Xu Shao-Jun, Luo Yun-Fan, Huang Jin, Tu Jia-Hua, Chen Chao, Shen Yan-Ming, Sun Zhao-Min, Chen Shu-Chen
Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian, China.
Front Immunol. 2025 Jan 7;15:1517968. doi: 10.3389/fimmu.2024.1517968. eCollection 2024.
The prognostic impact of human leukocyte antigen-E (HLA-E) expression and the proportion of natural killer (NK) cells in esophageal squamous cell carcinoma (ESCC) was investigated.
This study retrospectively evaluated 397 ESCC patients across two centers. The cumulative incidence of recurrence (CIR) and the incidence of tumor-related death (CID) were analyzed in various groups. An immunosuppression score (ISS) was developed based on HLA-E expression and NK cell proportion. Differences between groups were adjusted using inverse probability treatment weighting (IPTW). The factors influencing cancer-specific survival (CSS) and recurrence-free survival (RFS) were also examined.
Patients with low HLA-E expression had significantly higher five-year CIR and CID compared to those with high expression (CIR: 20.7% vs. 45.1%, CID: 19.3% vs. 40.1%; < 0.001). Similarly, NK cell-positive patients had significantly better five-year CIR and CID than NK cell-negative patients (CIR: 16.3% vs. 59.6%, CID: 13.9% vs. 53.7%; < 0.001). The Sankey diagram indicated that the low ISS group had a lower recurrence and tumor-related mortality rate ( < 0.05). After IPTW adjustment, the low ISS group showed improved five-year RFS (80.1% vs. 35.4%, < 0.001) and five-year CSS (82.3% vs. 42.5%, < 0.001) compared to the high ISS group.
ESCC with different ISS statuses represents two distinct biological subtypes, underscoring the need for personalized treatment strategies tailored to varying tumor behaviors.
研究了人类白细胞抗原-E（HLA-E）表达和自然杀伤（NK）细胞比例对食管鳞状细胞癌（ESCC）预后的影响。
本研究回顾性评估了两个中心的397例ESCC患者。分析了不同组的复发累积发生率（CIR）和肿瘤相关死亡发生率（CID）。基于HLA-E表达和NK细胞比例制定了免疫抑制评分（ISS）。使用逆概率处理加权（IPTW）调整组间差异。还研究了影响癌症特异性生存（CSS）和无复发生存（RFS）的因素。
与高表达患者相比，低HLA-E表达患者的五年CIR和CID显著更高（CIR：20.7%对45.1%，CID：19.3%对40.1%；<0.001）。同样，NK细胞阳性患者的五年CIR和CID明显优于NK细胞阴性患者（CIR：16.3%对59.6%，CID：13.9%对53.7%；<0.001）。桑基图表明，低ISS组的复发率和肿瘤相关死亡率较低（<0.05）。经过IPTW调整后，与高ISS组相比，低ISS组的五年RFS（80.1%对35.4%，<0.001）和五年CSS（82.3%对42.5%，<0.001）有所改善。
具有不同ISS状态的ESCC代表两种不同的生物学亚型，强调需要根据不同的肿瘤行为制定个性化的治疗策略。
