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Yuan M, Long Q, Sun X. OCTA-based research on changes of retinal microcirculation in digestive tract malignancy. Photodiagnosis Photodyn Ther 2024:104270. [PMID: 39002834 DOI: 10.1016/j.pdpdt.2024.104270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/02/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE This cross-sectional study measured retinal vessel density (VD) in patients with digestive tract malignancy by optical coherence tomography angiography (OCTA), and compared them with healthy controls to explore the retinal microcirculation changes in patients with digestive tract malignancy. METHODS 106 eligible participants were divided into three groups: gastric cancer (GC) group (36 individuals), colorectal cancer (CRC) group (34 individuals), and healthy control group (36 individuals). Angio 6*6 512*512 R4 and ONH Angio 6*6 512*512 R4 modes were performed to collect retinal vessel density data centered on fovea and papillary, respectively. The retina was automatically segmented into different layers (superficial vascular plexus (SVP), the inner retinal layer, radial peripapillary capillary plexus (RPCP), deep vascular plexus (DVP)) and areas to analyze. RESULTS At the optic nerve head (ONH) region, the VD of the inner retinal layer increased in both GC and CRC groups in all quadrants and areas. In the papillary area, VD in the inner retinal layer, SVP, and RPCP increased in the GC and CRC groups. In the parapapillary area, VD in the inner retinal layer increased in the GC and the CRC groups. Significant increase in the global VD were found in the GC group of the RPCP and SVP. Regarding the macular region, no statistical differences were observed in each layer. CONCLUSIONS The study suggested that retinal vessel density changed in patients with digestive tract malignancy, especially in the inner retinal layer of the ONH region, revealing the potential relevance of the relation between gastrointestinal cancer and retinal microcirculation.
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Affiliation(s)
- Mingzhu Yuan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Qi Long
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xufang Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
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Vaz da Silva DG, de Ribeiro HSDC, Dos Santos GO, Lindote MVN, Torres SM, Diniz AL, de Godoy AL, de Farias IC, Felismino TC, da Costa Junior WL, Coimbra FJF. Dense tumor-infiltrating lymphocytes (TILs) in liver metastasis from colorectal cancer are related to improved overall survival. J Surg Oncol 2024. [PMID: 38946284 DOI: 10.1002/jso.27759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/02/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND AND OBJECTIVES Tumor-infiltrating lymphocytes (TILs) represent a host-tumor interaction, frequently signifying an augmented immunological response. Nonetheless, implications with survival outcomes in patients with colorectal carcinoma liver metastasis (CRLM) warrant rigorous validation. The objective was to demonstrate the association between TILs and survival in patients with CRLM. METHOD In a retrospective evaluation conducted in a single institution, we assessed all patients who underwent hepatectomy due to CRLM between 2014 and 2018. Comprehensive medical documentation reviews were executed. TILs were assessed by a liver pathologist, blinded to the clinical information, in all surgical slides. RESULTS This retrospective cohort included 112 patients. Median overall survival (OS) was 58 months and disease-free survival (DFS) was 12 months for the entire cohort. Comparison between groups showed a median OS of 81 months in the dense TILs group and 40 months in the weak/absent group (p = 0.001), and DFS was 14 months versus 9 months (p = 0.041). Multivariable analysis showed that TILs were an independent predictor of OS (HR 1.95; p = 0.031). CONCLUSIONS Dense TILs are a pivotal prognostic indicator, correlating with enhanced OS. Including TILs information in histopathological evaluations should refine the clinical decision-making process for this group of patients.
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Affiliation(s)
| | | | | | | | - Silvio Mello Torres
- Department of Abdominal Surgery, A. C. Camargo Cancer, CenterSão Paulo, Brazil
| | | | - André Luiz de Godoy
- Department of Abdominal Surgery, A. C. Camargo Cancer, CenterSão Paulo, Brazil
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Castaneda CA, Castillo M, Bernabe LA, Sanchez J, Fassan M, Tello K, Wistuba II, Chavez Passiuri I, Ruiz E, Sanchez J, Barreda F, Valdivia D, Bazan Y, Abad-Licham M, Mengoa C, Fuentes H, Montenegro P, Poquioma E, Alatrista R, Flores CJ, Taxa L. Association between Helicobacter pylori infection, mismatch repair, HER2 and tumor-infiltrating lymphocytes in gastric cancer. World J Gastrointest Oncol 2024; 16:2487-2503. [PMID: 38994161 PMCID: PMC11236231 DOI: 10.4251/wjgo.v16.i6.2487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND The influence of Helicobacter-pylori (H. pylori) infection and the characteristics of gastric cancer (GC) on tumor-infiltrating lymphocyte (TIL) levels has not been extensively studied. Analysis of infiltrating-immune-cell subtypes as well as survival is necessary to obtain comprehensive information. AIM To determine the rates of deficient mismatch-repair (dMMR), HER2-status and H. pylori infection and their association with TIL levels in GC. METHODS Samples from 503 resected GC tumors were included and TIL levels were evaluated following the international-TILs-working-group recommendations with assessment of the intratumoral (IT), stromal (ST) and invasive-border (IB) compartments. The density of CD3, CD8 and CD163 immune cells, and dMMR and HER2-status were determined by immunohistochemistry (IHC). H. pylori infection was evaluated by routine histology and quantitative PCR (qPCR) in a subset of samples. RESULTS dMMR was found in 34.4%, HER2+ in 5% and H. pylori-positive in 55.7% of samples. High IT-TIL was associated with grade-3 (P = 0.038), while ST-TIL with grade-1 (P < 0.001), intestinal-histology (P < 0.001) and no-recurrence (P = 0.003). dMMR was associated with high TIL levels in the ST (P = 0.019) and IB (P = 0.01) compartments, and ST-CD3 (P = 0.049) and ST-CD8 (P = 0.05) densities. HER2- was associated with high IT-CD8 (P = 0.009). H. pylori-negative was associated with high IT-TIL levels (P = 0.009) when assessed by routine-histology, and with high TIL levels in the 3 compartments (P = 0.002-0.047) and CD8 density in the IT and ST compartments (P = 0.001) when assessed by qPCR. A longer overall survival was associated with low IT-CD163 (P = 0.003) and CD8/CD3 (P = 0.001 in IT and P = 0.002 in ST) and high IT-CD3 (P = 0.021), ST-CD3 (P = 0.003) and CD3/CD163 (P = 0.002). CONCLUSION TIL levels were related to dMMR and H. pylori-negativity. Low CD8/CD3 and high CD163/CD3 were associated with lower recurrence and longer survival.
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Affiliation(s)
- Carlos A Castaneda
- Faculty of Health Sciences, Universidad Cientifica del Sur, Lima 15038, Peru
- GECO PERU, Grupo de Estudios Clinicos Oncologicos del Peru, Lima 15038, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis A Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
- Faculty of Human Medicine, Universidad Ricardo Palma, Lima 15039, Peru
| | - Matteo Fassan
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Katherine Tello
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Ignacio Ivan Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Ivan Chavez Passiuri
- Department of Abdominal Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Eloy Ruiz
- Department of Abdominal Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Juvenal Sanchez
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Fernando Barreda
- Department of Medical Specialties, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Daniel Valdivia
- Department of Medical Specialties, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Yaqueline Bazan
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Milagros Abad-Licham
- Department of Pathology, Instituto Regional de Enfermedades Neoplasicas del Norte, Trujillo 13001, Peru
- Faculty of Human Medicine, Universidad Privada Antenor Orrego, Trujillo 13008, Peru
| | - Claudio Mengoa
- Department of Surgery, Instituto Regional de Enfermedades Neoplasicas del Sur, Arequipa 04002, Peru
| | - Hugo Fuentes
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Paola Montenegro
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Ebert Poquioma
- Department of Epidemiology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Raul Alatrista
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Claudio J Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15038, Peru
| | - Luis Taxa
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
- Faculty of Medicine, Universidad San Martin de Porres, Lima 15008, Peru
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4
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Castaneda CA, Castillo M, Bernabe LA, Sanchez J, Fassan M, Tello K, Wistuba II, Chavez Passiuri I, Ruiz E, Sanchez J, Barreda F, Valdivia D, Bazan Y, Abad-Licham M, Mengoa C, Fuentes H, Montenegro P, Poquioma E, Alatrista R, Flores CJ, Taxa L. Association between Helicobacter pylori infection, mismatch repair, HER2 and tumor-infiltrating lymphocytes in gastric cancer. World J Gastrointest Oncol 2024; 16:2475-2491. [DOI: 10.4251/wjgo.v16.i6.2475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND The influence of Helicobacter-pylori (H. pylori) infection and the characteristics of gastric cancer (GC) on tumor-infiltrating lymphocyte (TIL) levels has not been extensively studied. Analysis of infiltrating-immune-cell subtypes as well as survival is necessary to obtain comprehensive information.
AIM To determine the rates of deficient mismatch-repair (dMMR), HER2-status and H. pylori infection and their association with TIL levels in GC.
METHODS Samples from 503 resected GC tumors were included and TIL levels were evaluated following the international-TILs-working-group recommendations with assessment of the intratumoral (IT), stromal (ST) and invasive-border (IB) compartments. The density of CD3, CD8 and CD163 immune cells, and dMMR and HER2-status were determined by immunohistochemistry (IHC). H. pylori infection was evaluated by routine histology and quantitative PCR (qPCR) in a subset of samples.
RESULTS dMMR was found in 34.4%, HER2+ in 5% and H. pylori-positive in 55.7% of samples. High IT-TIL was associated with grade-3 (P = 0.038), while ST-TIL with grade-1 (P < 0.001), intestinal-histology (P < 0.001) and no-recurrence (P = 0.003). dMMR was associated with high TIL levels in the ST (P = 0.019) and IB (P = 0.01) compartments, and ST-CD3 (P = 0.049) and ST-CD8 (P = 0.05) densities. HER2- was associated with high IT-CD8 (P = 0.009). H. pylori-negative was associated with high IT-TIL levels (P = 0.009) when assessed by routine-histology, and with high TIL levels in the 3 compartments (P = 0.002-0.047) and CD8 density in the IT and ST compartments (P = 0.001) when assessed by qPCR. A longer overall survival was associated with low IT-CD163 (P = 0.003) and CD8/CD3 (P = 0.001 in IT and P = 0.002 in ST) and high IT-CD3 (P = 0.021), ST-CD3 (P = 0.003) and CD3/CD163 (P = 0.002).
CONCLUSION TIL levels were related to dMMR and H. pylori-negativity. Low CD8/CD3 and high CD163/CD3 were associated with lower recurrence and longer survival.
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Affiliation(s)
- Carlos A Castaneda
- Faculty of Health Sciences, Universidad Cientifica del Sur, Lima 15038, Peru
- GECO PERU, Grupo de Estudios Clinicos Oncologicos del Peru, Lima 15038, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis A Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
- Faculty of Human Medicine, Universidad Ricardo Palma, Lima 15039, Peru
| | - Matteo Fassan
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua 35121, Italy
| | - Katherine Tello
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Ignacio Ivan Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Ivan Chavez Passiuri
- Department of Abdominal Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Eloy Ruiz
- Department of Abdominal Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Juvenal Sanchez
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Fernando Barreda
- Department of Medical Specialties, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Daniel Valdivia
- Department of Medical Specialties, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Yaqueline Bazan
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Milagros Abad-Licham
- Department of Pathology, Instituto Regional de Enfermedades Neoplasicas del Norte, Trujillo 13001, Peru
- Faculty of Human Medicine, Universidad Privada Antenor Orrego, Trujillo 13008, Peru
| | - Claudio Mengoa
- Department of Surgery, Instituto Regional de Enfermedades Neoplasicas del Sur, Arequipa 04002, Peru
| | - Hugo Fuentes
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Paola Montenegro
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Ebert Poquioma
- Department of Epidemiology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Raul Alatrista
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Claudio J Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15038, Peru
| | - Luis Taxa
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
- Faculty of Medicine, Universidad San Martin de Porres, Lima 15008, Peru
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Costa T, Nogueiro J, Ribeiro D, Viegas P, Santos-Sousa H. Impact of serum albumin concentration and neutrophil-lymphocyte ratio score on gastric cancer prognosis. Langenbecks Arch Surg 2023; 408:57. [PMID: 36689025 DOI: 10.1007/s00423-023-02799-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/22/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION/AIM Serum albumin concentration (COA) and neutrophil-lymphocyte ratio (NLR) could reflect immunological and nutritional status. We aim to evaluate the impact of COA-NLR score on the prognosis of gastric cancer (GC). MATERIAL AND METHODS We perform a retrospective analysis on a database of 637 GC cases, between January 2010 and December 2017. In 396 patients, the inclusion criteria for this study were met (non-resectional or palliative surgery were excluded). Analytic data was only available in 203 patients. COA-NLR score was defined as follows: COA under 35 g/L and NLR value of 2.585 or higher, score 2; one of these conditions, score 1; and neither, score 0. RESULTS In our population (n = 203), 87 patients were classified as score 0, 82 as score 1 and 34 as score 2. COA-NLR score was significantly associated with DFS (HR 1.674; CI 95% 1.115-2.513; p = 0.013) and with OS (HR 2.072; CI 95% 1.531-2.805; p < 0.001). Kaplan-Meier curve analysis (log rank test) revealed that a higher score of COA-NLR predicted a worse OS (p < 0.001) and DFS (p = 0.03). COA-NLR was an independent prognostic factor for OS when adjusted to pStage and age (adjusted HR 1.566; CI 95% 1.145-2.143; p = 0.005). CONCLUSIONS Preoperative COA-NLR score was significantly associated with worse OS and DFS and, in this way, with worse prognosis on GC patients submitted to curative-intent resectional surgery.
