Cytotoxic T lymphocyte antigen-4 expression in esophageal carcinoma: implications for prognosis
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Xiao-Fei Zhang1,2, Ke Pan1,2, De-Sheng Weng1,2, Chang-Long Chen1,2, Qi-Jing Wang2, Jing-Jing Zhao1,2, Qiu-Zhong Pan1,2, Qing Liu2, Shan-Shan Jiang1,2, Yong-Qiang Li2, Hong-Xia Zhang1,2, Jian-Chuan Xia1,2
1State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, People’s Republic of China
2Department of Biotherapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, People’s Republic of China
Jian-Chuan Xia, e-mail: firstname.lastname@example.org
Keywords: esophageal carcinoma, overall survival, cytotoxic T lymphocyte antigen-4
Received: November 23, 2015 Accepted: March 02, 2016 Published: March 30, 2016
To examine the relationship between cytotoxic T lymphocyte antigen-4 (CTLA-4) expression and esophageal carcinoma prognosis, CTLA-4 expression was immunohistochemically detected in paraffin-embedded primary tumor specimens from 158 patients with esophageal cancer. CTLA-4 was detected in the cytoplasm and cell membranes of esophageal cancer cells and in interstitial lymphocytes. In univariate analyses (log-rank), higher interstitial CTLA-4+ lymphocyte density and higher tumor CTLA-4 expression were associated with shorter overall survival (OS). After controlling for age and clinical stage, multivariate analysis (Cox) found that tumor CTLA-4 expression was an independent predictor of shorter OS (HR 2.016, P = 0.004). These results indicate that CTLA-4 expression in the tumor environment (both lymphocytes and tumor cells) is associated with poorer prognosis. In addition, CTLA-4 profiles may be useful for predicting the benefits and toxicity of CTLA-4 blockade in patients with esophageal carcinoma.
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