CD200 expression predicts poor prognosis in neuroblastoma: a potential biomarker for treatment stratification-a retrospective cohort study.
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PURPOSE: High-risk neuroblastomas carry a poor prognosis, and the role of the immunosuppressive glycoprotein CD200 in this disease remains unclear. In this study, we investigated the role of CD200 expression. METHODS: We retrospectively analyzed CD200 expression in 45 neuroblastoma specimens using immunohistochemistry (IHC). Its association with clinicopathological features, patient survival, and tumor-infiltrating lymphocytes (TILs) density was evaluated. Changes in CD200 expression during chemotherapy were examined in the high-risk subgroup. The functional role of CD200 in chemosensitivity was assessed in vitro using siRNA-mediated silencing in SH-SY5Y and IMR-32 neuroblastoma cell lines. RESULTS: High CD200 expression was significantly associated with advanced-stage disease, recurrence, and poor overall survival (5-year OS: 57.3% vs. 100% in low-CD200, p = 0.007). High-CD200 tumors showed significantly reduced infiltration of CD4 + and CD8 + T cells. In high-risk patients, persistently high or increased post-chemotherapy CD200 expression was correlated with 100% recurrence and mortality. In vitro, CD200 silencing significantly enhanced the cytotoxic effects of cisplatin. CONCLUSION: CD200 is a strong negative prognostic biomarker in neuroblastoma, associated with an immunosuppressive tumor microenvironment and chemoresistance. It represents a promising candidate for treatment stratification and a potential therapeutic target for improving outcomes in high-risk patients.