Prognostic value of FOXP3+ regulatory T cells for patients with locally advanced oropharyngeal squamous cell carcinoma

• Published in: PloS one 2022-10, Vol.17 (10), p.e0274830-e0274830
• Main Authors: Hur, Joon Young, Ku, Bo Mi, Park, Sehhoon, Jung, Hyun Ae, Lee, Se-Hoon, Ahn, Myung-Ju
• Format: Article
• Language: English
• Subjects: Apoptosis; Biology and life sciences; Care and treatment; CD20 antigen; CD4 antigen; CD8 antigen; Cell density; Density; Development and progression; Exports; Foxp3 protein; Head & neck cancer; Health aspects; Human papillomavirus; Immunohistochemistry; Immunoregulation; Infections; Lymphocytes; Lymphocytes B; Lymphocytes T; Macrophages; Medical prognosis; Medicine and health sciences; Multivariate analysis; Neoplasia; Palate; Prognosis; Research and Analysis Methods; Squamous cell carcinoma; Stroma; T cells; Throat cancer; Tongue; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0274830

Oropharyngeal squamous cell carcinoma (OPSCC) is the most common neoplasm originating at the base of the tongue or in the tonsils or soft palate. In this study, we investigated the prognostic value of FOXP3+ regulatory T cells in OPSCC. Tumor tissues of patients with locally advanced OPSCC were analyzed using quantitative multiplex immunohistochemistry. Staining of CD8+ T cells, conventional CD4+FOXP3- T cells (Tconv cells), CD4+FOXP3+ regulatory T cells (Treg cells), CD20+ B cells, and CD68+ macrophages was performed, and cell density was evaluated in both the tumor and its stroma. Among the 71 patients included in this study, males constituted 93.0% of the cohort, and the median age was 59 years (range: 42-80 years). A total of 56 patients (78.9%) had a smoking history, and 53 (74.6%) patients were positive for human papillomavirus (HPV). The most frequent site of OPSCC was the tonsils (70.4%), followed by the base of the tongue (25.4%). The proportion of Treg cells was lower in the tumors of patients with HPV than in those of patients without HPV. Patients with OPSCC whose tumor Treg cell levels were above the median had longer relapse-free survival (RFS) periods than those with tumor Treg cell levels below the median (HR, 0.12; 95% CI, 0.03-0.46; p = 0.02). Our multivariate analysis identified high Treg levels (HR, 0.13; 95% CI, 0.02-1.00; p = 0.05) as an RFS factor that predicted a good prognosis. Our results demonstrated that high Treg cell density in locally advanced OPSCC tumors was correlated with longer RFS.