CD3 LEVELS IN TUMOR INFILTRATING LYMPHOCYTES ACROSS ORAL SQUAMOUS CELL CARCINOMA STAGES IN TERTIARY CARE HOSPITALS.
Main Article Content
Keywords
Oral squamous cell carcinoma, CD3-positive T-cells, tumor-infiltrating lymphocytes, tobacco, immunohistochemistry, tumor progression, biomarker.
Abstract
Background: Oral squamous cell carcinoma (OSCC) is the most common malignancy affecting the oral cavity, contributing significantly to cancer-related morbidity and mortality, especially in regions with high tobacco consumption. Tumor-infiltrating lymphocytes (TILs), particularly CD3-positive (CD3+) T-cells, play a critical role in the body’s immune response to cancer. However, the relationship between CD3+ T-cells and OSCC progression remains poorly understood.
Objective: This study aimed to assess the levels of CD3+ T-cells in TILs across different stages of OSCC and explore their association with tumor progression.
Methods: A retrospective cohort study was conducted on 200 patients diagnosed with OSCC at Dentistry Department, Ayub Medical College Abbottabad, Pakistan from January 1, 2023, to December 31, 2023. CD3 levels were evaluated using immunohistochemistry in TILs, with patients stratified based on tumor stage. Baseline characteristics such as age, gender, and tobacco use were recorded. Statistical analysis was performed using ANOVA and chi-square tests for categorical variables, while multivariate logistic regression was employed to identify significant predictors of CD3 expression.
Results: CD3 expression progressively increased with advancing OSCC stages. In Stage I, 25 patients (41.7%) had low CD3 expression, while 5 patients (8.3%) exhibited high expression. In Stage IV, only 10 patients (10.8%) had low CD3 expression, with 32 patients (34.9%) showing high expression. Tobacco use was significantly associated with higher CD3 levels (p=0.01). Multivariate analysis identified tumor stage and tobacco use as significant predictors of elevated CD3 expression (OR 2.3, 95% CI 1.3-4.0, p=0.01).
Conclusion: The study demonstrates that CD3+ T-cell levels increase with OSCC progression, particularly in tobacco users. These findings suggest that CD3 expression could serve as a potential biomarker for OSCC prognosis, supporting the integration of immunotherapy in advanced-stage OSCC management.
References
2. Ragin CC, Modugno F, Gollin SM. The epidemiology and risk factors of head and neck cancer: a focus on human papillomavirus. J Dent Res. 2007;86(2):104-14.
3. Fridman WH, Pagès F, Sautès-Fridman C, Galon J. The immune contexture in human tumours: impact on clinical outcome. Nat Rev Cancer. 2012;12(4):298-306.
4. Yu P, Fu YX. Tumor-infiltrating T lymphocytes: friends or foes? Lab Invest. 2006;86(3):231-45.
5. Daroqui MC, Frey AB. Tumor-induced dysfunction in CD4+ T cells. Semin Cancer Biol. 2013;23(6):306-13.
6. Ostrand-Rosenberg S, Sinha P. Myeloid-derived suppressor cells: linking inflammation and cancer. J Immunol. 2009;182(8):4499-506.
7. Warnakulasuriya, S. (2009). Global epidemiology of oral and oropharyngeal cancer. Oral Oncology, 45(4-5), 309-316. https://doi.org/10.1016/j.oraloncology.2008.06.002
8. Pagès F, Mlecnik B, Marliot F, Bindea G, Ou FS, Bifulco C, Lugli A, Zlobec I, Tosolini M, Rafii A. International validation of the consensus Immunoscore for the classification of colon cancer: a prognostic and accuracy study. Lancet. 2018;391(10135):2128-39. doi: 10.1016/S0140-6736(18)30789-X.
9. Galon J, Mlecnik B, Bindea G, Angell HK, Berger A, Lagorce C, Lugli A, Zlobec I, Hartmann A, Bifulco C. Towards the introduction of the ‘Immunoscore’ in the classification of malignant tumors. J Pathol. 2014;232(2):199-209. doi: 10.1002/path.4287.
10. Bruni D, Angell HK, Galon J. The immune contexture and Immunoscore in cancer prognosis and therapeutic efficacy. Nat Rev Cancer. 2020;20(11):662-80. doi: 10.1038/s41568-020-0285-7.
11. Rivera C. Essentials of oral cancer. Int J Clin Oncol. 2020;25(1):1-7. doi: 10.1007/s10147-019-01561-9.
12. Marur S, Forastiere AA. Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment. Mayo Clin Proc. 2016;91(3):386-96. doi: 10.1016/j.mayocp.2015.12.017.
13. Gajewski TF, Schreiber H, Fu YX. Innate and adaptive immune cells in the tumor microenvironment. Nat Immunol. 2013;14(10):1014-22. doi: 10.1038/ni.2703.
14. Ferris RL, Blumenschein G Jr, Fayette J, Guigay J, Colevas AD, Licitra L, Harrington K, Kasper S, Vokes EE, Even C. Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med. 2016;375(19):1856-67. doi: 10.1056/NEJMoa1602252
15. Dunn GP, Bruce AT, Ikeda H, Old LJ, Schreiber RD. Cancer immunoediting: from immuno surveillance to tumor escape. Nat Immunol. 2002;3(11):991-8. doi: 10.1038/ni1102-991.
16. Brahmer JR, Tykodi SS, Chow LQ, Hwu WJ, Topalian SL, Hwu P, Drake CG, Camacho LH, Kauh J, Odunsi K. Safety and activity of anti–PD-L1 antibody in patients with advanced cancer. N Engl J Med. 2012;366(26):2455-65. doi: 10.1056/NEJMoa1200694.
17. Sobin LH, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. Wiley-Liss; 2011.
18. Mellman I, Coukos G, Dranoff G. Cancer immunotherapy comes of age. Nature. 2011;480(7378):480-9. doi: 10.1038/nature10673.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Nadia Munir
Assistant Professor, Dentistry Department, Ayub Medical College Abbottabad, Pakistan
Dr Ayesha Bibi
Assistant Professor, Dentistry Department, Ayub Medical College Abbottabad, Pakistan
Dr Muhammad Afham Shahid
Senior Registrar Oncology, Department of Medicine, Al-Aleem Medical College, Gulab Devi Hospital Lahore
Dr Asfand Khan
Senior Lecturer Oral pathology, Abbottabad International Medical Institute, Abbottabad
Dr Mehreen Malik
Senior Lecturer Oral pathology, Abbottabad International Medical Institute, Abbottabad
Dr Malik Arshman Khan
Associate Professor, Department of Oral Biology, Abbottabad International Dental College, Abbottabad.