Prognostic Utility of Cytotoxic T-Lymphocyte Antigen 4 (CTLA-4) Expression in Head and Neck Squamous Cell Carcinoma: A Retrospective Study.

Purpose Head and neck squamous cell carcinomas (HNSCCs) represent a significant oncological challenge, with diverse anatomical presentations and variable clinical outcomes. Immune checkpoints, particularly cytotoxic T-lymphocyte antigen-4 (CTLA-4), play a pivotal role in regulating the immune response and may influence tumor progression and treatment response. Methods In this retrospective study, we aimed to assess the expression of CTLA-4 in paraffin-embedded HNSCC tissue samples and investigate its prognostic utility. Immunohistochemical analysis was planned to be performed on 50 patient samples to assess a significant association between CTLA-4 expression and tumor characteristics. Results Males exhibited a higher prevalence of CTLA-4 expression compared to females. The intensity of CTLA-4 staining correlated with the proportion of tumor distribution, with statistically significant differences observed between different intensity scores. Additionally, a significant relationship between CTLA-4 expression and tumor grade, particularly in moderately differentiated tumors (G2), was identified (p = 0.000). However, negative staining and membrane-cytoplasm staining lacked statistical significance. Conclusion Our findings suggest that CTLA-4 expression in HNSCC is associated with tumor progression to high-grade neoplasia and may serve as a marker of tumor biological behavior. Further research correlating CTLA-4 expression with other prognostic markers, such as p16, and its implications for immunotherapy in HNSCC are warranted.