Mitchell Kyle G, Lee Younghee, Deboever Nathaniel, Negrao Marcelo V, Tran Hai T, Parra Edwin, Byers Lauren, Reuben Alexandre, Federico Lorenzo, Bernatchez Chantale, Wang Jing, Antonoff Mara B, Vaporciyan Ara A, Swisher Stephen G, Cascone Tina, Wistuba Ignacio I, Heymach John V, Gibbons Don L, Zhang Jianjun, McGrail Daniel J, Sepesi Boris, Haymaker Cara L
Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
J Immunother Cancer. 2025 Jun 24;13(6):e011458. doi: 10.1136/jitc-2025-011458.
Tumor-initiated emergency granulopoiesis results in expansion of the circulating neutrophil compartment and neutrophil recruitment into the tumor microenvironment (TME), which may in turn promote tumor progression. Although an elevated circulating neutrophil-to-lymphocyte ratio (cNLR) has repeatedly been demonstrated to be an adverse prognostic factor in patients with non-small cell lung cancer (NSCLC), whether this neutrophil expansion in circulation reflects a similar relative neutrophil abundance in the TME remains unclear. We sought to characterize the relationships between cNLR and the intratumoral neutrophil-to-lymphocyte ratio (tNLR), between tNLR and proteogenomic and immune features of NSCLC tumors, and between tNLR and prognosis.We analyzed tNLR (transcriptomic signatures) and cNLR in a prospectively-enrolled cohort of patients with NSCLC (stage IA-III) that was subjected to multifaceted immunoprofiling (ImmunogenomiC prOfiling of early-stage Non-small cell lung cancer (ICON), N=150). We examined the relationship between tNLR and genomic, transcriptomic, and proteomic features of NSCLC tumors in The Cancer Genome Atlas (TCGA) and ICON. Finally, tNLR was analyzed for associations with postoperative recurrence-free survival (ICON) and overall survival (TCGA).In the ICON cohort, tNLR was significantly positively correlated with cNLR, but there was no association between intratumoral and circulating neutrophils or lymphocytes alone. High tNLR was associated with poor postoperative recurrence-free survival, and multivariate analysis indicated tNLR was a stronger driver of outcomes than cNLR. Mutations in , , , , and were associated with an increased tNLR. Tumors with elevated tNLR were marked by proteomic and transcriptomic features indicative of increased cell cycle, receptor tyrosine kinase, and YAP signaling, as well as immunosuppression (reduced and expression). Flow cytometry and multiplex immunofluorescence confirmed reduced CD8granzyme B T cells in the TME of tumors with high tNLR. Finally, TCGA confirmed associations between tNLR with prognosis, mutational status, and proteomic/transcriptomic features, and further showed that tNLR is prognostically relevant in multiple solid cancers.tNLR is mirrored by NLR in circulation (cNLR) in NSCLCs. High tNLR is associated with an immunosuppressed TME phenotype and poor prognosis across multiple cancers. These findings support ongoing investigations of the utility of cNLR and tNLR as clinical biomarkers in the context of patients with NSCLC treated with immune checkpoint inhibitor therapies.
肿瘤引发的应急粒细胞生成导致循环中性粒细胞池的扩张以及中性粒细胞募集到肿瘤微环境(TME)中,这反过来可能促进肿瘤进展。尽管循环中性粒细胞与淋巴细胞比值(cNLR)升高反复被证明是非小细胞肺癌(NSCLC)患者的不良预后因素,但循环中的这种中性粒细胞扩张是否反映了TME中类似的相对中性粒细胞丰度仍不清楚。我们试图描述cNLR与肿瘤内中性粒细胞与淋巴细胞比值(tNLR)之间的关系、tNLR与NSCLC肿瘤的蛋白质基因组和免疫特征之间的关系以及tNLR与预后之间的关系。我们在一个前瞻性纳入的NSCLC(IA-III期)患者队列中分析了tNLR(转录组特征)和cNLR,该队列接受了多方面的免疫分析(早期非小细胞肺癌的免疫基因组分析(ICON),N = 150)。我们研究了tNLR与癌症基因组图谱(TCGA)和ICON中NSCLC肿瘤的基因组、转录组和蛋白质组特征之间的关系。最后,分析tNLR与术后无复发生存期(ICON)和总生存期(TCGA)的相关性。在ICON队列中,tNLR与cNLR显著正相关,但肿瘤内和循环中的中性粒细胞或淋巴细胞单独之间无关联。高tNLR与术后无复发生存期差相关,多变量分析表明tNLR比cNLR是更强的预后驱动因素。 、 、 、 和 的突变与tNLR升高相关。tNLR升高的肿瘤具有指示细胞周期、受体酪氨酸激酶和YAP信号增加以及免疫抑制( 和 表达降低)的蛋白质组和转录组特征。流式细胞术和多重免疫荧光证实高tNLR肿瘤的TME中CD8颗粒酶B T细胞减少。最后,TCGA证实了tNLR与预后、突变状态和蛋白质组/转录组特征之间的关联,并进一步表明tNLR在多种实体癌中具有预后相关性。在NSCLC中,tNLR与循环中的NLR(cNLR)呈镜像关系。高tNLR与免疫抑制的TME表型以及多种癌症的不良预后相关。这些发现支持正在进行的关于cNLR和tNLR作为接受免疫检查点抑制剂治疗的NSCLC患者临床生物标志物效用的研究。
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