Department of Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Department of Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan; Department of Upper Gastroenterological Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
J Surg Res. 2020 Jan;245:552-563. doi: 10.1016/j.jss.2019.07.095. Epub 2019 Aug 28.
It is elusive which subtypes of immune cells are pivotal in cancer progression and prognosis in gastric cancer (GC). The aim of this study is to clarify clinical impact of immature myeloid-derived immune cells in patients with GC who underwent curative gastrectomy with curative lymphadenectomy and treated with S-1 (tegafur/gimeracil/oteracil) postoperatively.
The prognostic impact of recruited CD33+ immature myeloid-derived cells were clinicopathologically analyzed in curatively resected stage II and III GC. Correlation of preoperative peripheral leukocyte fractions with recruited CD33+ immature cells was also assessed.
Patients with high CD33+ cell counts in primary tumor showed dramatically worse prognosis (5-y recurrence-free survival 29.0%) than that of the counterparts (79.4%). High CD33+ cell counts independently predicted poor prognosis in stage II/III (hazard ratio, 4.34; P < 0.001). In analyses of each stage, high CD33+ cell count was pivotally associated with poor prognosis in both stages. There was no significant correlation of each peripheral leukocyte fraction with CD33+ cell recruitment. Of note, high CD33+ cell count was significantly correlated with hematogenous recurrence.
Recruitment of CD33+ immature myeloid cells critically predict hematogenous recurrences in curatively resected advanced GC. These results give rational to focusing on CD33+ myeloid-derived cells as a novel approach to tackle advanced GC.
胃癌（GC）中哪种免疫细胞亚型在癌症进展和预后中起关键作用尚不清楚。本研究旨在阐明在接受根治性胃切除术和根治性淋巴结清扫术且术后接受 S-1（替加氟/吉美嘧啶/奥替拉西）治疗的 GC 患者中，幼稚髓系来源免疫细胞对临床的影响。
在可治愈的 II 期和 III 期 GC 中，对募集的 CD33+幼稚髓系细胞的预后影响进行了临床病理分析。还评估了术前外周白细胞分数与募集的 CD33+幼稚细胞之间的相关性。
原发肿瘤中 CD33+细胞计数高的患者预后明显较差（5 年无复发生存率 29.0%），而 CD33+细胞计数低的患者预后较好（79.4%）。高 CD33+细胞计数独立预测 II/III 期患者的不良预后（危险比，4.34；P<0.001）。在每个阶段的分析中，高 CD33+细胞计数与两个阶段的不良预后均密切相关。各外周白细胞分数与 CD33+细胞募集均无显著相关性。值得注意的是，高 CD33+细胞计数与血行复发显著相关。
CD33+幼稚髓系细胞的募集可显著预测可治愈的晚期 GC 中的血行复发。这些结果为将 CD33+髓系来源细胞作为治疗晚期 GC 的新方法提供了合理依据。
