Therapy with immune checkpoint blockade became a first-line-therapy in relapsing head and neck squamous cell carcinoma (HNSCC) [1]. Neutrophils are a potential target in immunotherapy. For CD68 positive Macrophages expressing Factor 10 (FX) a prognostic role in tumorbiology is discussed [2]. For these reasons we aimed at better describing the tumour microenvironment (TME) with a focus on neutrophilic infiltration in the framework of either active acute or chronic inflammation and the prognostic role of macrophages in HPSCC (hypopharyngeal SCC) patients.

In a retrospective analysis 32 HPSCC patients were included. Severity of chronic inflammation was scored depending on the accumulation of cells and lymph follicles. Acute inflammation was scored depending on the density of neutrophil granulocyte infiltration. We analysed the number of cells, which were double positive for CD68 and Factor 10 (FX).

The primary tumour samples showed in 90% an active inflammation and 83% in relapsing tumours. Patients who developed a relapse or a distant metastasis had in 67% a score of ≥5 cells / mm² double positive for FX_CD68.

We found evidence that HPSCC are immunogenic cancers with a strong accumulation of inflammatory cells at first diagnosis. Furthermore, an increased infiltration with CD68 positive macrophages is more often found in patients with relapse. These patterns deserve further study as prognostic markers to different treatment modalities.

1)Parmar K et al. Immunotherapy in head and neck squamous cell carcinoma: An updated review. Cancer Treat Res Commun. 2022;33:100649.

2)Zhang Y et al. Coagulation Factor X Regulated by CASC2c Recruited Macrophages and Induced M2 Polarization in Glioblastoma Multiforme. Front Immunol. 2018 Jul 6;9:1557.

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