Predictive Value Of Different Assessment Methods Of Tumor Infiltrating Lymphocytes In Patients With Laryngeal Squamous Cell Carcinoma

Objective: More and more studies have shown that the type,density and location of tumor infiltrating lymphocytes(TILs)in tumors have prognostic value,and different evaluation methods of TILs have been developed.This study aims to evaluate the prognostic value of two TILs evaluation methods in Laryngeal squamous cell carcinoma(LSCC)patients,one is TILs evaluation method for solid tumor proposed by International Immuno-Oncology Biomarker Working Group(IBWG)and the other is Immunoscore proposed by Galon et al.Compare the predictive power of the two methods for LSCC patients,and establish a prognostic nomogram for LSCC patients.Methods: The clinicopathological data of 76 patients with laryngeal squamous cell carcinoma were retrospectively collected,and two methods based on hematoxylin and eosin(HE)and immunohistochemistry(IHC)staining were used to evaluate them.Univariate analysis and multivariate analysis were used to determine the risk factors related to OS and DFS.Receiver operating characteristic(ROC)curve was used to evaluate the indicators’ prediction performance,and R software was used to construct a nomogram model for predicting the prognosis of LSCC patients.Results: Stromal TILs(s TILs)are significantly related to differentiation,and the correlation is statistically significant.Tumor core CD8(CD8-CT),cancer nest CD8(CD8-NEST)and stromal CD8(CD8-STROMA)are negatively correlated with tumor T staging.The density of CD3 in each area of the tumor and CD8-STROMA negatively correlated with differentiation.The densities of CD3 and CD8 in all regions are correlated with s TILs.Univariate analysis showed that the patient’s age,T stage,N stage,differentiation,location,s TILs,CD3-CT,CD3-NEST,CD3-STROMA,CD8-CT,CD8-NEST and CD8-STROMA were related to the patient’s OS.The patient’s age,T stage,differentiation,s TILs,CD3-NEST,CD3-STROMA,CD8-NEST and CD8-STROMA were related to the patient’s DFS,and the correlation was statistically significant.Therefore,the Immunoscore scoring method established by Zhang et al.in head and neck squamous cell carcinoma(HNSCC)was selected.Immunoscore is significantly correlated with the density of stromal TILs(s TILs)(p<0.001,spearman’s rho=0.538).Univariate analysis and multivariate analysis show that Immunoscore and s TILs are both significantly correlated with OS and DFS.The two indicators ROC The area under the curve(AUC)was 0.896(95%CI:0.805-0.954)and 0.789(95%CI:0.68-0.874),respectively,and the difference was not statistically significant.Finally,based on the results of Immunoscore’s multivariate Cox regression analysis,a prognostic nomogram for OS in LSCC patients was established.Conclusion: Immunoscore and s TILs can be used as independent predictors of the prognosis of LSCC patients.By combining Immunoscore and clinicopathological characteristics,the nomogram obtained provides a more accurate prediction tool for LSCC patients.