The role of CD28 in the prognosis of young lung adenocarcinoma patients
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RESEARCH ARTICLE
Open Access
The role of CD28 in the prognosis of young lung adenocarcinoma patients Dantong Sun1, Lu Tian2, Tiantian Bian3, Han Zhao4, Junyan Tao1, Lizong Feng5, Qiaoling Liu6 and Helei Hou1*
Abstract Background: The prognosis of lung cancer was found to be associated with a series of biomarkers related to the tumor immune microenvironment (TIME), which can modulate the biological behaviors and consequent outcomes of lung cancer. Therefore, establishing a prognostic model based on the TIME for lung cancer patients, especially young patients with lung adenocarcinoma (LUAD), is urgently needed. Methods: In all, 809 lung cancer patients from the TCGA database and 71 young patients with LUAD in our center were involved in this study. Univariate and multivariate analysis based on clinical characteristics and TIME-related expression patterns (as evaluated by IHC) were performed to estimate prognosis and were verified by prognostic nomograms. Results: Both LUAD and lung cancer patients with high CD28 expression had shorter disease-free survival (DFS) (P = 0.0011; P = 0.0001) but longer overall survival (OS) (P = 0.0001; P = 0.0282). TIME-related molecules combined with clinical information and genomic signatures could predict the prognosis of young patients with LUAD with robust efficiency and could be verified by the established nomogram based on the Cox regression model. In addition, CD28 expression was correlated with an abundance of lymphocytes and could modulate the TIME. Higher CD28 levels were observed in primary tumors than in metastatic tissues. Conclusion: TIME-related molecules were identified as compelling biomarkers for predicting the prognosis of lung cancer, especially in a cohort of young patients. Furthermore, CD28, which is associated with poor DFS but long OS, might participate in the modulation of the TIME and has a different role in the prognosis of young patients with LUAD. Keywords: Nomogram, CD28, Prognosis, Lung cancer, Young patients
Background Among all malignancies in the past decade in China, lung cancer has ranked first in morbidity with a 5-year overall survival (OS) rate of 19.8%, which is lower than the global average [1]. Non-small-cell lung cancer (NSCLC) accounts for almost 85% of lung cancer patients [2] and shows a trend suggesting that more young patients (aged less than 45 years) are suffering from this disease, especially lung adenocarcinoma (LUAD) [3]. * Correspondence: [email protected] 1 Precision Medicine Center of Oncology, the Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong, China Full list of author information is available at the end of the article
LUAD is a disease with a high degree of malignancy that results in invasion and metastasis; this contributes to the poor prognosis of patients. Recent studies have provided evidence that young patients with LUAD present unique biological and genomic characteristics [4, 5], which revealed the necessity of establishing a model for predicting the prognosis of young patie
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