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Affiliation(s)
- Teresa Costa
- Faculty of Medicine, University of Porto, Porto, Portugal.
- Surgery Department, Guarda Local Health Unit, Guarda, Portugal.
| | - Jorge Nogueiro
- Faculty of Medicine, University of Porto, Porto, Portugal
- Surgery Department, São João University Medical Center, Porto, Portugal
| | - Daniel Ribeiro
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Pedro Viegas
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Hugo Santos-Sousa
- Faculty of Medicine, University of Porto, Porto, Portugal
- Surgery Department, São João University Medical Center, Porto, Portugal
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Wen X, Jin HY, Li M, Kim Y, Cho NY, Kwak Y, Bae JM, Lee HS, Kang GH. Methylation statuses of NCOR2, PARK2, and ZSCAN12 signify densities of tumor-infiltrating lymphocytes in gastric carcinoma. Sci Rep 2022; 12:862. [PMID: 35039565 PMCID: PMC8763922 DOI: 10.1038/s41598-022-04797-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/21/2021] [Indexed: 11/29/2022] Open
Abstract
Individual cell types of human tissues have their own CpG site methylation profiles, which might be utilized for the development of methylation markers to denote tumor-infiltrating lymphocytes (TILs). We aimed to develop DNA methylation markers that recapitulate the densities of TILs in gastric carcinoma (GC). Through genome-wide methylation profiling, NCOR2, PARK2, and ZSCAN12 were found to be highly methylated in CD3-positive and CD8-positive cells and rarely methylated in tumor cells. Scores of the three methylation markers were analyzed for their relationship with the overall survival and recurrence-free survival of patients with advanced GC (n = 471). The scores of three methylation markers were closely associated with densities of CD3-positive or CD8-positive cells at the tumor center or invasive front of GCs and found to be a significant prognostic factor in univariate analysis of overall survival and recurrence-free survival. In multivariate analysis, the highest score showed hazard ratios of 0.513 (CI 0.306–0.857) and 0.434 (CI 0.261–0.720) for overall survival and recurrence-free survival, respectively. The findings suggest that methylation markers signifying TILs might be utilized for the recapitulation of TIL density in GCs and serve as biomarkers for predicting prognosis in patients with GC.
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Affiliation(s)
- Xianyu Wen
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.,Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hye-Yeong Jin
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.,Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Meihui Li
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.,Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Younghoon Kim
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.,Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Yun Cho
- Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonjin Kwak
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Jeong Mo Bae
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.,Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Seung Lee
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Gyeong Hoon Kang
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea. .,Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
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7
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Mardi K, Kaur R, Negi L, Dheer A. Overexpression of HER2/Neu in gastric adenocarcinoma and its correlation with clinicopathological parameters. CLINICAL CANCER INVESTIGATION JOURNAL 2021. [DOI: 10.4103/ccij.ccij_130_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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8
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Ogut B, Ekinci O, Celik B, Unal ER, Dursun A. Comparison of the efficiency of transgelin, smooth muscle myosin, and CD31 antibodies for the assessment of vascular tumor invasion and free tumor deposits in gastric, pancreatic, and colorectal adenocarcinomas. INDIAN J PATHOL MICR 2020; 63:25-31. [PMID: 32031118 DOI: 10.4103/ijpm.ijpm_109_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background This study aimed to compare CD31, smooth muscle myosin (SMM), and transgelin antibodies for their efficiency in detecting venous invasion (VI) and the nature of free tumor deposits (TDs) in gastric, pancreatic, and colorectal adenocarcinomas. Materials and Methods Eleven Whipple, 5 gastrectomy, and 3 colectomy specimens and 1 low anterior resection specimen were reviewed and examined, revealing 254 probable foci. Foci were reviewed and divided into 3 types: Type A, the "orphan artery" pattern; Type F, free TDs in the periorgan adipose and connective tissue without an unaccompanied artery; and Type X, a focus that could be detected only with the immunohistochemical procedures mentioned. Results No foci were positive for CD31. Transgelin staining was more sensitive than SMM staining in all focus types, Type A only and Type F only (P < 0.001, P = 0.001, and P = 0.10, respectively). In free TDs (Type F), 35.7% of the samples were negative for all four stains, and 64.2% of the samples were positive for SMM and transgelin. We did not make the distinction between a metastatic lymph node and VI in positive foci. Conclusion We conclude that hematoxylin and eosin (H and E) staining is inadequate and that smooth muscle markers, such as transgelin and/or SMM, are more effective than endothelial markers, such as CD31, in revealing VI and lymph node/large extramural invasion.
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Affiliation(s)
- Betul Ogut
- Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozgur Ekinci
- Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bulent Celik
- Department of Statistics, Faculty of Science, Gazi University, Ankara, Turkey
| | - Emel Rodoplu Unal
- Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayse Dursun
- Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey
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9
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Zhao B, Lv W, Mei D, Luo R, Bao S, Huang B, Lin J. Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis. J Clin Pathol 2020; 73:544-551. [PMID: 31980559 DOI: 10.1136/jclinpath-2019-206372] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 12/22/2019] [Accepted: 12/23/2019] [Indexed: 12/24/2022]
Abstract
AIMS The prognostic significance of perineural invasion (PNI) for gastric cancer (GC) patients was under debate. This study aimed to review relevant studies and evaluate the impact of PNI on the survival outcome of GC patients. METHODS Systematic literature search was performed using PubMed and Embase databases. The relevant data were extracted, and the association between PNI and clinicopathological characteristics or survival outcome in GC patients were evaluated using a fixed-effect model or random-effect model. RESULTS A total 13 studies involving 7004 GC patients were included in this meta-analysis. The positive rate of PNI was 35.9% (2512/7004) in GC patients, ranging from 6.9% to 75.6%. There were significant relationships between PNI and a series of unfavourable clinicopathological factors including undifferentiated histology type (OR: 1.78, 95% CI 1.37 to 2.33, p<0.001; I2=75.3%), diffuse type (OR: 1.96, 95% CI 1.07 to 3.60, p=0.029; I2=79.5%), lymphatic invasion (OR: 7.00, 95% CI 3.76 to 13.03, p<0.001; I2=83.6%), vascular invasion (OR: 5.79, 95% CI 1.59 to 21.13, p=0.008; I2=95.8%), deeper tumour invasion (OR: 4.79, 95% CI 3.65 to 6.28, p<0.001; I2=65.0%) and lymph node metastasis (OR: 3.60, 95% CI 2.37 to 5.47, p<0.001; I2=89.6%). In addition, PNI was significantly associated with worse survival outcome in GC patients (HR: 1.69, 95% CI 1.38 to 2.06, p<0.001; I2=71.0%). CONCLUSION PNI was frequently detected in surgically resected specimens of GC patients, and it was a predictive factor for survival outcomes in these patients.
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Affiliation(s)
- Bochao Zhao
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China.,Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Wu Lv
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Di Mei
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Rui Luo
- Department of Central Laboratory, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Shiyang Bao
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Baojun Huang
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jie Lin
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
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10
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Parise IZS, Parise GA, Noronha L, Surakhy M, Woiski TD, Silva DB, Costa TEIJB, Del-Valle MHCP, Komechen H, Rosati R, Ribeiro MG, Nascimento ML, de Souza JA, Andrade DP, Paraizo MM, Galvão MMR, Barbosa JRS, Barbosa ML, Custódio GC, Figueiredo MMO, Fabro ALMR, Bond G, Volante M, Lalli E, Figueiredo BC. The Prognostic Role of CD8 + T Lymphocytes in Childhood Adrenocortical Carcinomas Compared to Ki-67, PD-1, PD-L1, and the Weiss Score. Cancers (Basel) 2019; 11:E1730. [PMID: 31694270 PMCID: PMC6896110 DOI: 10.3390/cancers11111730] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/25/2019] [Accepted: 11/01/2019] [Indexed: 12/24/2022] Open
Abstract
Adrenocortical carcinoma (ACC) is a rare disease among children. Our goal was to identify prognostic biomarkers in 48 primary ACCs from children (2.83 ± 2.3 y; mean age ± SD) by evaluating the tumor stage and outcome for an age of diagnosis before or after 3 years, and association with ACC cluster of differentiation 8 positive (CD8+) cytotoxic T lymphocytes (CD8+-CTL) and Ki-67 immunohistochemical expression (IHC). Programmed death 1(PD-1)/Programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) in ACC was analyzed in a second, partially overlapping cohort (N = 19) with a similar mean age. All patients and control children were carriers of the germline TP53 R337H mutation. Survival without recurrence for less than 3 years and death unrelated to disease were excluded. Higher counts of CD8+-CTL were associated with patients diagnosed with ACC at a younger age and stage I, whereas a higher percentage of the Ki-67 labeling index (LI) and Weiss scores did not differentiate disease free survival (DFS) in children younger than 3 years old. No PD-1 staining was observed, whereas weakly PD-L1-positive immune cells were found in 4/19 (21%) of the ACC samples studied. A high CD8+-CTL count in ACC of surviving children is compelling evidence of an immune response against the disease. A better understanding of the options for enhancement of targets for CD8+ T cell recognition may provide insights for future pre-clinical studies.
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Affiliation(s)
- Ivy Zortéa S. Parise
- Pelé Pequeno Príncipe Research Institute, 1532 Silva Jardim, AV., Curitiba, PR 80250-200, Brazil
- Faculdades Pequeno Príncipe, 333 Iguaçu Av., Rebouças, Curitiba, PR 80230-902, Brazil
- Hospital Infantil Joana Gusmão, 152 Rui Barbosa St., Florianópolis, SC 88025-300, Brazil
| | - Guilherme A. Parise
- Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC), UFPR, 400 Agostinho Leão Jr. Av., Curitiba, PR 80030-110, Brazil
| | - Lúcia Noronha
- Serviço de Anatomia Patológica, Hospital de Clínicas, Universidade Federal do Paraná, 181 General Carneiro, Alto da Glória, Curitiba, PR 80060-900, Brazil
- Departamento de Medicina, PUCPR, 1155 Imaculada Conceição St., Prado Velho, Curitiba, PR 80215-901, Brazil
| | - Mirvat Surakhy
- Oxford Ludwig Institute for Cancer Research, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Build, Roosevelt Dr, Oxford OX3 7DQ, UK
| | - Thiago Demetrius Woiski
- Pelé Pequeno Príncipe Research Institute, 1532 Silva Jardim, AV., Curitiba, PR 80250-200, Brazil
- Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC), UFPR, 400 Agostinho Leão Jr. Av., Curitiba, PR 80030-110, Brazil
| | - Denise B. Silva
- Hospital Infantil Joana Gusmão, 152 Rui Barbosa St., Florianópolis, SC 88025-300, Brazil
| | - Tatiana EI-Jaick B. Costa
- Faculdades Pequeno Príncipe, 333 Iguaçu Av., Rebouças, Curitiba, PR 80230-902, Brazil
- Hospital Infantil Joana Gusmão, 152 Rui Barbosa St., Florianópolis, SC 88025-300, Brazil
| | | | - Heloisa Komechen
- Pelé Pequeno Príncipe Research Institute, 1532 Silva Jardim, AV., Curitiba, PR 80250-200, Brazil
- Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC), UFPR, 400 Agostinho Leão Jr. Av., Curitiba, PR 80030-110, Brazil
| | - Roberto Rosati
- Pelé Pequeno Príncipe Research Institute, 1532 Silva Jardim, AV., Curitiba, PR 80250-200, Brazil
- Faculdades Pequeno Príncipe, 333 Iguaçu Av., Rebouças, Curitiba, PR 80230-902, Brazil
| | - Melyssa Grignet Ribeiro
- Serviço de Anatomia Patológica, Hospital de Clínicas, Universidade Federal do Paraná, 181 General Carneiro, Alto da Glória, Curitiba, PR 80060-900, Brazil
| | | | - José Antônio de Souza
- Hospital Infantil Joana Gusmão, 152 Rui Barbosa St., Florianópolis, SC 88025-300, Brazil
| | - Diancarlos P. Andrade
- Pelé Pequeno Príncipe Research Institute, 1532 Silva Jardim, AV., Curitiba, PR 80250-200, Brazil
- Faculdades Pequeno Príncipe, 333 Iguaçu Av., Rebouças, Curitiba, PR 80230-902, Brazil
| | - Mariana M. Paraizo
- Pelé Pequeno Príncipe Research Institute, 1532 Silva Jardim, AV., Curitiba, PR 80250-200, Brazil
- Faculdades Pequeno Príncipe, 333 Iguaçu Av., Rebouças, Curitiba, PR 80230-902, Brazil
| | - Marjorana Martini R. Galvão
- Ciência Laboratório Médico Ltda-Hospital Infantil Joana de Gusmão, 152 Rui Barbosa St., Florianópolis, SC 88025-300, Brazil
| | - José Renato S. Barbosa
- Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC), UFPR, 400 Agostinho Leão Jr. Av., Curitiba, PR 80030-110, Brazil
| | - Miriam Lacerda Barbosa
- Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC), UFPR, 400 Agostinho Leão Jr. Av., Curitiba, PR 80030-110, Brazil
| | - Gislaine C. Custódio
- Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC), UFPR, 400 Agostinho Leão Jr. Av., Curitiba, PR 80030-110, Brazil
| | - Mirna M. O. Figueiredo
- Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC), UFPR, 400 Agostinho Leão Jr. Av., Curitiba, PR 80030-110, Brazil
| | - Ana Luiza M. R. Fabro
- Faculdades Pequeno Príncipe, 333 Iguaçu Av., Rebouças, Curitiba, PR 80230-902, Brazil
- Hospital Pequeno Príncipe, 1070 Desembargador Motta Av., Curitiba, Paraná 80250-060, Brazil
| | - Gareth Bond
- Oxford Ludwig Institute for Cancer Research, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus Research Build, Roosevelt Dr, Oxford OX3 7DQ, UK
| | - Marco Volante
- Department of Oncology, University of Turin, San Luigi Hospital, regione Gonzole 10, Orbassano, 10043 Turin, Italy
| | - Enzo Lalli
- Institut de Pharmacologie Moléculaire et Cellulaire CNRS, 660 route des Lucioles, Sophia Antipolis, 06560 Valbonne, France
| | - Bonald C. Figueiredo
- Pelé Pequeno Príncipe Research Institute, 1532 Silva Jardim, AV., Curitiba, PR 80250-200, Brazil
- Faculdades Pequeno Príncipe, 333 Iguaçu Av., Rebouças, Curitiba, PR 80230-902, Brazil
- Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC), UFPR, 400 Agostinho Leão Jr. Av., Curitiba, PR 80030-110, Brazil
- Departamento de Saúde Coletiva, Federal University of Paraná, 280 Padre Camargo, Alto da Glória, Curitiba, PR 80060-240, Brazil
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11
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Hruban RH, Gaida MM, Thompson E, Hong SM, Noë M, Brosens LA, Jongepier M, Offerhaus GJA, Wood LD. Why is pancreatic cancer so deadly? The pathologist's view. J Pathol 2019; 248:131-141. [PMID: 30838636 DOI: 10.1002/path.5260] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/19/2019] [Accepted: 02/28/2019] [Indexed: 12/11/2022]
Abstract
The remarkable aggressiveness of pancreatic cancer has never been fully explained. Although clearly multifactorial, we postulate that venous invasion, a finding seen in most pancreatic cancers but not in most cancers of other organs, may be a significant, underappreciated contributor to the aggressiveness of this disease. Copyright © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Ralph H Hruban
- Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthias M Gaida
- Department of General Pathology, The University Hospital of Heidelberg, Heidelberg, Germany
| | - Elizabeth Thompson
- Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Seung-Mo Hong
- Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Michaël Noë
- Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lodewijk Aa Brosens
- Department of Pathology, The University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martine Jongepier
- Department of Pathology, The University Medical Center Utrecht, Utrecht, The Netherlands
| | - G Johan A Offerhaus
- Department of Pathology, The University Medical Center Utrecht, Utrecht, The Netherlands
| | - Laura D Wood
- Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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12
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Wu L, Liang Y, Zhang C, Wang X, Ding X, Huang C, Liang H. Prognostic significance of lymphovascular infiltration in overall survival of gastric cancer patients after surgery with curative intent. Chin J Cancer Res 2019; 31:785-796. [PMID: 31814682 PMCID: PMC6856698 DOI: 10.21147/j.issn.1000-9604.2019.05.08] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective Lymphovascular infiltration (LVI) is frequently detected in gastric cancer (GC) specimens. Studies have revealed that GC patients with LVI have a poorer prognosis than those without LVI. Methods In total, 1,007 patients with curatively resected GC at Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were retrospectively enrolled. The patients were categorized into two groups based on the LVI status: a positive group (PG; presence of LVI) and a negative group (NG; absence of LVI). The clinicopathological factors corrected with LVI and prognostic variables were analyzed. Additionally, a pathological lymphovascular-node (lvN) classification system was proposed to evaluate the superiority of its prognostic prediction of GC patients compared with that of the eighth edition of the N staging system. Results Two hundred twenty-four patients (22.2%) had LVI. The depth of invasion and lymph node metastasis were independently associated with the presence of LVI. GC patients with LVI demonstrated a significantly lower overall survival (OS) rate than those without LVI (42.8% vs. 68.9%, respectively; P<0.001). In multivariate analysis, LVI was identified as an independent prognostic factor for GC patients (hazard ratio: 1.370; 95% confidence interval: 1.094−1.717; P=0.006). Using strata analysis, significant prognostic differences between the groups were only observed in patients at stage I−IIIa or N0−2. The lvN classification was found to be more appropriate to predict the OS of GC patients after curative surgery than the pN staging system. The −2 log-likelihood of lvN classification (4,746.922) was smaller than the value of pN (4,765.196), and the difference was statistically significant (χ2=18.434, P<0.001).
