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Multicenter Study
. 2025 Jan 7:15:1517968.
doi: 10.3389/fimmu.2024.1517968. eCollection 2024.

Prognostic value of immunosuppression scores in patients with esophageal squamous cell carcinoma: a multicenter study

Shao-Jun Xu #  1   2   3 , Yun-Fan Luo #  1   2   3 , Jin Huang #  1   2   3 , Jia-Hua Tu  4 , Chao Chen  1   2   3 , Yan-Ming Shen  1   2   3 , Zhao-Min Sun  1   2   3 , Shu-Chen Chen  1   2   3
Affiliations
Multicenter Study

Prognostic value of immunosuppression scores in patients with esophageal squamous cell carcinoma: a multicenter study

Shao-Jun Xu et al. Front Immunol. .

Abstract

Introduction: The prognostic impact of human leukocyte antigen-E (HLA-E) expression and the proportion of natural killer (NK) cells in esophageal squamous cell carcinoma (ESCC) was investigated.

Methods: This study retrospectively evaluated 397 ESCC patients across two centers. The cumulative incidence of recurrence (CIR) and the incidence of tumor-related death (CID) were analyzed in various groups. An immunosuppression score (ISS) was developed based on HLA-E expression and NK cell proportion. Differences between groups were adjusted using inverse probability treatment weighting (IPTW). The factors influencing cancer-specific survival (CSS) and recurrence-free survival (RFS) were also examined.

Results: Patients with low HLA-E expression had significantly higher five-year CIR and CID compared to those with high expression (CIR: 20.7% vs. 45.1%, CID: 19.3% vs. 40.1%; p< 0.001). Similarly, NK cell-positive patients had significantly better five-year CIR and CID than NK cell-negative patients (CIR: 16.3% vs. 59.6%, CID: 13.9% vs. 53.7%; p < 0.001). The Sankey diagram indicated that the low ISS group had a lower recurrence and tumor-related mortality rate (p < 0.05). After IPTW adjustment, the low ISS group showed improved five-year RFS (80.1% vs. 35.4%, p < 0.001) and five-year CSS (82.3% vs. 42.5%, p < 0.001) compared to the high ISS group.

Conclusions: ESCC with different ISS statuses represents two distinct biological subtypes, underscoring the need for personalized treatment strategies tailored to varying tumor behaviors.

Keywords: esophageal squamous cell carcinoma (ESCC); human leukocyte antigen-E (HLA-E); inverse probability treatment weighting (IPTW); natural killer (NK) cells; prognosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Expression of human leukocyte antigen E [low expression (A); high expression (B)] and NK cells(the NK cells exhibit CD3 negative and CD56 positive staining (C), whereas CD56 negative and CD3 positive (D) or CD56 positive and CD3 positive (E) are not associated with NK cells) in ESCC [positive (F) negative (G)].
Figure 2
Figure 2
The CIR and CID of different HLA-E (A, B) and NK cell expressions (C, D) in ESCC patients.
Figure 3
Figure 3
Sankey diagrams shows recurrence and tumor-related death with different ISS.
Figure 4
Figure 4
The difference between the low-ISS and high-ISS of influencing factors before matching and after IPTW.
Figure 5
Figure 5
Kaplan-Meier curves analyzed the RFS and CSS of low and high ISS before matching [RFS (A); CSS (B)] and after IPTW [RFS (C); CSS (D)].
See this image and copyright information in PMC

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. (2021) 71(3):209–49. doi: 10.3322/caac.21660 - DOI - PubMed
    1. Rustgi AK, El-Serag HB. Esophageal carcinoma. N Engl J Med. (2014) 371:2499–509. doi: 10.1056/NEJMra1314530 - DOI - PubMed
    1. Kudo T, Hamamoto Y, Kato K, Ura T, Kojima T, Tsushima T, et al. Nivolumab treatment for oesophageal squamous-cell carcinoma: an open-label, multicentre, phase 2 trial. Lancet Oncol. (2017) 18(5):631–9. doi: 10.1016/S1470-2045(17)30181-X - DOI - PubMed
    1. Xu J, Kato K, Raymond E, Hubner RA, Shu Y, Pan Y, et al. Tislelizumab plus chemotherapy versus placebo plus chemotherapy as first-line treatment for advanced or metastatic oesophageal squamous cell carcinoma (RATIONALE-306): a global, randomised, placebo-controlled, phase 3 study. Lancet Oncol. (2023) 24(5):483–95. doi: 10.1016/S1470-2045(23)00108-0 - DOI - PubMed
    1. Sun JM, Shen L, Shah MA, Enzinger P, Adenis A, Doi T, et al. Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): a randomised, placebo-controlled, phase 3 study. Lancet. (2021) 398(10302):759–71. doi: 10.1016/S0140-6736(21)01234-4 - DOI - PubMed

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