Prognostic and Therapeutic Implications of Immune Classification by CD8+ Tumor-Infiltrating Lymphocytes and PD-L1 Expression in Sinonasal Squamous Cell Carcinoma

Sinonasal squamous cell carcinoma (SNSCC) is an aggressive tumor predominantly arising in the maxillary sinus and nasal cavities. Advances in imaging, surgical and radiotherapeutic techniques have reduced complications and morbidity; however, the prognosis generally remains poor, with an overall 5-y...

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Published in:International journal of molecular sciences 2021-07, Vol.22 (13), p.6926
Main Authors: García-Marín, Rocío, Reda, Sara, Riobello, Cristina, Cabal, Virginia N., Suárez-Fernández, Laura, Vivanco, Blanca, Álvarez-Marcos, César, López, Fernando, Llorente, José L., Hermsen, Mario A.
Format: Article
Language:English
Subjects:
CD8 antigen
CD8+ TILs
Chemotherapy
Endoscopy
Head & neck cancer
Immune checkpoint inhibitors
Immune system
Immunogenicity
Immunohistochemistry
Immunotherapy
Lymphocytes
Maxillary sinus
Medical prognosis
Metastasis
Morbidity
Patients
PD-L1
PD-L1 protein
Radiation therapy
sinonasal cancer
Sinus
Squamous cell carcinoma
Subgroups
Surgery
Survival
Survival analysis
Tumor cells
Tumor microenvironment
Tumor-infiltrating lymphocytes
Tumors
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Summary:Sinonasal squamous cell carcinoma (SNSCC) is an aggressive tumor predominantly arising in the maxillary sinus and nasal cavities. Advances in imaging, surgical and radiotherapeutic techniques have reduced complications and morbidity; however, the prognosis generally remains poor, with an overall 5-year survival rate of 30–50%. As immunotherapy may be a new therapeutic option, we analyzed CD8+ tumor-infiltrating lymphocytes (TILs) and the tumor microenvironment immune type (TMIT, combining CD8+ TILs and PD-L1) in a series of 57 SNSCCs. Using immunohistochemistry, tissue samples of 57 SNSCCs were analyzed for expression of CD8 on TILs and of PD-L1 on tumor cells. The results were correlated to the clinical and survival data. In total, 88% (50/57) of the tumors had intratumoral CD8+ TILs; 19% (11/57)—CD8high (>10%); and 39/57 (68%)—CD8low (1–10%). PD-L1 positivity (>5%) was observed in 46% (26/57) of the SNSCCs and significantly co-occurred with CD8+ TILs (p = 0.000). Using univariate analysis, high intratumoral CD8+ TILs and TMIT I (CD8high/PD-L1pos) correlated with a worse survival rate. These results indicate that SNSCCs are immunogenic tumors, similar to head and neck squamous cell carcinomas. Nineteen percent of the cases were both CD8high and PD-L1pos and this subgroup may benefit from therapy with immune checkpoint inhibitors.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms22136926