Conclusions The presence of LVI influences the OS of GC patients at stage I−IIIa or N0−2. LVI should be incorporated into the pN staging system to enhance the accuracy of the prognostic prediction of GC patients.
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Affiliation(s)
- Liangliang Wu
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Yuexiang Liang
- Department of Gastrointestinal Oncology, the First Affiliated Hospital of Hainan Medical University, Haikou 570102, China
| | - Chen Zhang
- Nutritional Department, Tianjin Beichen Hospital, Tianjin 300000, China
| | - Xiaona Wang
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Xuewei Ding
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Chongbiao Huang
- Senior Ward, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Han Liang
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
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13
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Inoue D, Sekiguchi S, Yamagata W, Maeda G, Yamada D, Fujiwara S, Itou S, Kurihara M, Hijioka Y, Shimoji K, Fujiki J, Nakazono A, Horike H, Yoshioka A, Ogura Y, Hatao F, Imamura K, Namiki S. Elevation of Neutrophil-to-Lymphocyte Ratio before First-Line Chemotherapy Predicts a Poor Prognosis for Second-Line Chemotherapy in Gastric Cancer. Oncology 2018; 96:140-146. [PMID: 30368510 DOI: 10.1159/000493427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 09/01/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The neutrophil-to-lymphocyte ratio (NLR) has been proposed as an indicator of cancer-related inflammation. The aim of our study was to examine the prognostic value of the NLR for patients with advanced gastric cancer receiving second-line chemotherapy. METHODS The association of overall survival (OS) in second-line chemotherapy and the clinicopathological findings including NLR were analyzed retrospectively. The selection criteria were patients who received second-line chemotherapy between January 2010 and June 2015, had histologically confirmed gastric adenocarcinoma, and were followed up until death or for 180 days or longer. RESULTS Eighty-six patients met the selection criteria. Multivariate analysis revealed that performance status 2, hemoglobin < 10 g/dL, and NLR before first-line chemotherapy ≥3 were adverse predictive markers. NLR before second-line chemotherapy was not associated with OS. A prognostic model was constructed dividing patients into three groups according to the number of adverse predictive factors: good (no factor), intermediate (one factor), and poor (more than two factors). The median OS for the good, intermediate, and poor groups was 14.3, 7.2, and 4.4 months, respectively (p < 0.001). CONCLUSIONS Patients with advanced gastric cancer with performance status 2, hemoglobin < 10 g/dL, and NLR before first-line chemotherapy ≥3 are not likely to benefit from second-line chemotherapy.
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Affiliation(s)
- Dai Inoue
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo,
| | - Shuhei Sekiguchi
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Wataru Yamagata
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Gen Maeda
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Daiki Yamada
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Shun Fujiwara
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Shiori Itou
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Masamichi Kurihara
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Yuko Hijioka
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Kohei Shimoji
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Junko Fujiki
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Ayano Nakazono
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Hideyuki Horike
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Atsushi Yoshioka
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Yuki Ogura
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Fumihiko Hatao
- Department of Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Kazuhiro Imamura
- Department of Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Shin Namiki
- Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
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14
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Miyamoto R, Inagawa S, Sano N, Tadano S, Adachi S, Yamamoto M. The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients. Eur J Surg Oncol 2018; 44:607-612. [PMID: 29478743 DOI: 10.1016/j.ejso.2018.02.003] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 01/12/2018] [Accepted: 02/03/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The preoperative neutrophil-to-lymphocyte ratio (NLR) is a well-known prognostic marker for gastric cancer patients. However, the utility of the NLR in predicting short-term outcomes in gastric cancer patients remains unclear. Here, we investigated whether the preoperative NLR is a predictor of short-term outcomes in gastric cancer patients. METHODS We retrospectively evaluated 154 consecutive gastric cancer patients. We compared the perioperative outcomes and median survival times (MSTs). In particular, for stage II/III (UICC, 7th edition) gastric cancer patients, we compared median disease-free survival time (MDFST) between the low- and high-NLR groups. RESULTS Between the low-NLR group (n = 110) and the high-NLR group (n = 44), significant differences were observed in perioperative outcomes, including postoperative complications (3 (2.7%) vs. 5 (11.3%); p = 0.015), intraoperative blood loss (158 ± 168 g vs. 232 ± 433 g; p = 0.022), and intraoperative blood transfusions (0 vs. 3 (6.8%); p = 0.042). MSTs and MDFSTs were also significantly different (812 vs. 594 days, p = 0.04; and 848 vs. 475 days, p = 0.03, respectively). Multivariate analysis identified the NLR (hazard ratio [HR], 2.015; p = 0.004), Glasgow Prognostic Score (GPS) (HR, 1.533; p = 0.012), and presence of stage III/IV disease (HR, 5.488; p < 0.001), preoperative symptoms (HR, 3.412; p = 0.008), or postoperative complications (HR, 2.698; p < 0.001) as independent prognostic factors. CONCLUSIONS We suggest that the preoperative NLR is an additional useful predictor of both long-term and short-term outcomes in gastric cancer patients.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Satoshi Inagawa
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Naoki Sano
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Sosuke Tadano
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Shinya Adachi
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Masayoshi Yamamoto
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
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15
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Akiyama T, Ogura K, Gokita T, Tsukushi S, Iwata S, Nakamura T, Matsumine A, Yonemoto T, Nishida Y, Saita K, Kawai A, Matsumoto S, Yamaguchi T. Analysis of the Infiltrative Features of Chordoma: The Relationship Between Micro-Skip Metastasis and Postoperative Outcomes. Ann Surg Oncol 2017; 25:912-919. [DOI: 10.1245/s10434-017-6268-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Indexed: 01/31/2023]
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16
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Min KW, Kwon MJ, Kim DH, Son BK, Kim EK, Oh YH, Wi YC. Persistent elevation of postoperative neutrophil-to-lymphocyte ratio: A better predictor of survival in gastric cancer than elevated preoperative neutrophil-to-lymphocyte ratio. Sci Rep 2017; 7:13967. [PMID: 29070814 PMCID: PMC5656603 DOI: 10.1038/s41598-017-13969-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 09/25/2017] [Indexed: 02/06/2023] Open
Abstract
Postoperative neutrophil-to-lymphocyte ratio change (NLRc) reflects the dynamic change of balance between host inflammatory response and immune response after treatment. In gastric cancer, an elevated initial NLR (iNLR) is reported to be a prognostic predictor, but the clinical application of the NLRc remains unclear. The NLRc was assessed in 734 patients undergoing total/subtotal gastrectomy and endoscopic submucosal dissection for gastric adenocarcinoma. The iNLR and NLRc were recorded within 10 days of the first diagnosis and 3–6 months after surgery, respectively. Using receiver operating characteristic (ROC) curves, we investigated the relationship between NLRc or iNLR and patient survival. The analysis revealed a higher predictive power for correlating patient survival with the NLRc compared with iNLR. NLRc was defined as negative (lower than iNLR) and positive (higher than iNLR). A positive NLRc was frequently observed in patients with advanced AJCC stage, local recurrence, distant metastasis, perineural invasion, and adjuvant chemotherapy (all p < 0.05). Univariate and multivariate analyses revealed a significant relationship between patient survival and NLRc (all p < 0.05) but no association between survival and iNLR. The NLRc could be a better indicator than iNLR for predicting survival in patients with gastric cancer.
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Affiliation(s)
- Kyueng-Whan Min
- Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Gyeonggi-do, Republic of Korea
| | - Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-do, Republic of Korea
| | - Dong-Hoon Kim
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Byoung Kwan Son
- Departments of Internal medicine, Eulji Hospital, Eulji University School of medicine, Seoul, Republic of Korea.
| | - Eun-Kyung Kim
- Department of Pathology, Eulji Hospital, Eulji University School of medicine, Seoul, Republic of Korea
| | - Young Ha Oh
- Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Gyeonggi-do, Republic of Korea
| | - Young Chan Wi
- Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Gyeonggi-do, Republic of Korea
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17
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Park WC, Kim HR, Kang DB, Ryu JS, Choi KH, Lee GO, Yun KJ, Kim KY, Park R, Yoon KH, Cho JH, Lee YJ, Chae SC, Park MC, Park DS. Comparative expression patterns and diagnostic efficacies of SR splicing factors and HNRNPA1 in gastric and colorectal cancer. BMC Cancer 2016; 16:358. [PMID: 27282379 PMCID: PMC4901428 DOI: 10.1186/s12885-016-2387-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 05/26/2016] [Indexed: 01/14/2023] Open
Abstract
Background Serine/arginine-rich splicing factors (SRSFs) and HNRNPA1 have oncogenic properties. However, their proteomic expressions and practical priority in gastric cancer (GC) and colorectal cancer (CRC) are mostly unknown. To apply SFs in clinics, effective marker selection and characterization of properties in the target organ are essential. Methods We concurrently analyzed SRSF1, 3, and 5–7, and HNRNPA1, together with the conventional tumor marker carcinoembryonic antigen (CEA), in stomach and colorectal tissue samples (n = 420) using semiquantitative immunoblot, subcellular fractionation, and quantitative real-time polymerase chain reaction methods. Results In the semiquantitative immunoblot analysis, HNRNPA1 and SRSF7 levels were significantly higher in GC than in gastric normal mucosa, and SRSF7 levels were higher in intestinal-type compared with diffuse-type of gastric adenocarcinoma. Of the SFs, only HNRNPA1 presented greater than 50 % upregulation (cancer/normal mucosa > 2-fold) incidences and CEA-comparable, acceptable (>70 %) detection accuracy (74 %) for GC. All SF protein levels were significantly higher in CRC than in colorectal normal mucosa, and HNRNPA1 levels were higher in low-stage CRC compared with high-stage CRC. Among the SFs, HNRNPA1 and SRSF3 presented the two highest upregulation incidences (88 % and 74 %, respectively) and detection accuracy (90 % and 84 %, respectively) for CRC. The detection accuracy of HNRNPA1 was comparable to that of CEA in low (≤ II)-stage CRC but was inferior to that of CEA in high (>II)-stage CRC. Extranuclear distributions of HNRNPA1 and SRSF6 (cytosol/microsome) differed from those of other SRSFs (membrane/organelle) in both cancers. In an analysis of the six SF mRNAs, all mRNAs presented unacceptable detection accuracies (≤70 %) in both cancers, and all mRNAs except SRSF6 were disproportionate to the corresponding protein levels in GC. Conclusion Our results provide a comprehensive insight into the six SF expression profiles in GC and indicate that, among the SFs, HNRNPA1, but not HNRNPA1 mRNA, is the most effective, novel GC marker. Regardless of the good to excellent detection accuracy of SRSF3 and HNRNPA1 in CRC, the SFs have lower practical priority than CEA, especially for high-stage CRC detection.
