Background In head and neck squamous cell carcinoma (HNSCC), risk stratification and planning of therapy are until today almost entirely based on clinical parameters. Despite recent advances in the identification of immunactive and immunomodulatory cells in HNSCC, there is a lack of knowledge in exact mechanisms and impact on the course of the disease.
Material and methods We performed immunohistochemical analysis of tissue samples of 252 patients with HNSCC diagnosed between 2000 and 2017. Therefore, we analyzed tissue microarrays (TMAs) both from center and invasion front of primary tumor as well as metastases on a variety of immunologic markers (PD1, PDL1, CD4, CD8, IDO). Results were correlated with clinical data.
Results Immunohistochemical tests and analysis of factors of heterogeneity showed significant differences in immunoactive markers, also between center and invasion front of the carcinomas, and therefore a distict heterogeneity in HNSCC. This was shown in primary tumor as well as in local lymph node metastases. In Patients with local lymph node metastases we observed a higher heterogeneity of PDL1 in primary tumor as patients without metastases.
Conclusion Head and neck squamous cell carcinomas are showing a distinct heterogeneity of immunoactive cells. The factor of heterogeneity may be a possible marker for individual risk stratification and individual therapy in future treatment of HNSCC.
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