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. 2019 Aug 14:2019:1601072.
doi: 10.1155/2019/1601072. eCollection 2019.

Prognostic Value of Combined Analysis of CTLA-4 and PLR in Esophageal Squamous Cell Carcinoma (ESCC) Patients

Cui-Ying Zhang  1   2 , Juan Zhang  3 , Yun-Fan Ma  4 , Hong Zhe  1 , Ren Zhao  1 , Yan-Yang Wang  1
Affiliations

Prognostic Value of Combined Analysis of CTLA-4 and PLR in Esophageal Squamous Cell Carcinoma (ESCC) Patients

Cui-Ying Zhang et al. Dis Markers. .

Abstract

Objective: The purpose of this study was to evaluate the prognostic role of the cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) expression level and the platelet lymphocyte ratio (PLR) level in esophageal squamous cell carcinoma (ESCC) patients.

Methods: 84 ESCC patients who received surgical treatment in our hospital were enrolled in the study. The correlation of each biomarker's level with ESCC patients' clinicopathological characteristics and overall survival (OS) was assessed.

Results: The elevated expression rate of T-CTLA-4 (tumor cell CTLA-4) and I-CTLA-4 (interstitial lymphocyte CTLA-4) was 48.8% and 44.0%, respectively. The number of enrolled patients with a higher PLR level (≥119) was 48. The prognostic value of T-CTLA-4, I-CTLA-4, and PLR in ESCC patients was not detected. However, patients with both a low T-CTLA-4 expression level and a low PLR level that had longer OS (p = 0.023) were found. The prognostic role of T-CTLA-4(-) +PLR (-) status in ESCC patients was also confirmed in multivariate analyses (p = 0.027).

Conclusion: These results demonstrated the potential prognostic value of combined analysis of CTLA-4 and PLR in ESCC patients.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Representative immunostaining for T-CTLA-4 and I-CTLA-4. Positive staining for CTLA-4 in tumor cells ((a) 200x magnification; (b) 400x magnification). Positive staining for CTLA-4 in interstitial lymphocytes ((c) 200x magnification; (d) 400x magnification).
Figure 2
Figure 2
ROC curve. The optimal cut-off value of PLR was determined by ROC analysis.
Figure 3
Figure 3
The overall survival curve of ESCC patients with different levels of T-CTLA-4, I-CTLA-4, and PLR. The Kaplan-Meier survival curve for patients with ESCC whose tumors were classified as either higher or lower level for T-CTLA-4, I-CTLA-4, and PLR, respectively. T-CTLA-4 (p = 0.453), I-CTLA-4 (p = 0.654), and PLR (p = 0.703) status did not demonstrate a significant relation with patient survival.
Figure 4
Figure 4
Patients with T-CTLA-4(-) +PLR (-) status had superior overall survival. Effects of different levels of T-CTLA-4 (a), I-CTLA-4 (b), PLR (c), and T-CTLA-4(-) +PLR (-) status (d) on the overall survival of ESCC patients without inflammatory diseases. Patients with T-CTLA-4(-) +PLR (-) status had significantly longer overall survival (p = 0.023).
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