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Affiliation(s)
- Won Cheol Park
- Department of Surgery, School of Medicine, Wonkwang University, Iksan, South Korea
| | - Hak-Ryul Kim
- Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, South Korea
| | - Dong Baek Kang
- Department of Surgery, School of Medicine, Wonkwang University, Iksan, South Korea
| | - Jae-Suk Ryu
- Department of Laboratory Medicine, School of Medicine, Wonkwang University, 895 Muwang-ro, Iksan, 54538, Republic of Korea.,Center for Metabolic Function Regulation, Institute of Wonkwang Medical Science and Institute of Wonkwang Clinical Medicine, School of Medicine, Wonkwang University, Iksan, Korea
| | - Keum-Ha Choi
- Department of Pathology, School of Medicine, Wonkwang University, Iksan, Korea
| | - Gyeong-Ok Lee
- Department of Laboratory Medicine, School of Medicine, Wonkwang University, 895 Muwang-ro, Iksan, 54538, Republic of Korea.,Center for Metabolic Function Regulation, Institute of Wonkwang Medical Science and Institute of Wonkwang Clinical Medicine, School of Medicine, Wonkwang University, Iksan, Korea
| | - Ki Jung Yun
- Department of Pathology, School of Medicine, Wonkwang University, Iksan, Korea
| | - Keun Young Kim
- Department of Surgery, School of Medicine, Wonkwang University, Iksan, South Korea
| | - Raekil Park
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangu, Korea
| | - Kwon-Ha Yoon
- Department of Radiology, School of Medicine, Wonkwang University, Iksan, Korea
| | - Ji-Hyun Cho
- Department of Laboratory Medicine, School of Medicine, Wonkwang University, 895 Muwang-ro, Iksan, 54538, Republic of Korea
| | - Young-Jin Lee
- Department of Laboratory Medicine, School of Medicine, Wonkwang University, 895 Muwang-ro, Iksan, 54538, Republic of Korea
| | - Soo-Cheon Chae
- Department of Pathology, School of Medicine, Wonkwang University, Iksan, Korea
| | - Min-Cheol Park
- Department of Herbology, School of Oriental Medicine, Wonkwang University, Iksan, Korea
| | - Do-Sim Park
- Department of Laboratory Medicine, School of Medicine, Wonkwang University, 895 Muwang-ro, Iksan, 54538, Republic of Korea. .,Center for Metabolic Function Regulation, Institute of Wonkwang Medical Science and Institute of Wonkwang Clinical Medicine, School of Medicine, Wonkwang University, Iksan, Korea.
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Circulating tumour cells predict survival in gastric cancer patients: a meta-analysis. Contemp Oncol (Pozn) 2016; 19:451-7. [PMID: 26843841 PMCID: PMC4731451 DOI: 10.5114/wo.2015.56651] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 05/29/2014] [Indexed: 12/11/2022] Open
Abstract
AIM OF THE STUDY The prognostic value of the detection of circulating tumour cells (CTCs) in gastric cancer has been studied intensely in recent years. However, the application of different technologies led to inconsistent results between the studies. Here, we performed a meta-analysis of published studies to summarise the evidence. MATERIAL AND METHODS Medline and ISI Web of Knowledge were searched up to March 2013 using "circulating tumor cells" and "gastric cancer" as search terms. Hazard ratio (HR) with 95% confidence intervals (CIs) for prognostic outcomes and clinical characteristics were extracted from each study. Pooled hazard ratios (HR) and odds ratios (OR) were calculated using random or fixed-effects models. RESULTS Twelve studies enrolling 774 patients were included. The combined HR estimate for overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) were 1.41 (95% CI: 1.28-1.62), 2.99 (95% CI: 2.01-4.45) and 1.64 (95% CI: 1.02-2.62), respectively. Subgroup analysis concerning detection methods and sampling time showed that results of RT-PCR for the OS group and RT-PCR for the DFS group suggest a prognostic significance of CTC detection (pooled HR [95% CI]: 1.45 [1.28-1.65], I(2) = 38%, p = 0.13; 2.99 [2.01-4.45], I(2) = 0%, p = 0.32). In addition, results of the baseline CTC detection group also indicated a significant prognostic value to predict OS and DFS (pooled HR [95% CI]: 1.47 [1.19-1.82], I(2) = 38%, p = 0.14; 2.99 [2.01-4.45], I(2) = 0%, p = 0.32). We simultaneously found that the detection of CTCs correlated with pathological stage (pooled OR [95% CI]: 2.95 [1.65-5.28], I(2) = 56%, p = 0.03), lymph node status (pooled OR [95% CI]: 2.26 [1.50-3.41], I(2) = 37%, p = 0.09), the depth of invasion (pooled OR [95% CI]: 3.21 [1.38-7.43], I(2) = 72%, p = 0.002), and distant metastasis (pooled OR [95% CI]: 2.68 [1.25-5.73], I(2) = 43%, p = 0.15). CONCLUSIONS Detection of CTCs is associated with poorer prognosis in gastric cancer patients.
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Sejben I, Kocsis L, Török L, Cserni G. Elastic staining does not assist detection of venous invasion in cutaneous melanoma. Pathol Res Pract 2015; 212:51-3. [PMID: 26639870 DOI: 10.1016/j.prp.2015.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/03/2015] [Accepted: 11/11/2015] [Indexed: 12/01/2022]
Abstract
The aim of the present study was to determine the benefit of orcein elastic staining of primary cutaneous melanoma specimens in detecting venous invasion. Primary cutaneous melanomas in vertical growth phase were assessed for vascular invasion. All tumour blocks were stained with haematoxylin and eosin (H&E) and orcein. The cases were reviewed by two pathologists. Vascular invasion was not identified more frequently on orcein stained slides than on H&E stained ones. Elastosis and periappendiceal elastic fibres interfered with vascular invasion detection with elastic staining. Based on our study, we conclude that elastic stains such as orcein do not improve the detection rate of venous invasion in primary cutaneous melanomas.
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Affiliation(s)
- István Sejben
- Department of Pathology, Bács-Kiskun County Teaching Hospital, Nyíri út 38, H-6000 Kecskemét, Hungary.
| | - Lajos Kocsis
- Department of Pathology, Bács-Kiskun County Teaching Hospital, Nyíri út 38, H-6000 Kecskemét, Hungary; Department of Dermatology, Bács-Kiskun County Teaching Hospital, Nyíri út 38, H-6000 Kecskemét, Hungary
| | - László Török
- Department of Dermatology, Bács-Kiskun County Teaching Hospital, Nyíri út 38, H-6000 Kecskemét, Hungary
| | - Gábor Cserni
- Department of Pathology, Bács-Kiskun County Teaching Hospital, Nyíri út 38, H-6000 Kecskemét, Hungary; Department of Pathology, University of Szeged, Állomás u. 2, H-6720 Szeged, Hungary
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20
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Li P, He HQ, Zhu CM, Ling YH, Hu WM, Zhang XK, Luo RZ, Yun JP, Xie D, Li YF, Cai MY. The prognostic significance of lymphovascular invasion in patients with resectable gastric cancer: a large retrospective study from Southern China. BMC Cancer 2015; 15:370. [PMID: 25947284 PMCID: PMC4435771 DOI: 10.1186/s12885-015-1370-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 04/25/2015] [Indexed: 12/26/2022] Open
Abstract
Background The focus of this study was to assess the impact of lymphovascular invasion (LVI) on both the recurrence of cancer and the long-term survival of Chinese patients with resectable gastric cancer (GC). Methods A retrospective analysis of the clinicopathological data for 1148 GC patients who had undergone gastrectomy with regional lymphadenectomy was performed. The primary objective was to assess the correlation between LVI and post-surgery outcomes for each patient. This was done by routine H & E staining for LVI on patients’ disease-free survival (DFS) and disease-specific survival (DSS). Results LVI was detected in 404 (35.2%) of the 1148 GC patients. The presence of LVI was significantly correlated with the level of CA19-9, the tumor size, the Lauren classification, tumor differentiation, gastric wall invasive depth, lymph node involvement, distant metastasis and an advanced TNM stage. There was a lower DFS and DSS in the patients with LVI as compared to the patients without LVI. A multivariate analysis also identified LVI as an independent prognostic factor of both DSS and DFS. Conclusions The presence of LVI is a risk factor for the recurrence of cancer and an independent indicator of a poor outcome in GC patients following surgery. The LVI status should be taken into consideration when determining the best approach for the treatment of the individual.
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Affiliation(s)
- Peng Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Pathology, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.
| | - Hao-Qiang He
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Diagnostic Imaging and Intervening Center, Sun Yat-sen University Cancer Center, Guangzhou, China.
| | - Chong-Mei Zhu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Pathology, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.
| | - Yi-Hong Ling
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Pathology, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.
| | - Wan-Ming Hu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Pathology, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.
| | - Xin-Ke Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Pathology, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.
| | - Rong-Zhen Luo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Pathology, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.
| | - Jing-Ping Yun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Pathology, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.
| | - Dan Xie
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
| | - Yuan-Fang Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Gastric & Pancreatic Surgery, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.
| | - Mu-Yan Cai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .,Department of Pathology, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.
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Sentani K, Matsuda M, Oue N, Uraoka N, Naito Y, Sakamoto N, Yasui W. Clinicopathological significance of MMP-7, laminin γ2 and EGFR expression at the invasive front of gastric carcinoma. Gastric Cancer 2015; 17:412-22. [PMID: 24048760 DOI: 10.1007/s10120-013-0302-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 08/30/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND For several types of cancer, including gastric cancer (GC), tumor cells at the invasive front are considered to have a more aggressive behavior compared with those in the more central region. The aim of the present study was to analyze the expression of MMP-7, laminin γ2 and EGFR in a large number of GCs and to investigate how these expression patterns correlate with clinicopathologic parameters, infiltrative patterns, histology or mucin phenotype. METHODS We immunohistochemically examined the expression of MMP-7, laminin γ2 and EGFR using a tissue microarray analysis of 790 GCs, and evaluated their clinicopathological significance. RESULTS MMP-7, cytoplasmic laminin γ2, extracellular laminin γ2 and EGFR expression were observed in 25, 25, 8 and 21 % of the 790 GC cases, respectively. Expression of MMP-7, cytoplasmic laminin γ2 and EGFR was associated with advanced T grade, N grade and tumor stage. Extracellular laminin γ2 expression was not associated with any clinicopathologic parameters, infiltrative patterns, histology or mucin phenotype. Furthermore, we investigated the correlations of MMP-7, laminin γ2 and EGFR expression. MMP-7 expression was significantly more frequent in positive expression of cytoplasmic laminin γ2 than negative cases, and EGFR expression was significantly more frequent in positive expression of cytoplasmic laminin γ2 and MMP-7. CONCLUSIONS Molecular expression of MMP-7, laminin γ2 or EGFR, and their combinations, may be associated with GC tumor aggressiveness. Assessment of expression of these molecules at the invasive front of primary tumors is clinically significant in predicting the malignant behavior of GC.
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Affiliation(s)
- Kazuhiro Sentani
- Department of Molecular Pathology, Hiroshima University Institute of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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Graziosi L, Marino E, De Angelis V, Rebonato A, Cavazzoni E, Donini A. Prognostic value of preoperative neutrophils to lymphocytes ratio in patients resected for gastric cancer. Am J Surg 2014; 209:333-7. [PMID: 25190544 DOI: 10.1016/j.amjsurg.2014.06.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 05/21/2014] [Accepted: 06/03/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND The neutrophil/lymphocyte ratio (NLR) in the peripheral blood is considered an easily assessable prognostic factor in cancer patients. We evaluated the predictive significance of the NLR in patients affected by gastric cancer that underwent gastric resection. METHODS From July 2003 to March 2012, 156 patients who had undergone gastrectomy with curative intent for gastric adenocarcinoma were included. Data were retrieved from a prospective collected database. NLR was calculated from lymphocyte and neutrophil counts on routine blood tests taken before surgery. Survival analyses were generated according to the Kaplan-Meier method. Univariate and multivariate analyses were carried out by the Cox proportional hazard model. RESULTS The median follow-up time for surviving patients was 38 months (range 1 to 108 months) and median preoperative NLR was 2.3 (range .47 to 19.73). Subjects were dichotomized at the N/L value of 2.3. Median survival of patients with NLR below the median was around 60 months compared with the 36 months of patients with an NLR above the median. A multivariate analysis established a significant and independent relationship between the NLR and the overall survival with a P value of less than .05. CONCLUSIONS The results suggest that the elevated preoperative NLR predicts poor overall survival following resection for gastric adenocarcinoma. It may be used as a simple, reliable prognostic factor for risk stratification.
