THE ASSOCIATION BETWEEN TUMOR INFILTRATING LYMPHOCYTES (TILS) LEVELS AND METASTATIC STATUS IN PATIENTS WITH HEAD AND NECK CANCER

Background: Head and neck cancer (HNC) is a major public health issue, ranking as the seventh most prevalent cancer worldwide. The challenge is the early detection of the disease. Despite progress in imaging techniques, detecting early metastases continues to be problematic. Tumor infiltrating lymphocytes (TILs) have become recognized as key players within the tumor microenvironment, impacting tumor growth and the spread of cancer in multiple types. Their significance as a biomarker has been widely investigated. Objectives: This study aimed to investigate the role of TILs level as a predictor of metastasis head and neck cancer. Method: This was an observational analytic cross-sectional study of patients at Universitas Gadjah Mada Academic Hospitals and Dr. Sardjito General Hospital, Yogyakarta. The study was performed from Jun 2024 until December 2024 on patients who had been diagnosed head and neck cancer based on histopathologic examination. TILs levels differences between metastatic and non-metastatic head and neck carcinoma cases were assessed using the Chi-square test. Odds ratios (OR) were calculated, and multivariate analysis was conducted. The cut-off point for TILs levels was established through receiver operating characteristic (ROC) curve analysis. Result: Seventy-five head and neck cancer patients were involved in this study. The patients were divided into metastatic and non-metastatic groups. The study subjects consisted of 32 patients without metastasis and 43 patients with metastasis. Based on receiver operating characteristic curve, the cut of point 12,5 % with a sensitivity of 62.8% (0.628) and a specificity of 87.5% (0.875). There was a significant difference in TILs levels between the metastatic and non-metastatic groups based on a cut-off value of 12.5 (p = 0.001; OR: 11.8; 95% CI: 3.5–39.8). Conclusion: There was a significant difference of TILs levels between metastatic and non-metastatic head and neck carcinoma. The TILs more than 12,5 % can be considered as predictor of decreased metastasis risk in head and neck cancer. Keywords: head and neck cancer, metastasis, predictor, tumor-infiltrating lymphocytes