Department of Gastrointestinal Surgery, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Pudong New Area, Shanghai, 200025, China.
Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200025, China.
J Transl Med. 2019 Jun 7;17(1):192. doi: 10.1186/s12967-019-1929-9.
Gastric cancer (GC) remains a refractory cancer worldwide. Currently, exploring the differences of the immune status in GC patients with different subgroups might provide promising immunotherapeutic approaches for the treatment of GC.
In this study, a total of 598 surgically resected FFPE primary gastric cancer samples were assessed for FOXP3, CD163, CD3, CD8, and PD-L1 markers. The correlations between the immune markers expression and clinicopathological features and prognosis were investigated retrospectively.
In general, PD-L1, CD3, and CD8 could be regarded as favorable prognostic factors. Our data demonstrated that high infiltration of FOXP3 Treg indicates better prognosis in stage I-II patients, while the converse outcome was noted in stage III-IV patients. Our data also confirmed different prognostic value in different pathological classifications, chemotherapy strategies, and locations, with or without lymph node metastasis. Also, M2 macrophages indicated poor prognosis in general. However, high M2 macrophage infiltration suggests a favorable prognosis in signet ring cell carcinoma and mucinous adenocarcinoma. Moreover, the prognostic value of the two indices when they are combined is reported.
These results suggested that different immune statuses are exhibited in different subgroups of GC, which may direct further understanding of the immune status of GC as well as provide a further theoretical basis and potential targets for GC immunotherapy.
胃癌（GC）仍然是全球范围内一种难治性癌症。目前，探索不同亚组 GC 患者免疫状态的差异，可能为 GC 的治疗提供有前景的免疫治疗方法。
本研究共评估了 598 例手术切除的 FFPE 原发性胃癌样本中 FOXP3、CD163、CD3、CD8 和 PD-L1 标志物的表达情况。回顾性分析了免疫标志物表达与临床病理特征和预后的关系。
一般来说，PD-L1、CD3 和 CD8 可作为有利的预后因素。我们的数据表明，FOXP3+Treg 浸润程度高提示 I-II 期患者预后较好，而在 III-IV 期患者中则相反。我们的数据还证实了在不同的病理分类、化疗策略以及有或无淋巴结转移的位置中，存在不同的预后价值。此外，M2 巨噬细胞通常预示着预后不良。然而，在印戒细胞癌和黏液性腺癌中，高 M2 巨噬细胞浸润提示预后较好。此外，还报告了这两个指标联合时的预后价值。
这些结果表明，GC 的不同亚组表现出不同的免疫状态，这可能有助于进一步了解 GC 的免疫状态，并为 GC 的免疫治疗提供进一步的理论基础和潜在靶点。
