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Cancer Immunol Immunother. 2017 Nov;66(11):1449-1461. doi: 10.1007/s00262-017-2039-2. Epub 2017 Jul 13.

CTLA-4 expression in the non-small cell lung cancer patient tumor microenvironment: diverging prognostic impact in primary tumors and lymph node metastases.

Author information

1
Department of Oncology, University Hospital of North Norway, Mailbox 13, 9038, Tromso, Norway. epa014@post.uit.no.
2
Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway. epa014@post.uit.no.
3
Translational Cancer Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9038, Tromso, Norway. epa014@post.uit.no.
4
Department of Oncology, University Hospital of North Norway, Mailbox 13, 9038, Tromso, Norway.
5
Department of Clinical Medicine, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway.
6
Department of Medical Biology, UiT The Arctic University of Norway, Mailbox 6050, Langnes, 9037, Tromso, Norway.
7
Department of Clinical Pathology, University Hospital of North Norway, Mailbox 46, 9038, Tromso, Norway.

Abstract

The immune checkpoint receptor CTLA-4 plays a crucial part in negatively regulating T cell activation and maintaining self-tolerance. It is frequently overexpressed in a variety of malignancies, yet its prognostic impact in non-small cell lung cancer (NSCLC) remains unclear. We constructed tissue microarrays from tumor tissue samples and evaluated the immunohistochemical expression of CTLA-4 in 536 patients with primary resected stage I-IIIA NSCLC. Expression of CTLA-4 was analyzed in tumor and stromal primary tumor tissue and in locoregional metastatic lymph nodes. CTLA-4 expression in neither tumor epithelial cells (T-CTLA-4) nor stromal cells (S-CTLA-4) of primary tumors was significantly associated with disease-specific survival (DSS) in all patients. However, high S-CTLA-4 expression independently predicted significantly improved DSS in the squamous cell carcinoma subgroup (HR 0.62, 95% CI 0.41-0.93, P = 0.021). In contrast, there was an independent negative prognostic impact of T-CTLA-4 expression in metastatic lymph nodes (HR 1.65, 95% CI 1.03-2.65, P = 0.039). Our results indicate that the expression of CTLA-4 has diverging prognostic impacts in metastatic NSCLC lymph nodes versus primary tumors. The presented results highlight important differences in the tumor microenvironments of primary and metastatic NSCLC tissues, and have potential to guide treatment and clinical sampling strategies.

KEYWORDS:

CTLA-4; Immune checkpoints; Immunoscore; Non-small cell lung cancer; Prognostic

PMID:
28707078
PMCID:
PMC5645427
DOI:
10.1007/s00262-017-2039-2
[Indexed for MEDLINE]
Free PMC Article

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