Tumor CTLA-4 overexpression predicts poor survival in patients with nasopharyngeal carcinoma

// Pei-Yu Huang 1, 2, * , Shan-Shan Guo 1, 2, * , Yu Zhang 1, 3, * , Jia-Bin Lu 1, 3 , Qiu-Yan Chen 1, 2 , Lin-Quan Tang 1, 2 , Lu Zhang 1, 2 , Li-Ting Liu 1, 2 , Li Zhang 1, 4 , Hai-Qiang Mai 1, 2 1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China 2 Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China 3 Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, China 4 Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China * These authors contributed equally to this work Correspondence to: Li Zhang, e-mail: zhangli@sysucc.org.cn Hai-Qiang Mai, e-mail: maihq@sysucc.org.cn Keywords: CTLA-4, CD28, nasopharyngeal carcinoma, immunohistochemistry, prognostic factor Received: July 05, 2015 Accepted: January 26, 2016 Published: February 16, 2016 ABSTRACT The expression levels of CTLA-4 and CD28 were analyzed in 191 nasopharyngeal carcinoma (NPC) patients diagnosed and treated at our hospital between January 2010 and November 2011. The 3-year overall survival (OS) rate (91.4% vs. 81.2%, p = 0.043), failure-free survival (FFS) rate (82.8% vs. 68.0%, p = 0.009) and distant failure-free survival (D-FFS) rate (85.8% vs. 72.3%, p = 0.006) in the low tumor CTLA-4 expression group was higher than in the high tumor CTLA-4 group. There were no differences between the locoregional failure-free survival (LR-FFS) rates in the high and low tumor CTLA-4 expression groups. Moreover, no differences in the OS, FFS, D-FFS, or LR-FFS were observed between the groups with high and low lymphocyte CTLA-4 levels, high and low tumor CD28 levels, or high and low lymphocyte CD28 levels. Cox regression analysis confirmed the prognostic value of tumor CTLA-4 expression, particularly for D-FFS, in NPC patients ( p = 0.044). NPC patients with high tumor CTLA-4 expression had a poorer prognosis than those with low expression.