Clinical Significance Of CD47 Expression In Non-small Cell Lung Cancer And Association With Tumor Associated Macrophage Infiltration

Objective: The association of CD47 expression with clinical characteristics of NSCLC patients and the correlation with prognosis of NSCLC patients were analyzed by detecting CD47 expression in NSCLC patients.CD47 has the function of regulating immune cells,playing a regulatory role for the immune microenvironment of the body.But the role of CD47 in non-small cell lung cancer tumor microenvironment is still not elaborated,especially there is no related study on the role of CD47 in tumor associated macrophage TAMs in non-small cell lung cancer.Meanwhile this study based on the role relationship between NSCLC and TAMs,and then explored the relationship between CD47 protein expression levels and Tam infiltration in NSCLC tissues.To study the relationship between the expression level of CD47 and the distribution of TAMs in NSCLC,so as to provide a new idea for the comprehensive treatment of NSCLC.Methods: Clinical data of 49 NSCLC patients who were diagnosed by the Department of Pathology,Department of thoracic and cardiac surgery,the First Affiliated Hospital of Jiamusi University,were collected from January 2016 to January 2021,and included age,gender,smoking or not,histological typing,differentiation grade,T stage,N stage,M stage and clinical stage of the patients.Paraffin embedded blocks of cancer tissues from 49 patients with nonsmall cell lung cancer,and 39 adjacent normal lung tissues(≥ 5 cm from the edge of cancer tissues)were collated.Tissue microarrays were prepared from the target samples by specialists in pathology,and CD47 protein expression in non-small cell lung cancer(NSCLC)tissues and adjacent noncancerous tissues was determined by immunohistochemistry(IHC),and statistical analysis was used to evaluate the relationship between CD47 expression levels and clinical characteristics and prognosis.The expression level of cd204,a marker of M2 type macrophages,was evaluated in NSCLC tissue samples by immunohistochemistry.The relationship between Tam infiltration and patient prognosis in NSCLC tissues and the relationship between CD47 expression levels and Tam infiltration in cancer tissues were analyzed.Results: The expression of CD47 protein in non-small cell lung cancer tissues and paraneoplastic tissues was statistically different(P < 0.05),with CD47 protein expression being higher in cancer tissues than in paraneoplastic tissues.CD47 expression levels correlated with the degree of differentiation(P = 0.042),T-stage(P = 0.016),N-stage(P = 0.006)and clinical stage(P = 0.008)of patients.Patients with non-small cell lung cancer with high CD47 expression had relatively short survival(P=0.007).Univariate analysis showed that CD47 expression level,smoking,and distant metastasis were risk factors affecting patient prognosis.In the multifactorial analysis,CD47 expression level and distant metastasis were independent risk factors affecting patients’ prognosis.The degree of TAM infiltration in non-small cell lung cancer tissues was correlated with patient survival(P < 0.01),and the more TAM infiltration,the shorter the patient survival.The expression level of CD47 in cancer tissues showed a linear relationship with the number of M2 type macrophages.Patients with non-small cell lung cancer with high CD47 expression had relatively more TAM infiltration,which was statistically significant(P < 0.01).Conclusions: CD47 is highly expressed in non-small cell lung cancer tissues and is a risk factor for patient prognosis.CD47 positively correlates with tumor associated macrophage infiltration in non-small cell lung cancer.CD47 has the potential to serve as a novel target for non-small cell lung cancer therapy.