The Prognostic Value of Sex-Determining Region Y-Box 2 and CD8+Tumor-Infiltrating Lymphocytes in Limited-Stage Small-Cell Lung Cancer
- Authors
- Lee, Jinsoo; Jung, Yoon Yang; Lee, Jung Hoon; Hong, Mineui; Hwang, Hye-Won; Hong, Soon Auck; Hong, Sook-Hee
- Issue Date
- Jul-2021
- Publisher
- KARGER
- Keywords
- Sex-determining region Y-box 2; CD8+tumor-infiltrating lymphocyte; Small-cell lung cancer
- Citation
- ONCOLOGY, v.99, no.8, pp 528 - 538
- Pages
- 11
- Journal Title
- ONCOLOGY
- Volume
- 99
- Number
- 8
- Start Page
- 528
- End Page
- 538
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/62345
- DOI
- 10.1159/000516444
- ISSN
- 0030-2414
1423-0232
- Abstract
- Background: Sex-determining region Y-box 2 (SOX2) is a transcriptional factor that drives embryonic stem cells to neuroendocrine cells in lung development and is highly expressed in small-cell lung cancer (SCLC). However, the prognostic role of SOX2 and its relationship with tumor-infiltrating lymphocytes (TILs) has not been determined in SCLC. Herein, we assessed the expression of SOX2 and CD8+ TILs to obtain insights into the prognostic role of SOX2 and CD8+ TILs in limited-stage (LS)-SCLC. Methods: A total of 75 patients with LS-SCLC was enrolled. The SOX2 expression and CD8+ TILs were evaluated by immunohistochemistry. Results: High SOX2 and CD8+ TIL levels were identified in 52 (69.3%) and 40 (53.3%) patients, respectively. High SOX2 expression was correlated with increased density of CD8+ TILs (p = 0.041). Unlike SOX2, high CD8+ TIL numbers were associated with significantly longer progression-free survival (PFS; 13.9 vs. 8.0 months, p = 0.014). Patients with both high SOX2 expression and CD8+ TIL numbers (n = 29, 38.7%) had significantly longer PFS and overall survival (OS) compared to those from the other groups (median PFS 19.3 vs. 8.4 months; p = 0.002 and median OS 35.7 vs. 17.4 months; p = 0.004, respectively). Multivariate Cox regression analysis showed that the combination of high SOX2 expression and CD8+ TIL levels was an independent good prognostic factor for OS (HR = 0.471, 95% CI, 0.250-0.887, p = 0.02) and PFS (HR = 0.447, 95% CI, 0.250-0.801, p = 0.007) in SCLC. Conclusions: Evaluation of the combination of SOX2 and CD8+ TIL levels may be of a prognostic value in LS-SCLC.
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