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Affiliation(s)
- Luigina Graziosi
- Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy
| | - Elisabetta Marino
- Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy.
| | - Verena De Angelis
- Oncologia Medica, Ospedale Santa Maria della Misericordia, Sant'Andrea delle Fratte, Perugia 06132, Italy
| | - Alberto Rebonato
- Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy
| | - Emanuel Cavazzoni
- Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy
| | - Annibale Donini
- Dipartimento di Scienze Chirurgiche, Radiologiche e Odontostomatologiche, Nuova Facoltà di Medicina e Chirurgia, Sant'Andrea delle Fratte, Perugia 06132, Italy
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Arigami T, Uenosono Y, Ishigami S, Matsushita D, Hirahara T, Yanagita S, Okumura H, Uchikado Y, Nakajo A, Kijima Y, Natsugoe S. Decreased density of CD3+ tumor-infiltrating lymphocytes during gastric cancer progression. J Gastroenterol Hepatol 2014; 29:1435-41. [PMID: 25587614 DOI: 10.1111/jgh.12551] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Peritransplant lymphopenia is a novel prognostic factor in recurrence of hepatocellular carcinoma after liver transplantation. Transplantation 2014; 97:694-701. [PMID: 24637868 DOI: 10.1097/01.tp.0000437426.15890.1d] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Absolute lymphocyte count (ALC) is considered a surrogate marker for the level of immunosuppression and nutritional status of patients and a prognostic factor for survival and recurrence in several cancers. The aim of this study was to investigate the prognostic value of peritransplant ALC for the recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT). METHODS HCC patients who underwent LT between 2000 and 2010 were evaluated. Exclusion criteria were combined HCC and cholangiocarcinoma. Peritransplant ALCs (before LT and 2 weeks and 1 month after LT) were analyzed along with tumor, operative, and donor characteristics to identify risk factors for the recurrence of HCC. RESULTS HCC developed in 27 of the 173 LT patients investigated for risk factors (15.6%). The median time to recurrence was 1.14 years. Low ALCs before and after LT were associated with a higher recurrence rate in a continuous manner (before LT: hazard ratio=1.12, P=0.003; 2 weeks after LT: hazard ratio=1.14, P=0.008; 1 month after LT: hazard ratio=1.06, P=0.055) (increased risk per 100/μL down). On multivariate Cox regression analysis, peritransplant persistent lymphopenia (<1000/μL before LT and <500/μL at 2 weeks and 1 month after LT) was an independent risk factor for cancer recurrence (hazard ratio=7.05, P<0.001), along with tumor characteristics. CONCLUSION Peritransplant lymphopenia is a powerful prognostic factor for the recurrence of HCC after LT, which suggests that maintaining ALCs in LT patients might improve cancer outcome.
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Deng J, You Q, Gao Y, Yu Q, Zhao P, Zheng Y, Fang W, Xu N, Teng L. Prognostic value of perineural invasion in gastric cancer: a systematic review and meta-analysis. PLoS One 2014; 9:e88907. [PMID: 24586437 PMCID: PMC3931634 DOI: 10.1371/journal.pone.0088907] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 01/13/2014] [Indexed: 12/14/2022] Open
Abstract
Background The prognostic role of perineural invasion in gastric cancer is controversial. Here, we present a systemic review and meta-analysis of the association between perineural invasion and survival in resectable gastric cancer patients. Methods A comprehensive literature search for relevant reports published up to April 2013 was performed using PubMed, Embase, Web of Science and Wanfang Data. Studies that investigated the role of perineural invasion with a sample size greater than 100 were included and analyzed. Results A total of 30,590 gastric cancer patients who had undergone curative gastrectomy from twenty-four studies were included. The median rate of perineural invasion positive was 40.9% (6.8%–75.6%). Fourteen studies investigated overall survival unadjusted for other variables in 23,233 gastric cancer patients. The relative hazard estimates ranged from 0.568–7.901 with a combined random effects estimate of 2.261 (95% CI = 1.841–2.777, P = 0.000). The effect of perineural invasion on overall survival adjusted for other prognostic factors was reported in 17 studies incorporating 8,551 cases. The hazard estimates ranged from 0.420–8.110 with a pooled random effects estimates of 1.484 (95% CI = 1.237–1.781, P = 0.000). There was heterogeneity between the studies (Q = 49.22, I-squared = 67.5%, P = 0.000). Disease-free survival was investigated adjusted in four studies incorporating 9,083 cases and the pooled fixed hazard ratio estimate was 1.371(95% CI = 1.230–1.527, P = 0.000). Conclusion Perineural invasion is an independent prognostic factor affecting overall survival and disease-free survival of gastric cancer patients who had undergone the curative resection. This effect is independent of lymph node status, tumor size and the depth of invasion as well as a range of other biological variables on multivariate analysis. Large prospective studies are now needed to establish perineural invasion as an independent prognostic marker for gastric cancer.
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Affiliation(s)
- Jing Deng
- Department of Medical Oncology, The First Hospital Affiliated to Medical School of Zhejiang University, Hangzhou, China
| | - Qihan You
- Department of Pathology, The First Hospital Affiliated to Medical School of Zhejiang University, Hangzhou, China
| | - Yang Gao
- Medical School of Zhejiang University, Hangzhou, China
| | - Qing Yu
- Medical School of Zhejiang University, Hangzhou, China
| | - Peng Zhao
- Department of Medical Oncology, The First Hospital Affiliated to Medical School of Zhejiang University, Hangzhou, China
| | - Yulong Zheng
- Department of Medical Oncology, The First Hospital Affiliated to Medical School of Zhejiang University, Hangzhou, China
| | - Weijia Fang
- Department of Medical Oncology, The First Hospital Affiliated to Medical School of Zhejiang University, Hangzhou, China
| | - Nong Xu
- Department of Medical Oncology, The First Hospital Affiliated to Medical School of Zhejiang University, Hangzhou, China
- * E-mail:
| | - Lisong Teng
- Department of Surgical Oncology, The First Hospital Affiliated to Medical School of Zhejiang University, Hangzhou, China
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Atanackovic D, Reinhard H, Meyer S, Spöck S, Grob T, Luetkens T, Yousef S, Cao Y, Hildebrandt Y, Templin J, Bartels K, Lajmi N, Stoiber H, Kröger N, Atz J, Seimetz D, Izbicki JR, Bokemeyer C. The trifunctional antibody catumaxomab amplifies and shapes tumor-specific immunity when applied to gastric cancer patients in the adjuvant setting. Hum Vaccin Immunother 2013; 9:2533-42. [PMID: 23955093 DOI: 10.4161/hv.26065] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Patients with gastric cancer benefit from perioperative chemotherapy, however, treatment is toxic and many patients will relapse. The trifunctional antibody catumaxomab targets EpCAM on tumor cells, CD3 on T cells, and the Fcγ-receptor of antigen-presenting cells. While in Europe catumaxomab is approved for treating malignant ascites, it has not been investigated in the perioperative setting and its exact immunological mode of action is unclear. METHODS In our study, gastric cancer patients received neoadjuvant platinum-based chemotherapy, one intraoperative application of catumaxomab, and 4 postoperative doses of intraperitoneal catumaxomab. Immunomonitoring was performed in 6 patients before surgery, after completion of catumaxomab treatment, and one month later. RESULTS Intraperitoneal application of catumaxomab caused an increased expression of activation markers on the patients' T cells. This was accompanied by a transient decrease in numbers of CXCR3(+) effector T cells with a T-helper (Th)-1 phenotype in the peripheral blood. All patients evidenced pre-existing EpCAM-specific CD4(+) and/or CD8(+) T cells. While these cells transiently disappeared from the blood stream after intraperitoneal application of catumaxomab, we detected increased numbers of peripheral EpCAM-specific cells and a modified EpCAM-specific T-cell repertoire 4 weeks after completion of treatment. Finally, catumaxomab also amplified humoral immunity to tumor antigens other than EpCAM. CONCLUSIONS Our findings suggest that catumaxomab exerts its clinical effects by (1) activating peripheral T cells, (2) redistributing effector T cells from the blood into peripheral tissues, (3) expanding and shaping of the pre-existing EpCAM-specific T-cell repertoire, and (4) spreading of anti-tumor immunity to different tumor antigens.
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Affiliation(s)
- Djordje Atanackovic
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Henrike Reinhard
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Sabrina Meyer
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Stefanie Spöck
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Tobias Grob
- Institute for Pathology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Tim Luetkens
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Sara Yousef
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Yanran Cao
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - York Hildebrandt
- Department of Stem Cell Transplantation; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Julia Templin
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Katrin Bartels
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Nesrine Lajmi
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Heribert Stoiber
- Division of Virology; Medical University IBK; Innsbruck, Austria
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | | | | | - Jakob R Izbicki
- Department of General, Visceral, and Thoracic Surgery; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
| | - Carsten Bokemeyer
- Department of Internal Medicine II; Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology; University Medical Center Hamburg-Eppendorf; Hamburg, Germany
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Kim DH, Kim SM, Hyun JK, Choi MG, Noh JH, Sohn TS, Bae JM, Kim S. Changes in postoperative recurrence and prognostic risk factors for patients with gastric cancer who underwent curative gastric resection during different time periods. Ann Surg Oncol 2013; 20:2317-27. [PMID: 23677605 DOI: 10.1245/s10434-012-2700-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Indexed: 12/18/2022]
Abstract
BACKGROUND Current rates of survival for gastric cancer patients are much improved compared with those of the past. The purpose of our study was to analyze the survival of gastric cancer patients according to time period and to examine how different prognostic factors are related to changing survival rates. METHODS We analyzed data from 7,757 patients who underwent curative gastrectomy after diagnoses of gastric cancer at Samsung Medical Center from 1994 to 2006. Clinicopathologic characteristics and prognostic factors were analyzed retrospectively, with patients divided into period I, from 1994 to 2001, and period II, from 2002 to 2006. RESULTS The 5-year, disease-free survival rate of patients with gastric cancer increased significantly from 76.7 % during period I to 85.9 % during period II (p < 0.001). The prognosis of the patient who underwent surgery during period I was worse than that of the patient in period II. When multivariate analyses were performed for each time period, independent prognostic factors for period I included patient age >60 years, tumor located in the whole stomach, tumor size, stage, vascular invasion, perineural invasion, and adjuvant chemotherapy. For period II, tumor size, vascular, and adjuvant chemotherapy were no longer independent prognostic risk factors. CONCLUSIONS The disease-free survival of gastric cancer improved and prognostic factors changed over time. Active, concurrent chemoradiotherapy together with radical gastric resection performed by an expert surgeon seemed to contribute to the improvement in the survival rates of gastric cancer.
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Affiliation(s)
- Dae Hoon Kim
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea.
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Kimura Y, Sumiyoshi M. Anti-tumor and anti-metastatic actions of wogonin isolated from Scutellaria baicalensis roots through anti-lymphangiogenesis. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2013; 20:328-336. [PMID: 23219337 DOI: 10.1016/j.phymed.2012.10.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 10/23/2012] [Accepted: 10/29/2012] [Indexed: 06/01/2023]
Abstract
Tumor growth and metastasis are associated with angiogenesis and lymphangiogenesis through the production of vascular endothelial growth factor (VEGF) or VEGF-C in tumors, and the phosphorylation of VEGF receptor (VEGFR)-2 or VEGFR-3 in vascular endothelial cells or lymphatic endothelial cells (LECs). Tumor-associated macrophages (TAMs) play an important role in tumor lymphangiogenesis, and consequently stimulate metastasis through the lymphatic system to lymph nodes. We examined the effects of wogonin isolated from Scutellaria baicalensis roots on tumor growth and metastasis using a highly metastatic model in osteosarcoma LM8-bearing mice. Wogonin (25 and 50 mg/kg, twice daily) reduced tumor growth and metastasis to the lung, liver and kidney, angiogenesis (CD31-positive cells), lymphangiogenesis (LYVE-1-positive cells), and TAM (F4/80-positive cell) numbers in the tumors of LM8-bearing mice. Wogonin (10-100 μM) also inhibited increases in IL-1β production and cyclooxygenase (COX)-2 expression induced by lipopolysaccharide in THP-1 macrophages. Wogonin had no effect on VEGF-C production in LM8 cells, or VEGFR-3 expression in human lymphatic endothelial cells (HLECs), however, it inhibited VEGF-C-induced VEGFR-3 phosphorylation in HLECs. The anti-tumor and anti-metastatic actions of wogonin may be associated with the inhibition of VEGF-C-induced lymphangiogenesis through a reduction in VEGF-C-induced VEGFR-3 phosphorylation by the inhibition of COX-2 expression and IL-1β production in TAMs.
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MESH Headings
- Animals
- Antineoplastic Agents, Phytogenic/isolation & purification
- Antineoplastic Agents, Phytogenic/pharmacology
- Antineoplastic Agents, Phytogenic/therapeutic use
- Body Weight/drug effects
- Chemokine CCL2/metabolism
- Cyclooxygenase 2/metabolism
- Cytokines/metabolism
- Drug Screening Assays, Antitumor
- Drugs, Chinese Herbal/pharmacology
- Drugs, Chinese Herbal/therapeutic use
- Endothelial Cells/drug effects
- Endothelial Cells/metabolism
- Flavanones/isolation & purification
- Flavanones/pharmacology
- Flavanones/therapeutic use
- Hypoxia-Inducible Factor 1, alpha Subunit/metabolism
- Immunohistochemistry
- Lymphangiogenesis/drug effects
- Macrophages/drug effects
- Macrophages/metabolism
- Male
- Mice
- Mice, Inbred C3H
- Neoplasm Metastasis
- Phosphorylation/drug effects
- Phytotherapy
- Plant Roots/chemistry
- Sarcoma, Experimental/drug therapy
- Sarcoma, Experimental/metabolism
- Scutellaria baicalensis/chemistry
- Vascular Endothelial Growth Factor C/metabolism
- Vascular Endothelial Growth Factor Receptor-3/metabolism
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Affiliation(s)
- Yoshiyuki Kimura
- Division of Biochemical Pharmacology, Department of Basic Medical Research, Ehime University Graduate School of Medicine, Shitsukawa, Toon City, Ehime, Japan.
