Clinicopathological Characterization of Squamous Cell Lung Carcinoma Adjacent to Emphysema

ABSTRACT The study investigated the clinicopathological features and characteristic immune tumor microenvironment (TME) of lung squamous cell carcinoma (SqCC) adjacent to emphysematous lesions. 184 consecutive patients with peripheral‐type SqCC who had undergone complete surgical resection were enrolled. The clinicopathological differences between emphysema‐adjacent SqCC (EA‐SqCC) and non‐emphysema‐adjacent SqCC (non‐EA‐SqCC) were examined. The immune TME, including tumor‐infiltrating lymphocytes (TILs) and PD‐L1 expression, was also analyzed. EA‐SqCC was detected in 132 (71.7%) of the 184 patients. Patients with EA‐SqCC had shorter recurrence‐free survival (RFS) [median 58.2 months vs. not Reached (NR); hazard ratio (HR) 0.47; 95% CI 0.25–0.81, p < 0.01] and tended to have shorter overall survival (NR vs. NR; HR 0.47; 95% CI 0.27–1.03, p = 0.07) compared to patients with non‐EA‐SqCC. Evaluation of TILs in the cancer stroma showed the number of Foxp3+ TILs in the EA‐SqCC group was significantly higher than that in the non‐EA‐SqCC group (median number 58 vs. 43, p < 0.01). However, there were no significant differences in the number of CD8 + T cells and the PD‐L1 expression between the two groups. Immunosuppressive microenvironment is a characteristic feature of EA‐SqCC, which may contribute to the poor prognosis of this disease.