Mohan Aishwarya, Gunabooshanam Barathi, Sundaram Sandhya, Keerthana Banu
Clinical Immunology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2025 Jul 25;17(7):e88775. doi: 10.7759/cureus.88775. eCollection 2025 Jul.
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.
目的 头颈部鳞状细胞癌（HNSCC）是一项重大的肿瘤学挑战，其解剖学表现多样，临床结局各异。免疫检查点，尤其是细胞毒性T淋巴细胞抗原4（CTLA-4），在调节免疫反应中起关键作用，并可能影响肿瘤进展和治疗反应。方法 在这项回顾性研究中，我们旨在评估CTLA-4在石蜡包埋的HNSCC组织样本中的表达，并研究其预后效用。计划对50例患者样本进行免疫组织化学分析，以评估CTLA-4表达与肿瘤特征之间的显著关联。结果 男性CTLA-4表达的患病率高于女性。CTLA-4染色强度与肿瘤分布比例相关，不同强度评分之间存在统计学显著差异。此外，还确定了CTLA-4表达与肿瘤分级之间存在显著关系，特别是在中分化肿瘤（G2）中（p = 0.000）。然而，阴性染色和膜-细胞质染色缺乏统计学意义。结论 我们的研究结果表明，HNSCC中CTLA-4的表达与肿瘤进展为高级别肿瘤有关，可能作为肿瘤生物学行为的标志物。有必要进一步研究CTLA-4表达与其他预后标志物（如p16）的相关性及其对HNSCC免疫治疗的影响。
