Zhang Zhen, Zhang Shaoyan, Xu Yalai, Liu Xiaoning, Dong Wenjie
Department of Oncology Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Respiratory Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Henan Vocational College of Water Conservancy and Environment, Zhengzhou, China.
Chin Clin Oncol. 2024 Dec;13(6):83. doi: 10.21037/cco-24-62.
The characteristics of tumor immune microenvironment are important factors affecting the efficacy of immunotherapy, and there are differences in the distribution of tumor-infiltrating lymphocyte (TIL) subsets in different types of tumors. This study aims to compare the distributions of cluster of differentiation (CD) 4+ and CD4+ T cell subsets of TILs and their clinical significance between lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC).
The tumor tissues of 78 LUAD and 56 LUSC patients who underwent surgery at The Second Affiliated Hospital of Zhengzhou University between October 2020 and October 2022 were collected, TIL level were detected by pathological observation, and the proportions of CD4+, CD4+ T cell subsets and CD4+/CD4+ ratio in TILs were detected by flow cytometry. These indicators were compared between LUAD and LUSC, and their correlations with clinicopathological characteristics and patient survival were analyzed.
There was no significant difference in the TILs level between LUAD and LUSC (P>0.05). The CD4+/CD4+ ratio in LUSC was lower, and proportion of CD4+ T cells was higher than those in LUAD (all P<0.05). In LUAD, the proportions of CD4+, CD4+ T cells and CD4+/CD4+ were correlated with tumor size or tumor-node-metastasis (TNM) stage, while in LUSC, only the proportions of CD4+ and CD4+ T cells were correlated with tumor size, degree of differentiation or TNM stage. In LUAD patients, higher proportions of CD4+, CD4+ T cells and lower CD4+/CD4+ predicted longer survival, and high CD4+/CD4+ (>1.04) was an independent risk factor for PFS and OS (P<0.05); In LUSC patients, there was no correlation between the proportions of CD4+ T cells, CD4+ T cells and CD4+/CD4+ ratio, and patient prognosis (P>0.05).
There were differences in the distribution and balance of CD4+ and CD4+ TIL subsets between LUAD and LUSC, among which CD4/CD4+ ratio closely affected the prognosis of LUAD patients but had relatively weak prognostic value in LUSC patients due to the restriction of CD4+ T cells.
肿瘤免疫微环境的特征是影响免疫治疗疗效的重要因素，不同类型肿瘤中肿瘤浸润淋巴细胞（TIL）亚群的分布存在差异。本研究旨在比较肺腺癌（LUAD）和肺鳞癌（LUSC）中TILs的分化簇（CD）4 +和CD4 + T细胞亚群的分布及其临床意义。
收集2020年10月至2022年10月在郑州大学第二附属医院接受手术的78例LUAD和56例LUSC患者的肿瘤组织，通过病理观察检测TIL水平，采用流式细胞术检测TILs中CD4 +、CD4 + T细胞亚群的比例及CD4 + /CD4 +比值。比较LUAD和LUSC之间的这些指标，并分析它们与临床病理特征及患者生存的相关性。
LUAD和LUSC之间的TILs水平无显著差异（P>0.05）。LUSC中的CD4 + /CD4 +比值较低，CD4 + T细胞比例高于LUAD（均P<0.05）。在LUAD中，CD4 +、CD4 + T细胞的比例及CD4 + /CD4 +与肿瘤大小或肿瘤-淋巴结-转移（TNM）分期相关，而在LUSC中，只有CD4 +和CD4 + T细胞的比例与肿瘤大小、分化程度或TNM分期相关。在LUAD患者中，较高比例的CD4 +、CD4 + T细胞和较低的CD4 + /CD4 +预示着更长的生存期，高CD4 + /CD4 +（>1.04）是无进展生存期（PFS）和总生存期（OS）的独立危险因素（P<0.05）；在LUSC患者中，CD4 + T细胞、CD4 + T细胞的比例及CD4 + /CD4 +比值与患者预后无相关性（P>0.05）。
LUAD和LUSC之间CD4 +和CD4 + TIL亚群的分布及平衡存在差异，其中CD4 /CD4 +比值密切影响LUAD患者的预后，但在LUSC患者中由于CD4 + T细胞的限制，其预后价值相对较弱。