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Romano F, Uggeri F, Nespoli L, Gianotti L, Garancini M, Maternini M, Nespoli A, Uggeri F. Gastric Cancer Immunotherapy: An Overview. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/jct.2013.45116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Liu X, Cai H, Shi Y, Wang Y. Prognostic factors in patients with node-negative gastric cancer: a single center experience from China. J Gastrointest Surg 2012; 16:1123-7. [PMID: 22488657 DOI: 10.1007/s11605-012-1881-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 03/22/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Lymph node metastasis was the most important prognostic factor in gastric cancer. Patients with node-negative gastric cancer presented better survival. However, some of them would die of the disease. The aim of this study was to evaluate the prognostic factors of patients with node-negative gastric cancer. METHODS From 1996 to 2007, 4,426 patients had undergone curative D2 gastrectomy for gastric cancer at the Fudan University Shanghai Cancer Center. Patients with node-negative gastric cancer who underwent curative D2 gastrectomy with more than 15 lymph nodes dissected were selected into this study. The prognostic value of pathological features was investigated. RESULTS This study included 234 patients with node-negative gastric cancer. The 5-year overall survival in these patients was 85 %. The factors correlating significantly with overall survival on univariate analysis included age (P = 0.016), depth of invasion (P = 0.000), tumor size (P = 0.013), tumor site (P = 0.000), histological grade (P = 0.009), lymphatic tumor emboli (P = 0.014), vascular tumor emboli (P = 0.005), and nervous invasion (P = 0.033). Multivariate analysis showed that lymphatic tumor emboli (hazard ratio (HR) = 7.270), vascular tumor emboli (HR = 3.010), and depth of invasion (HR = 2.735) were defined as independent prognostic factors. CONCLUSION Among patients with node-negative gastric cancer and higher risk for recurrence, the use of adjuvant therapies should be considered.
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Affiliation(s)
- Xiaowen Liu
- Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, 270 Dong An Road, Shanghai, 200032, People's Republic of China
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Comparison of the prognostic value of tumour and patient related factors in patients undergoing potentially curative resection of gastric cancer. Am J Surg 2012; 204:294-9. [PMID: 22444831 DOI: 10.1016/j.amjsurg.2011.10.015] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 10/27/2012] [Accepted: 10/27/2011] [Indexed: 12/22/2022]
Abstract
BACKGROUND There is increasing evidence that the patient-related systemic inflammatory response is a powerful prognostic factor. The aim of the present study was to compare the prognostic value of selected markers of the systemic inflammatory response in patients undergoing resection of gastric cancer. METHODS One hundred twenty patients undergoing resection of gastric cancer, had measurements of various systemic inflammatory markers in addition to tumor-related factors. From these, the modified Glasgow Prognostic Score (mGPS), neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and metastatic lymph node ratio were calculated. RESULTS On multivariate analysis, only the ratio of positive to total lymph nodes (hazard ratio, 2.29%; 95% confidence interval, 1.57%-3.33%; P < .001) and the mGPS (hazard ratio, 2.23%; 95% confidence interval, 1.40%-3.54%; P = .001) were independently associated with cancer-specific survival in patients with gastric cancer. An increase in the mGPS was associated with a higher neutrophil/lymphocyte ratio (P < .05) and poorer survival (P < .001). CONCLUSIONS The present study indicates that the mGPS, an acute-phase, protein-based prognostic score, is a superior predictor of cancer survival compared with the cellular components of the systemic inflammatory response in patients undergoing resection of gastric cancer.
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Ladányi A, Kiss J, Mohos A, Somlai B, Liszkay G, Gilde K, Fejös Z, Gaudi I, Dobos J, Tímár J. Prognostic impact of B-cell density in cutaneous melanoma. Cancer Immunol Immunother 2011; 60:1729-38. [PMID: 21779876 PMCID: PMC11028465 DOI: 10.1007/s00262-011-1071-x] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 07/06/2011] [Indexed: 12/25/2022]
Abstract
Studies on the prognostic importance of tumor-infiltrating lymphocytes have mainly focused on T cells, while little is known about the role of tumor-infiltrating B lymphocytes. We investigated the prevalence of CD20(+) B cells by immunohistochemistry in primary melanoma samples of 106 patients and analyzed in relation to clinicopathological parameters and patients' survival. The majority of samples contained a significant amount of B lymphocytes, predominantly dispersed in the stroma surrounding tumor deposits (mean peritumoral and intratumoral densities: 178.7 ± 156.1 vs. 4.9 ± 6.9 cells/mm², respectively). B cells organized in follicle-like aggregates were also observed in 26% of the samples. B-cell density correlated with that of activated (CD25(+) or OX40(+)) T lymphocytes. Infiltration by CD20(+) lymphocytes did not correlate with tumor thickness, while the presence of B-cell aggregates was observed more frequently in thick melanomas. On the other hand, B-cell infiltration was more pronounced in nonmetastatic or lymph node metastatic tumors, compared to visceral metastatic ones. Accordingly, high number of these cells provided significant survival advantage (P = 0.0391 and P = 0.0136 for intra- and peritumoral infiltration, respectively). Furthermore, combination of peritumoral B-cell density with the number of activated T lymphocytes identified patient subgroups with different disease outcome, which was most favorable in the case of high density, while very poor in the case of low density of both cell types. Multivariate survival analysis identified tumor thickness and CD20(+)/OX40(+) cell density combination as significant independent prognostic factors. Taken together, our results show correlation between low number of CD20(+) B lymphocytes and melanoma progression, indicating a possible role of tumor-infiltrating B cells in antitumoral immune response. It was also reflected in better outcome of the disease since the density of B lymphocytes alone as well as in combination with that of activated T cells proved of prognostic importance in patients with malignant melanoma.
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Affiliation(s)
- Andrea Ladányi
- Center of Surgical and Molecular Tumor Pathology, National Institute of Oncology, 7-9. Ráth György u., Budapest 1122, Hungary.
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Ansari J, Chehrei A, Amini M, Alizade SH, Sanei MH. The Prognostic Significance of Her2-Neu Over expression in Gastric Carcinomas. IRANIAN JOURNAL OF CANCER PREVENTION 2011; 4:170-6. [PMID: 26322194 PMCID: PMC4551287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Accepted: 09/12/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND Her2/neu is one of the epidermal growth factor receptors families and seems to have prognostic significance of some solid tumors. The objective of this study is to evaluate the possibility of Her2 expression in gastric cancers and the possible relationship of Her2 with tumor's clinicopathologic parameters and also its prognostic role. METHODS This study was performed on 100 cases of gastric carcinoma with stage I b to III (according to TNM staging). Survival, recurrence date of patients, grade and lymph nodes involvement were assessed. Her2/neu expression was determined by immunohistochemical method on received sample blocks. Survival of patients with or without Her2-neu expression were evaluated by Kaplan- Meier method and compared with the log-rank test followed by multivariate analysis using Cox regression. RESULTS Seven cases were 3+ membranous Her2 reactivity, 5 cases were 2+ and13 cases were 1+; also 75% of cases demonstrated no reactivity. Regardingrelationship between tumor grade and membranous Her2 , all patients with poorly differentiated tumors were Her2 negative but patients with moderate and well differentiated tumor had 18.1% and 19.6% Her2 reactivity respectively; there were no significant difference between groups statistically(P>0.05). Median overall survival was 27.25 and 46 months in Her2 negative and her2 positive cases respectively; there were no significant difference between groups statistically as well (P>0.05). CONCLUSION Her2 reactivity has not relationship with tumor grade and lymph node involvement as well as tumor stage. From the other point of view no significant correlation is found between Her2 expression and disease free survival or overall survival of gastric cancer patients.
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Affiliation(s)
- J Ansari
- Dept. of Radiation Oncology, Aiatollah Khoansari Hospital, Arak University of Medical Sciences, Arak, Iran,Corresponding Author:
Jamshid Ansari MD; Radiation Oncologist
Tel: (+98) 861 36 70 004
| | - A Chehrei
- Dept. of Pathology, Amiralmoamenin Hospital, Arak University of Medical Sciences, Arak, Iran
| | - M Amini
- Dept. of Surgery, Valiasr Hospital, Arak University of Medical Sciences, Arak, Iran
| | - SH Alizade
- Dept. of Surgery, Valiasr Hospital, Arak University of Medical Sciences, Arak, Iran
| | - MH Sanei
- Dept. of Pathology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Clinicopathological characteristics and prognostic analysis of gastric cancer in the young adult in China. Tumour Biol 2010; 32:509-14. [DOI: 10.1007/s13277-010-0145-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 12/06/2010] [Indexed: 02/07/2023] Open
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Qiu MZ, Wang ZQ, Luo HY, Zhang DS, Zhou ZW, Li YH, Jiang WQ, Xu RH. Prognostic analysis in node-negative gastric cancer patients in China. Tumour Biol 2010; 32:489-92. [PMID: 21181465 DOI: 10.1007/s13277-010-0142-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 12/01/2010] [Indexed: 10/18/2022] Open
Abstract
Gastric cancer patients with negative nodes were considered to have better outcomes, however, some of them still suffered from disease recurrences or distant metastases after radical resection. A total of 1,020 gastric carcinoma patients receiving treatment in our center between 2003 and 2008 were selected for the analysis. All patients received gastrectomy and D2 lymphadenectomy. Survival analysis was performed with Cox regression model. The final study includes 222 patients. The overall 5-year disease-specific survival rate was 73.0%. Factors bearing significant association with lower survival on univariate analysis included the age of 58 years old or more (P = 0.021), tumor size longer than 4 cm (P < 0.001), presence of angiolymphatic invasion (P = 0.006), proximal site (P = 0.030), serosal invasion (T3+T4, P = 0.003), and higher TNM stage (P < 0.001). Only three factors including serosal invasion, tumor size at least 4.0 cm, and presence of angiolymphatic invasion remained independent negative predictors of survival in multivariable analysis. These parameters can be employed to select node-negative gastric cancer patients for an adjuvant setting and close follow-up scheduling.
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Affiliation(s)
- Miao-zhen Qiu
- State Key Laboratory of Oncology in South China, Guangzhou 510060, China
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Expression of thymidylate synthase determines the response of gastric cancer patients undergoing gastrectomy to 5-fluorouracil-based adjuvant chemotherapy. Langenbecks Arch Surg 2009; 395:217-25. [PMID: 20012317 DOI: 10.1007/s00423-009-0573-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 11/05/2009] [Indexed: 01/12/2023]
Abstract
PURPOSE We investigated whether the intensity of thymidylate synthase (TS) staining in tissue samples obtained from gastric cancer (GC) patients undergoing gastrectomy could predict response to 5-FU-based adjuvant chemotherapy after gastrectomy. METHOD AND MATERIALS Clinicopathological features of 124 patients with histologically proven GC who underwent radical gastrectomy were retrospectively reviewed. Tissue samples obtained from these patients were immunohistochemically stained for assessing TS expression. We arbitrarily classified the TS staining results as low (<20% cytoplasmic immunostaining) and high (> or =20% cytoplasmic immunostaining) TS expression. RESULTS The clinicopathological features of the low TS expression group patients were typically similar to those of the high TS expression group patients. However, multivariate forward stepwise logistic regression analysis revealed that low TS expression was independently associated with females and responders to 5-FU-based adjuvant chemotherapy. The median follow-up duration for the 124 GC patients who had undergone curative resection was 41.3 months. The GC patients who showed poor tumor differentiation and high TS expression had short disease-free survival (DFS) and overall survival (OS). CONCLUSIONS Low TS expression is significantly associated with female GC patients and responders to 5-FU-based adjuvant chemotherapy. It predicts longer DFS and OS in selected GC patients treated with 5-FU-based adjuvant chemotherapy after curative resection. The results suggest that prospective assessment of TS staining intensity in tissue samples obtained from GC patients undergoing gastrectomy would be useful to predict the patients who would be benefited from 5-FU-based adjuvant chemotherapy after gastrectomy.
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Kamata I, Ishikawa Y, Akishima-Fukasawa Y, Ito K, Akasaka Y, Uzuki M, Fujimoto A, Morita H, Tamai S, Maehara T, Ogata K, Shimokawa R, Igarashi Y, Miki K, Ishii T. Significance of lymphatic invasion and cancer invasion-related proteins on lymph node metastasis in gastric cancer. J Gastroenterol Hepatol 2009; 24:1527-33. [PMID: 19383080 DOI: 10.1111/j.1440-1746.2009.05810.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Cancer invasion and metastasis are critical events for patient prognosis; however, the most important step in the whole process of lymph node (LN) metastasis in gastric cancer remains obscure. In this study, the significance of cancer cell behaviors, such as cell detachment, stromal invasion and lymphatic invasion on regional LN metastasis in gastric cancer was investigated by comprehensive immunohistochemistry. METHODS A total of 210 cases with gastric cancer were selected. These consisted of 105 cases with regional LN metastasis (LN[+] group) and 105 cases without LN metastasis (LN[-] group). Both groups exhibited the same depth of invasion. Cancer tissues were subjected to immunohistochemistry with antibodies against claudin-3, claudin-4, beta-catenin, matrix metalloproteinase (MMP)-1, and MMP-2, as well as endothelial markers of lymphatic vessel endothelial hyaluronan receptor-1 and von Willebrand factor for the objective discrimination between lymphatics and blood vessels. The expression of each protein as well as the histopathological parameters were compared between LN(+) and LN(-) groups. RESULTS Along with lymphatic invasion by cancer cells and gross tumor size, MMP-1 expression in cancer cells at the invasive front of the primary tumor was a significant, independent predictor of LN metastasis. The expression of claudins and beta-catenin was associated with the histopathological type of cancer, but not with LN status. CONCLUSION Among the cancer invasion-related proteins examined, MMP-1 plays a vital role in LN metastasis of gastric cancer. Tumor size, lymphatic invasion and MMP-1 expression level at the invasive front were the predictive factors of LN metastasis of gastric cancer.
