Research Paper|Volume 13, Issue 4|pp 5674—5685

High expression of heme oxygenase-1 in tumor-associated macrophages characterizes a poor-prognosis subtype in nasopharyngeal carcinoma

Jianfeng Huang¹, Binbin Wan², Sha Li³, Gang Liu², Qingfeng Pang², Jia Wu¹, Erwen Bao¹, Changling Sun⁴, Yan Qin⁵, Kewei Wang⁶, Fei Yang⁷, Yaxian Wu², Fuzheng Zhang¹, Bo Yang¹

¹Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
²Department of Physiopathology, Wuxi Medical School of Jiangnan University, Wuxi 214122, Jiangsu Province, China
³Department of Anesthesiology, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu Province, China
⁴Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
⁵Department of Pathology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
⁶Department of Epidemiology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu Province, China
⁷Department of Radiation Oncology, University of Miami, Miami, FL 33136, USA

* Equal contribution

Received: June 2, 2020Accepted: August 20, 2020Published: February 11, 2021

https://doi.org/10.18632/aging.202492

Copyright: © 2021 Huang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Tumor-associated macrophages (TAMs) are important components of the tumor microenvironment, which are characterized by pro-tumor M2 phenotype and correlate with poor survival of nasopharyngeal carcinoma (NPC). Heme oxygenase-1 (HO-1) plays a crucial role in macrophage polarization toward M2 phenotype, but its prognosis significance in NPC has been rarely determined. To gain insights into the HO-1 expression profile and to determine the clinical significance of HO-1 in NPC, we performed immunohistochemistry analyses in 126 NPC specimens. CD163, a highly specific marker of M2 macrophages, was used as a surrogate for the polarization state of TAMs. Our results showed that high expression of HO-1 and CD163 were detected in TAMs for 57.9% (73/126) and 61.9% (78/126) of the studied patients, and both of them were significantly associated with worse survival. Additionally, a significant correlation between the intensities of HO-1 and CD163 was identified, and HO-1 exhibited a superior ability in predicting survival compared with CD163. Our study revealed for the first time that overexpression of HO-1 characterized a poor-prognosis subtype in NPC. Individualized therapy targeting HO-1 might serve as a promising treatment modality for NPC.