSCC病例术前血液NLR以及病理检查时的PD-L1（联合阳性评分[CPS]）和TILs进行评估。
血液NLR、中性粒细胞和淋巴细胞计数在预测无病生存期（DFS）和复发风险方面具有显著价值。此外，PD-L1 CPS≥1和TILs计数率≥30%与更高的无病生存期（DFS）和降低的复发风险相关。逻辑回归模型发现NLR值升高与PD-L1 CPS <1和TILs计数率<30%之间存在显著正相关。
需要进一步研究以更好地阐明术前血液NLR与PD-L1表达和肿瘤免疫微环境特征作为LSCC预后因素和抗肿瘤免疫反应标志物的作用，也涉及免疫治疗方案的有效性。
