Negative Impact of High FOXP3 Status in Lymph Nodes of Esophageal Squamous Cell Carcinoma Patients

Available data on the immune profiles of regional lymph nodes in individuals with esophageal squamous cell carcinoma (ESCC) are limited. This study investigated the immune profiles of proximal regional lymph nodes (PLNs) and evaluated the association between PLNs and the outcomes of patients with ESCC. This study included 39 patients with ESCC who underwent subtotal esophagectomy with three-field lymph node dissection. The immune profiles of tumor-infiltrating lymphocytes and PLNs were evaluated through immunohistochemistry. Furthermore, the impact of this immune profile on long-term outcomes was analyzed. Cox proportional-hazards analysis for overall survival revealed that ypT ≥3 [hazard ratio (HR)=8.91; 95% confidence interval (CI)=1.59-49.8] and high FOXP3 status in PLNs (HR=4.29; 95%CI=1.06-17.4) are significant independent prognostic factors. Meanwhile, analysis of disease-free survival (DFS) revealed that ypT ≥3 (HR=5.52; 95%CI=1.15-26.6) and ypN ≥1 (HR=7.74; 95%CI=1.58-37.9) are independent prognostic factors. Furthermore, high FOXP3 status in PLNs was associated with low DFS rate, although the association was not statistically significant (HR=1.70; 95%CI=0.58-5.02). High FOXP3 status in PLNs is associated with poor prognosis in patients with ESCC.