Overexpressed <scp>CD24</scp> and <scp>CD47</scp> Indicate a Worse Prognosis in Cervical Cancer

BACKGROUND: Two antiphagocytic ("don't eat me") signals that allow tumor immune evasion have been discovered, including CD24 and CD47. This study explored the association between CD24/CD47 expression and macrophage infiltration and clinical outcomes in cervical cancer. METHODS: RNA expression and survival data of the Cancer Genome Atlas (TCGA) cohort were extracted from OncoLnc. The macrophage infiltration level was calculated using xCell, TIMER, and ImmuCellAI. The expression of CD24 and CD47 was detected by immunohistochemistry in tissue microarrays composed of 130 clinical cervical cancer specimens from Fudan University Shanghai Cancer Center (FUSCC). Patients' medical records were also retrospectively assessed to correlate demographic and survival data. RESULTS: Expression levels of both CD24 and CD47 in the cancer population were higher than those in the normal population. Patients with high CD24 expression had poorer survival than those with low CD24 expression in the TCGA and FUSCC cervical cancer cohorts. Although CD47 alone was not statistically significant in predicting outcomes, patients with high CD47 and low CD11c expression, a specific marker of M1-polarized macrophages, exhibited worse survival in the TCGA cohort. CONCLUSIONS: Our study implies that high CD24 expression is an important predictor of a worse prognosis, and CD24 blockade might have therapeutic potential for the treatment of cervical cancer. High expression levels of CD47 and low M1-polarized macrophage infiltration predict a worse prognosis.