Prognostic Role of Monocytic Myeloid-Derived Suppressor Cells in Advanced Non-Small-Cell Lung Cancer: Relation to Different Hematologic Indices

Abstract

Background and Aim. Myeloid-derived suppressor cells (MDSCs) contribute to the process of malignant transformation and tumor progression through immuno- and nonimmunosuppressive mechanisms. The current study is aimed at providing the predictive and prognostic role of Mo-MDSCs in advanced non-small-cell lung cancer (NSCLC) in relation to different hematologic indices. Methods. We recruited 40 cases of advanced NSCLC, stages III and IV, aged > 18 – < 70 years old, and eligible to receive chemotherapy with or without radiotherapy, along with 20 healthy controls of comparable age and sex; after diagnosis and staging of patients, blood samples were collected for flow cytometric detection of Mo-MDSCs. Results. Significant accumulation of Mo-MDSCs in patients compared to their controls ( p < 0.0001 ). Furthermore, these cells accumulated significantly in stage IV compared to stage III ( p = 0.006 ) and correlated negatively with overall survival ( r = − 0.471 , p = 0.002 ), lymphocyte to monocyte ratio ( r = − 0.446 , p = 0.004 ), and mean platelet volume to platelet count ratio (MPV/PC) ( r = − 0.464 , p = 0.003 ), patients with Mo ‐ MDSCs < 13 % had significantly better survival than those with Mo ‐ MDSCs ≥ 13 % ( p = 0.041 ). Conclusion. Mo-MDSCs represent one of the key mechanisms in the immunosuppressive tumor microenvironment (TME) to play major roles not only in the carcinogenesis of lung cancer but also in disease progression and prognosis and, in addition, predict the efficacy of immune checkpoint inhibitors; our results provided some support to target Mo-MDSCs and needed to be augmented by further studies.

The prognostic effects of circulating myeloid-derived suppressor cells in non-small cell lung cancer: systematic review and meta-analysis

“…Among these articles, we further excluded 7 of them because met the above-described exclusion criteria. We obtained 14 eligible articles for qualitative and quantitative analysis [29][30][31][32][33][34][35][36][37][38][39][40][41][42]. The selection PRISMA diagram is depicted in Fig.…”

Hematologic dysfunction in cancer: Mechanisms, effects on antitumor immunity, and roles in disease progression

“…Myeloid biased hematopoiesis is a major feature of hematopoietic dysfunction in cancer. It produces heterogeneous populations of monocytes and neutrophils with immunosuppressive properties, and the abundance of such cells is a prognostic marker of poor outcomes in cancer patients ( 30 , 31 ). The term myeloid-derived suppressor cells (MDSCs) has been widely used for such cells, despite their significant heterogeneity in surface markers, morphology, gene expression, and life-span ( 32 ).…”

Mean platelet volume/platelet count ratio in combination with tumor markers in colorectal cancer: a retrospective clinical study

“…Therefore, we guessed that the combination of MPV/PC with tumor markers may act as a prognosis prediction index. In advanced non-small-cell lung cancer, a low MPV/PC ratio may be correlated with increased monocytic myeloid-derived suppressor cells which represent one of the key mechanisms in immunosuppressive tumor microenvironments to play major roles not only in the carcinogenesis of lung cancer but also in disease progression and prognosis and, in addition, predict the efficacy of immune checkpoint inhibitors [34]. Tumor mismatch repair defect in CRC may lead to high tumor mutation burden and more tumor neoantigens are produced, thus influencing the tumor microenvironment to infiltrate more T cells required for antitumor immune activation, and therefore, potentially achieving better immunotherapeutic efficacy [35].…”