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Affiliation(s)
- Itaru Kamata
- Department of Pathology, Toho University School of Medicine, Tokyo, Japan
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Kim JH, Park SS, Park SH, Kim SJ, Mok YJ, Kim CS, Lee JH, Kim YS. Clinical significance of immunohistochemically-identified lymphatic and/or blood vessel tumor invasion in gastric cancer. J Surg Res 2009; 162:177-83. [PMID: 20031164 DOI: 10.1016/j.jss.2009.07.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2008] [Revised: 06/30/2009] [Accepted: 07/10/2009] [Indexed: 12/16/2022]
Abstract
BACKGROUND Tumor invasion and lymph node metastasis are significant prognostic factors for gastric cancer, and lymphatic and vascular tumor invasion are also significant risk factors for gastric cancer recurrence. Recently, the immunohistochemical detection of lymphatic and blood vessel tumor invasion (LBVI) has been shown to have a higher sensitivity and specificity than hematoxylin-eosin staining methods. MATERIALS AND METHODS One hundred forty-nine gastric cancer patients who underwent curative resection at Korea University Hospital between November 2003 and December 2006 served as the study subjects. Lymphatic vessel invasion was evaluated by immunostaining with the new selective marker, D2-40, and blood vessel invasion was assessed with anti-CD31 antibody. Patients were divided according to the presence of LBVI, clinicopathologic factors were compared, and postoperative surgical outcomes were analyzed. RESULTS LBVI was present in 66 patients (44.3%). LBVI was significantly correlated with depth of tumor invasion (P < 0.001), lymph node stage (P < 0.001), and lymph node micrometastasis (P = 0.013). Cancer recurrence was more common in the LBVI group (P = 0.007), and peritoneal seeding was the most prevalent type of recurrence (P = 0.028). Univariate analysis showed tumor size, depth of tumor invasion, lymph node stage, and LBVI to have a significant impact on survival. Based on multivariate analysis, however, depth of tumor invasion and lymph node stage were correlated with survival. CONCLUSION Immunohistochemical demonstration of LBVI is an additional prognostic marker, and provides useful information for planning treatment strategies in gastric cancer patients.
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Affiliation(s)
- Jong-Han Kim
- Department of Surgery, Korea University College of Medicine, Ansan City, Gyeong gi-Do, Korea.
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Payette MJ, Katz M, Grant-Kels JM. Melanoma prognostic factors found in the dermatopathology report. Clin Dermatol 2009; 27:53-74. [PMID: 19095154 DOI: 10.1016/j.clindermatol.2008.09.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Significant prognostic information is available in a routine melanoma dermatopathology report. Features that are enumerated in the pathology report and that portend a potentially poorer prognosis are older age, site (acral, head, neck), male sex, increasing Breslow tumor thickness, increasing Clark's level, ulceration, increasing number of mitoses, vertical growth phase, regression, absence of a host inflammatory response, increased tumor vascularity, angiotropism, vascular invasion, neurotropism, marked atypia, and satellite metastasis.
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Affiliation(s)
- Michael J Payette
- Department of Dermatology, MC-6230, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA
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Zhang H, Pan Z, Du L, Yan C, Ding B, Song Q, Ling H, Chen K. Advanced gastric cancer and perfusion imaging using a multidetector row computed tomography: correlation with prognostic determinants. Korean J Radiol 2008; 9:119-27. [PMID: 18385558 PMCID: PMC2627224 DOI: 10.3348/kjr.2008.9.2.119] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objective To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. Materials and Methods A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti- CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. Results The mean perfusion values and MVD for tumors were as follows: BF (48.14±16.46 ml/100 g/min), BV (6.70±2.95 ml/100 g), MTT (11.75±4.02 s), PS (14.17±5.23 ml/100 g/min) and MVD (41.7±11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p = 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). Conclusion The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.
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Affiliation(s)
- Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai, China.
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Deng JY, Liang H, Sun D, Zhan HJ, Zhang RP. Analysis of risk factors for the interval time, number and pattern of hepatic metastases from gastric cancer after radical gastrectomy. World J Gastroenterol 2008; 14:2440-7. [PMID: 18416477 PMCID: PMC2705105 DOI: 10.3748/wjg.14.2440] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze the risk factors for interval time, number and pattern of hepatic metastases from gastric cancer after radical gastrectomy, and provide evidence for predicting and preventing hepatic metastasis from gastric cancer after radical gastrectomy.
METHODS: A retrospective study of 87 patients with hepatic metastasis who underwent radical gastrectomy for gastric cancer from 1996 to 2001. The data was analyzed to evaluate significant risk factors for interval time, number and pattern of hepatic metastases originating from gastric cancer after radical gastrectomy.
RESULTS: The size of gastric cancer and lymph node metastases were independently correlated with the interval time of hepatic metastases; the depth of invasion was independently correlated with the number of hepatic metastases; while the depth of invasion and Lauren classification were independently correlated with the pattern of hepatic metastases.
CONCLUSION: We evaluated the interval time of hepatic metastases with the size of gastric cancer and lymph node metastases. The depth of invasion could be used to evaluate the number of hepatic metastases, while the depth of invasion and the Lauren classification could be used to evaluate the pattern of hepatic metastases in patients who underwent radical gastrectomy.
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Mader AMAA, Patrício FRDS, Rigueiro MP, Lourenço LG. [Analysis of clinicopathological, tumor cell proliferation and apoptosis parameters in adenocarcinoma of the gastric cardia]. ARQUIVOS DE GASTROENTEROLOGIA 2007; 43:184-90. [PMID: 17160232 DOI: 10.1590/s0004-28032006000300006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2005] [Accepted: 01/18/2006] [Indexed: 02/23/2023]
Abstract
BACKGROUND/AIMS In view of the increased incidence of carcinoma of the cardia over recent years, this work had the aim of studying the clinicopathological aspects, cell proliferative and tumor apoptotic indices of this neoplasm, their interrelations and possible influences on the prognosis. MATERIAL AND METHODS Forty cases of adenocarcinoma of the cardia were studied between 1988 and 2001, with a minimum clinical follow-up of 3 years. Patients were excluded if they had previous chemotherapy or radiotherapy treatment, presented early neoplasia, or died during the operations or for other reasons unrelated to cancer. Gender; age, Laurén and Ming histological type, staging, and the presence or absence of intestinal metaplasia, epithelial dysplasia and Helicobacter pylori in the adjacent mucosa were analyzed. The apoptotic index was evaluated via hematoxylin-eosin in the primary tumor. To analyze the cell proliferation tumor, PCNA was utilized. The immunohistochemical technique utilized was streptavidin-biotin-peroxidase. For the survival analysis, cases with distant metastasis upon diagnosis were excluded. For the statistical analysis, the Student t and Mann-Whitney tests, Kaplan-Meier curves and Cox regression model were utilized. RESULTS The mean age was 61 years (median: 63). There was predominance of the male gender (72.5%), diffuse histological type (55%) and infiltrative histological type (72.5%), and the more advanced stages (III and IV: 67.5%). There was no association with intestinal metaplasia and/or H. pylori. No epithelial dysplasia was detected in adjacent mucosa in any of the cases. The mean apoptotic index was 7.05 in 10 high power fields and 11.40 in 500 cells (2.28%). The mean positivity to PCNA was 275.05 cells in ten high power fields and 409.33 in 500 cells (81.9%). There was a positive correlation between the cell proliferative and apoptotic indices. There was a positive correlation for intestinal histological type with PCNA and apoptotic indices, in 10 high power fields. The mean survival was 28.41 months. Age over 63 and apoptotic index over 7.05 showed a negative correlation with survival, in multivariate analysis. CONCLUSIONS Adenocarcinoma of the cardia predominated in male adults of mean age 61 years, and the predominant type was diffuse in more advanced stages. There was a correlation between apoptosis and tumoral cell proliferation. Survival in cases of adenocarcinoma of the cardia is still low. Both age and apoptosis were independent prognostic factors in cancer of the cardia.
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del Casar JM, Corte MD, Alvarez A, García I, Bongera M, González LO, García-Muñiz JL, Allende MT, Astudillo A, Vizoso FJ. Lymphatic and/or blood vessel invasion in gastric cancer: relationship with clinicopathological parameters, biological factors and prognostic significance. J Cancer Res Clin Oncol 2007; 134:153-61. [PMID: 17628829 DOI: 10.1007/s00432-007-0264-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 06/07/2007] [Indexed: 02/06/2023]
Abstract
BACKGROUND Lymphatic and/or blood vessel tumoral invasion (LBVI) is a common histopathologic finding of gastric carcinomas, which could make it an additional cost efficient marker and help in the detection of patients at risk for recurrence. MATERIALS AND METHODS The subjects of this study were 144 patients with primary gastric adenocarcinoma, who consecutively underwent surgery. LBVI was evaluated by H&E staining and complementary with immunohistochemical staining with anti-CD34. Intratumoral levels of EGFR were analyzed with a radioligand technique, whereas c-erbB-2 and tPA were determined by ELISA methods; pS2, cathepsin D and hyaluronic acid by immunoradiometric assays; and VEGFR-1 and -2 by immunohistochemical assays. The mean follow-up period for these patients was 33.1 months. RESULTS LBVI was present in 46 patients (31.9%). The presence of LBVI correlated significantly with tumor stage, lymph node involvement, surgical resectability, histological type and histological grade, being present in a higher percentage among II-IV tumor stage (P = 0.0001), poorly differentiated (P = 0.01), diffuse type (P = 0.009), R1-R2 (P = 0.002) and lymph node-positive (P = 0.005) tumors. In addition, statistical analysis demonstrated that LBVI was significantly associated with a poorer overall patients' survival in the univariate analysis (P = 0.0001) as well as in the multivariate analysis (P = 0.009). However, our results failed to show any significant relationship between LBVI and any of the intratumoral biological parameters studied. CONCLUSION LBVI provides additional useful information that could be applied to identify gastric cancer patients at risk for recurrence, who might be candidates for further adjuvant therapies.
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Lee CC, Wu CW, Lo SS, Chen JH, Li AFY, Hsieh MC, Shen KH, Lui WY. Survival predictors in patients with node-negative gastric carcinoma. J Gastroenterol Hepatol 2007; 22:1014-8. [PMID: 17608847 DOI: 10.1111/j.1440-1746.2006.04488.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Presence or absence of nodal metastasis influences outcome of gastric cancer patients. This study gives insight into survival predictors and clinicopathological features of node-negative gastric adenocarcinoma. METHODS Between 1988 and 1999, 689 gastric cancer patients without other cancer or gastrectomy for benign disease who underwent curative resection were enrolled in this study. Clinicopathological data in patients with node metastasis were compared with those without. RESULTS The survival rate at 5 and 10 years for node-negative cases was 91.7% and 89.7%, respectively. On univariate analysis, node-negative patients were characterized by frequent location in the lower two-thirds of the stomach (84.9%), tumor size less than 4 cm (63.5%), grossly superficial type (71.6%), more medullary stromal reaction (50.5%) and intestinal type (67.7%), tumor invasion confined to serosa (78.4%), less poorly differentiated cell type (43.2%), and less lymphovascular invasion (33.4%). Multivariate analysis demonstrated that lymphovascular invasion (relative risk: 5.036) and depth of cancer invasion (relative risk: 4.404) were independent poor prognostic factors. However, lymphovascular invasion and serosal invasion were also correlated (P < 0.001). CONCLUSION Patients with node-negative gastric adenocarcinoma had less disease progression and a favorable survival. Lymphovascular invasion and depth of cancer invasion were two independent but correlated survival predictors.
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Affiliation(s)
- Chin-Chun Lee
- Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
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Cesana GC, Romano F, Piacentini G, Scotti M, Brenna A, Bovo G, Vaghi M, Aletti G, Caprotti R, Kaufman H, Uggeri F. Low-dose interleukin-2 administered pre-operatively to patients with gastric cancer activates peripheral and peritumoral lymphocytes but does not affect prognosis. Ann Surg Oncol 2007; 14:1295-304. [PMID: 17225981 DOI: 10.1245/s10434-006-9239-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Revised: 09/06/2006] [Accepted: 09/07/2006] [Indexed: 02/01/2023]
Abstract
BACKGROUND There is evidence that cancer is immunogenic under certain situations. IL-2 is described to stimulate an effective antitumor immune response in vitro and in vivo. The ability of cancer patients to undergo surgical resection is still the most important prognostic factor for many solid tumors, including gastric adenocarcinoma. The host immune system may be further compromised by surgical procedures leading to a generalized state of immunodepression in the post-operative period. The aim of this randomized case-control study is to evaluate the effects of pre-operative low-dose IL-2 treatment on patients with gastric adenocarcinoma who undergo surgery. METHODS Sixty-eight patients with gastric adenocarcinoma were enrolled in the study and randomized in two groups: 36 patients were pre-treated with IL-2 and 32 underwent surgery without any treatment. Total peripheral WBC, neutrophils, CD3(+) T, CD4(+) T, CD8(+) T and NK cells were obtained before and after surgery, at different times. Peritumoral infiltration was analyzed on all surgical specimens. Overall survival and relapse-free survival were studied with a median follow-up of 51 months. RESULTS Low-dose IL-2 treatment resulted in an increase peritumoral lymphocytic and eosinophilic infiltrations and in a minor decrease in CD3(+) T and CD4(+) T cells after surgery (P < 0.05). A stepwise multivariate analysis revealed that overall survival and relapse-free survival were affected only by stage of tumor and age of patients. CONCLUSIONS According to our data low-doses of IL-2 administered pre-operatively to patients with gastric cancer activate peripheral and peri-tumoral lymphocytes but did not affect prognosis.
