Correlation of cancer stem cell markers and immune cell markers in resected non-small cell lung cancer

Background: Recent studies confirmed that immunotherapy showed prominent efficacy in non-small cell lung cancer (NSCLC).Cancer stem cells/cancer initiating cells are resistant to anticancer treatment.The purpose of the study was to analyze the correlation of cancer stem cells/cancer initiating cells and tumor-infiltrating immune cells in NSCLC.Methods: CD133, octamer 4 (OCT-4), CD8, CD56, human leukocyte antigen (HLA) class I and programmed death ligand-1 (PD-L1) were assessed in 172 resected NSCLC samples.The staining was analyzed and scored by the pathologist who was blinded to the clinical pathological data of the patients.Results: High CD8+ T cell infiltration was correlated significantly with squamous cell carcinoma histology (p=0.008).High PD-L1 expression (≥10%) was associated with high tumor status (p=0.043).Pearson's correlation test showed that CD56+ cells were negatively correlated with CD133 expression (r=-0.361,p<0.001) and weakly correlated with negative OCT-4 expression (r=-0.180,p=0.018).There was a strong positive correlation between CD8 and HLA class I (r=0.573,p<0.001).In the survival analysis, high CD8+ T cell infiltration is an independent predictor of improved disease-free survival and overall survival.Patients with low CD133 expression and high CD56 expression had a longer overall survival than those with high CD133 expression and/or low CD56 expression (p=0.013).Conclusion: There is a negative correlation between CD56+ cells and cancer stem cell markers.This correlation may confirm the possibility that natural killer cells can target CD133+ cancer stem cells/cancer initiating cells in non-small cell lung cancer.