High tumor hexokinase-2 expression promotes a pro-tumorigenic immune microenvironment by modulating CD8+/regulatory T-cell infiltration

BMC Cancer. 2022 Nov 1;22(1):1120. doi: 10.1186/s12885-022-10239-6.

Abstract

Background: Relationship between cancer cell glycolysis and the landscape of tumor immune microenvironment in human cancers was investigated.

Methods: Forty-one fresh lung adenocarcinoma (ADC) tissues were analyzed using flow cytometry for comprehensive immunoprofiling. Formalin-fixed tissues were immunostained for hexokinase-2 (HK2) to assess cancer cell glycolysis. For validation, formalin-fixed tissues from 375 lung ADC, 118 lung squamous cell carcinoma (SqCC), 338 colon ADC, and 78 lung cancer patients treated with anti-PD-1/PD-L1 immunotherapy were immunostained for HK2, CD8, and FOXP3.

Results: Based on immunoprofiling of lung ADC, HK2 tumor expression was associated with the composition of lymphoid cells rather than myeloid cells. High HK2 tumor expression was associated with immunosuppressive/pro-tumorigenic features, especially decreased ratio of CD8 + T-cells to Tregs (rho = -0.415, P = 0.012). This correlation was also confirmed in four different cohorts including lung ADC and SqCC, colon ADC, and the immunotherapy cohort (rho = -0.175~-0.335, all P < 0.05). A low CD8 + T-cell to Treg ratio was associated with poor progression-free survival and overall survival in lung SqCC patients, and a shorter overall survival in the immunotherapy cohort (all, P < 0.05).

Conclusion: An increase in HK2 expression may contribute to shaping the immunosuppressive/pro-tumorigenic tumor microenvironment by modulating the CD8 + T-cell to Treg ratio. Targeting tumor HK2 expression might be a potential strategy for enhancing anti-tumor immunity.

Keywords: CD8 + T-cell to Treg ratio; Glycolysis; Hexokinase-2; Immunotherapy; Tumor microenvironment; Tumor-infiltrating lymphocytes.

MeSH terms

  • Adenocarcinoma of Lung* / metabolism
  • B7-H1 Antigen / metabolism
  • CD8-Positive T-Lymphocytes
  • Carcinogenesis / metabolism
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Carcinoma, Squamous Cell* / metabolism
  • Formaldehyde
  • Hexokinase / metabolism
  • Humans
  • Lung Neoplasms* / pathology
  • Lymphocytes, Tumor-Infiltrating
  • T-Lymphocytes, Regulatory
  • Tumor Microenvironment

Substances

  • Hexokinase
  • B7-H1 Antigen
  • Formaldehyde