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Affiliation(s)
- Giovanni Carlo Cesana
- Department of General Surgery, University of Milano-Bicocca, S. Gerardo Hospital, via Donizzetti 106, Monza, 20052 Milan, Italy.
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Deans DAC, Wigmore SJ, Gilmour H, Paterson-Brown S, Ross JA, Fearon KCH. Elevated tumour interleukin-1beta is associated with systemic inflammation: A marker of reduced survival in gastro-oesophageal cancer. Br J Cancer 2006; 95:1568-75. [PMID: 17088911 PMCID: PMC2360731 DOI: 10.1038/sj.bjc.6603446] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Systemic inflammation is associated with adverse prognosis cancer but its aetiology remains unclear. We investigated the expression of proinflammatory cytokines within normal mucosa from healthy controls and tumour tissue in cancer patients and related these levels with markers of systemic inflammation and with the presence of a tumour inflammatory infiltrate. Tissue was collected from 56 patients with gastro-oesophageal cancer and from 12 healthy controls. Tissue cytokine mRNA concentrations were measured by real-time PCR and tissue protein concentrations by cytometric bead array. The degree of chronic inflammatory cell infiltrate was recorded. Serum cytokine and acute phase protein concentrations (including C-reactive protein (CRP)) were measured by enzyme-linked immunosorbent assay. Proinflammatory cytokines were significantly overexpressed (interleukin (IL)-1β, IL-6, IL-8 and tumour necrosis factor-α) both at mRNA and protein levels in the cancer specimens compared with mucosa from controls. Interleukin-1β was expressed in greatest (10–100-fold) concentration and protein levels correlated significantly with systemic inflammation (CRP) (P=0.05, r=0.31). A chronic inflammatory infiltrate was observed in 75% of the cancer specimens and was associated with systemic inflammation (CRP: P=0.01). However, the presence of chronic inflammation per se was not associated with altered cytokine expression within the tumour. Both a chronic inflammatory infiltrate and systemic inflammation (CRP) were associated with reduced survival (P=0.05 and P=0.03, respectively). Tumour chronic inflammatory infiltrate and tumour tissue IL-1β overexpression are potential independent factors influencing systemic inflammation in oesophagogastric cancer patients.
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Affiliation(s)
- D A C Deans
- Tissue Injury and Repair Group, Department of Clinical and Surgical Sciences, MRC Centre for Inflammation Research, The Chancellor's Building, Edinburgh University, 49 Little France Crescent, Edinburgh EH16 4SB, UK
| | - S J Wigmore
- Tissue Injury and Repair Group, Department of Clinical and Surgical Sciences, MRC Centre for Inflammation Research, The Chancellor's Building, Edinburgh University, 49 Little France Crescent, Edinburgh EH16 4SB, UK
| | - H Gilmour
- Tissue Injury and Repair Group, Department of Clinical and Surgical Sciences, MRC Centre for Inflammation Research, The Chancellor's Building, Edinburgh University, 49 Little France Crescent, Edinburgh EH16 4SB, UK
| | - S Paterson-Brown
- Tissue Injury and Repair Group, Department of Clinical and Surgical Sciences, MRC Centre for Inflammation Research, The Chancellor's Building, Edinburgh University, 49 Little France Crescent, Edinburgh EH16 4SB, UK
| | - J A Ross
- Tissue Injury and Repair Group, Department of Clinical and Surgical Sciences, MRC Centre for Inflammation Research, The Chancellor's Building, Edinburgh University, 49 Little France Crescent, Edinburgh EH16 4SB, UK
| | - K C H Fearon
- Tissue Injury and Repair Group, Department of Clinical and Surgical Sciences, MRC Centre for Inflammation Research, The Chancellor's Building, Edinburgh University, 49 Little France Crescent, Edinburgh EH16 4SB, UK
- University Department of Surgery, Royal Infirmary, 51 Little France Crescent, Edinburgh EH16 4SA UK. E-mail:
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Chen CN, Hsieh FJ, Cheng YM, Chang KJ, Lee PH. Expression of inducible nitric oxide synthase and cyclooxygenase-2 in angiogenesis and clinical outcome of human gastric cancer. J Surg Oncol 2006; 94:226-33. [PMID: 16900533 DOI: 10.1002/jso.20372] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVES It has been recognized that inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX-2) produce important endogenous factors of human tumors such as nitric oxide (NO) and prostaglandins, which is involved in the process of carcinogenesis and tumor progression. This study aimed to evaluate the association of clinicopathologic factors, microvessel density, and patient survival with the expression of iNOS and COX-2 in patients with gastric adenocarcinoma. MATERIALS AND METHODS Seventy-nine specimens, resected from patients with gastric adenocarcinoma, were investigated by immunohistochemical stain against iNOS and COX-2. Microvessels were stained using anti-CD34 antibody and counted as microvessel density. RESULTS Positive iNOS and COX-2 expressions were significantly correlated with microvessel density by multivariate analysis, respectively (P = 0.0127 vs. P = 0.0214). There was significant difference among the four groups (both iNOS and COX-2 positive, iNOS positive only, COX-2 positive only, and both negative) in serosal invasion (P = 0.038), lymph node metastasis (P = 0.038), Helicobacter pylori infection (P = 0.025), vascular invasion (P = 0.035), and microvessel density (P = 0.019). In patients with gastric cancer that co-expressed iNOS and COX-2, prognosis was significantly poorer than in those that expressed either iNOS or COX-2, or did not express both of them (P = 0.01738). The Cox proportional hazard regression analysis indicated that iNOS expression, vascular invasion, serosal invasion, and microvessel density are independent prognostic factors for patients with gastric cancer. CONCLUSIONS iNOS and COX-2 expression of gastric cancer are related to tumor angiogenesis, tumor progression, and patient survival in human gastric cancer.
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Affiliation(s)
- Chiung-Nien Chen
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Varney ML, Johansson SL, Singh RK. Tumour-associated macrophage infiltration, neovascularization and aggressiveness in malignant melanoma: role of monocyte chemotactic protein-1 and vascular endothelial growth factor-A. Melanoma Res 2006; 15:417-25. [PMID: 16179869 DOI: 10.1097/00008390-200510000-00010] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The objective of this study was to evaluate the role of tumour-associated macrophages (TAMs) in malignant melanoma progression, invasion and angiogenesis. We examined the levels of macrophage infiltration and monocyte chemotactic protein-1 (MCP-1), neovascularization and vascular endothelial growth factor-A (VEGF-A) in different Clark's level melanomas with varying thicknesses and metastases. The level of TAM density was significantly higher in thick (>0.75 mm) than thin (<or=0.75 mm) melanomas, and positively correlated with melanoma invasiveness and metastasis. In contrast, MCP-1 expression was significantly lower in thick (>0.75 mm) than thin (<or=0.75 mm) melanomas and negatively correlated with melanoma aggressiveness and invasion. We did not observe any significant difference in the levels of neovascularization between thin and thick melanomas, and no correlation with VEGF-A expression, TAM density or melanoma aggressiveness and invasion. Interestingly, levels of VEGF-A were significantly higher in metastatic melanoma than in thick melanoma. In addition, we observed lower levels of MCP-1 messenger RNA (mRNA) expression in more aggressive melanomas and in cell lines with higher metastatic potential. In summary, our data suggest a distinct pattern of TAM infiltration, MCP-1 expression, neovascularization and VEGF-A expression during human melanoma progression, and a complex interaction between TAMs and melanoma cells in the regulation of melanoma progression, angiogenesis and metastasis.
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Affiliation(s)
- Michelle L Varney
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Nakahara Y, Mochiduki Y, Miyamoto Y, Nakahara Y, Katsura Y. Prognostic significance of the lymphocyte-to-neutrophil ratio in percutaneous fine-needle aspiration biopsy specimens of advanced nonsmall cell lung carcinoma. Cancer 2005; 104:1271-80. [PMID: 16047345 DOI: 10.1002/cncr.21290] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The prognostic significance of tumor-infiltrating lymphocytes (TILs) in surgically resected carcinomas was reported. To apply this to inoperable nonsmall cell lung carcinomas (NSCLC) of Stage IIIB-IV, the authors estimated the occurrence of TILs using percutaneous fine-needle aspiration biopsy specimens, and tested the validity of this method. METHODS The authors defined the L-N index as [L(S)/(L(S) + N(S)) - L(B)/(L(B) + N(B))], in which L(S) and N(S) denoted lymphocyte and neutrophil counts in the aspiration smear, and L(B) and N(B) denoted lymphocyte and neutrophil counts in the peripheral blood specimen. The cutoff value was set at twice the standard deviation of the L-N index of 41 smears contaminated with abundant blood. Retrospectively, the authors compared the survival rate of the group with a high L-N index (lymphocyte-dominant group) (n = 12) with the survival rate of the group with a low L-N index (lymphocyte-nondominant group) (n = 60). Then, they performed a prospective study and compared the survival rates of these 2 groups (n = 21 and n = 54). The Cox proportional hazards model was used to determine the effect of the L-N index as a continuous variable and other prognostic factors. The correlation (r) between the L-N index-based grouping (L-N grouping) and the histologic grade of TILs was studied among resected lung tumor specimens (n = 164). RESULTS In the retrospective and prospective studies, the survival rate was significantly higher in the lymphocyte-dominant group than in the lymphocyte-nondominant group (P = 0.0019 and P = 0.0001). Using multivariate analysis, the L-N index was an independent prognostic factor. A significant correlation was noted between L-N grouping and histologic grade of TILs (r = 0.476). CONCLUSIONS The L-N index of aspiration smears was found to be an independent prognostic factor for patients with advanced-stage NSCLC. L-N grouping was correlated with the histologic assessment of TILs.
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Affiliation(s)
- Yasuharu Nakahara
- Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, Himeji-city, Japan.
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Romano F, Cesana G, Berselli M, Gaia Piacentini M, Caprotti R, Bovo G, Uggeri F. Biological, histological, and clinical impact of preoperative IL-2 administration in radically operable gastric cancer patients. J Surg Oncol 2004; 88:240-7. [PMID: 15565596 DOI: 10.1002/jso.20155] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES Surgery induces lymphocytopenia and this decrease of host defenses, related to interleukin-2 (IL-2) endogenous imbalance during postoperative period could promote the proliferation of possible micrometastases and the implantation of surgically disseminated tumor cells. Moreover, tumor infiltrating lymphocytes (TILs), activated by endogenous IL-2 release, are linked to prognosis in cancer patients. The aim of this randomized study is to assess the biological (peripheral blood cells count, related to the grade of immunosuppression), histological (TILs), and clinical (overall and disease-free survival) impact of preoperative low doses administration of IL-2 in patients with radically operable gastric cancer. METHODS This prospective study enrolled 69 consecutive patients with histologically proven gastric adenocarcinoma who underwent radical surgery from October 1999 to December 2002 (M/F 39/30; mean age 66; range 42-82) who underwent radical surgery from October 1999 to December 2000. Patients were randomized to be treated with surgery alone as controls (35 patients) or surgery plus preoperative treatment with recombinant human IL-2 (34 patients). We considered the total lymphocyte count and lymphocyte subset (CD4, CD4/CD8) during the preoperative period, before IL-2 administration, and on the 14th and 50th day, peritumoral stromal (fibrosis) reaction, neutrophils, lymphocytes, and eosinophils infiltration in tumor histology, and morbidity disease free and overall survival were evaluated. RESULTS Two groups were well matched for type of surgery and extent of disease. All the patients underwent radical surgery plus D2 lymphadenectomy. At baseline, there were no significant differences in total lymphocyte and lymphocyte subsets between groups. The control group showed a significant decrease of total lymphocytes, CD4 cells, and CD4/CD8 ratio at the 14th postoperative day relative to the baseline value. In the control group 65% of patients had a decrease of CD4 under 500 cells/mmc. Instead it has been observed in IL-2 group a significant increase over the control group values of total lymphocytes and CD4 cells (14th total lymphocytes and CD4: IL-2 vs. control P < 0.05). Moreover in this group only 15% patients had CD4 under 500 cells/mmc. This difference, in CD4 count, is significant even at the 50th postoperative day (P = 0.006). IL-2 group showed lower postoperative complications (2/34 vs. 11/35; P < 0.05), and higher lymphocyte/eosinophil infiltration into the tumor (P < 0.0002). Median follow-up was 26 months (range 10-48) and median overall and disease-free survivals were longer, even if not significantly, in the IL-2 group than in the control arm (P = 0.07 and P = 0.06 respectively). CONCLUSIONS This randomized study would suggest that a preoperative immunotherapy with IL-2 is a well-tolerated treatment able to prevent surgery-induced lymphocytopenia. IL-2 seems to neutralize the immunosuppression induced by operation and so to stimulate the host reaction against tumor tissue (lymphocytes/eosinophils infiltration). Furthermore IL-2 seems to have an impact on clinical course reducing morbidity of surgery and ameliorating overall and disease-free survival.
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Affiliation(s)
- Fabrizio Romano
- Department of Surgery, San Gerardo Hospital--II University of Milan--Bicocca, Italy.
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