Background:Regulatory T cells (FOXP3+), checkpoint signaling (PD-1), and inhibitory B-cell signaling (CD32B/FCGR2B) may shape recurrence risk after resection of lung adenocarcinoma, but small, stage-heterogeneous cohorts complicate inference.Methods:We profiled 21 resected lung adenocarcinomas by immunohistochemistry (IHC) for CD3, CD8, FOXP3, PD-1, CD19, and CD32B. Five systematically sampled 200× fields per stain were quantified in ImageJ to derive continuous percentages and prespecified ratios: FOXP3/CD8 and CD32B/CD19 (primary), and PD-1/CD8 (exploratory). Analyses emphasized effect sizes with exact non-parametric tests for clinicopathologic associations and Cox time-to-event models for disease-free survival (DFS). Kaplan–Meier plots used median splits for visualization only.Results:Higher immunosuppressive balance associated with adverse features and shorter DFS. Patients with higher FOXP3/CD8 and CD32B/CD19 had markedly shorter DFS on K-M displays (FOXP3/CD8: 18.9 vs. 45.6 months; CD32B/CD19: 25.0 vs. 72.8 months). In Cox models, each ratio was associated with increased hazard of recurrence (FOXP3+PD-1/CD8, HR 2.03, 95% CI 1.26–3.29; CD32B/CD19, HR 1.98, 95% CI 1.16–3.37).Conclusions:In this hypothesis-generating pilot, an immunosuppressive tumor microenvironment, indexed by higher FOXP3 (relative to CD8) and higher CD32B (relative to CD19), portends earlier recurrence after surgery. These results support external validation in larger, stage-balanced cohorts and motivate incorporation of quantitative IHC ratios into postoperative risk stratification.
背景：调节性T细胞（FOXP3+）、检查点信号（PD-1）以及抑制性B细胞信号（CD32B/FCGR2B）可能影响肺腺癌切除术后的复发风险，但现有研究队列规模小且分期混杂，增加了推断难度。方法：我们通过免疫组织化学（IHC）检测了21例切除肺腺癌标本中CD3、CD8、FOXP3、PD-1、CD19和CD32B的表达。每项染色选取5个系统采样的200倍视野，使用ImageJ软件进行定量分析，获得连续百分比及预设比值：FOXP3/CD8与CD32B/CD19（主要指标），以及PD-1/CD8（探索性指标）。分析重点评估效应量，采用精确非参数检验分析临床病理关联，使用Cox事件时间模型分析无病生存期（DFS）。Kaplan–Meier曲线仅按中位数分组进行可视化展示。结果：更高的免疫抑制平衡状态与不良病理特征及较短DFS相关。在K-M曲线中，FOXP3/CD8与CD32B/CD19比值较高的患者DFS显著缩短（FOXP3/CD8：18.9个月 vs. 45.6个月；CD32B/CD19：25.0个月 vs. 72.8个月）。Cox模型显示，各比值均与复发风险增加相关（FOXP3+PD-1/CD8：HR 2.03，95% CI 1.26–3.29；CD32B/CD19：HR 1.98，95% CI 1.16–3.37）。结论：这项假设生成性初步研究表明，以较高FOXP3（相对于CD8）和较高CD32B（相对于CD19）为特征的免疫抑制性肿瘤微环境预示着术后更早复发。该结果支持在更大规模、分期均衡的队列中进行外部验证，并推动将定量IHC比值纳入术后风险分层体系。
Exploratory Immunohistochemical Profiling of FOXP3, PD-1 and CD32B in Resectable Lung Adenocarcinoma
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