ABSTRACT
BACKGROUND: Tumor-infiltrating lymphocytes (TILs) and other immune cells have been reported as a prognostic factor in several tumors, including gastric cancer, and they play an important role in antitumor effect at the primary site. There were few reports on the immune status in peritoneal metastatic lesions for gastric cancer. AIMS: The aims of this study were to assess the prognostic significance of TILs (CD4, CD8, CD19, regulatory T cells [Tregs]), and myeloid-derived suppressor cells (MDSCs) in peritoneal metastatic lesions. METHODS: We retrospectively investigated 60 patients for gastric cancer with peritoneal metastasis who were treated between 2009 and 2016 in our institute. Immunohistochemistry for CD4, CD8, CD19, FOXP3, and CD33 was performed in the peritoneal metastatic lesions. The absolute numbers of immune cells and ratios were evaluated, and the relationship between immune-related marker and overall survival (OS) was investigated. RESULTS: A high infiltration of CD8+ lymphocytes or high CD8/CD33 ratio was a better prognosis for OS in univariate analysis using all immunologic variables (P = .012, P = .001). In multivariate analysis for clinical and immunologic variables, high CD8/CD33 ratio was identified as an independent prognostic factor for OS (Hazard ratio: 0.291, 95% confidence interval: 0.126-0.670, P = .004). CONCLUSION: High CD8/CD33 ratio and high infiltration of CD8+ lymphocytes in peritoneal metastatic lesions were favorable prognoses for gastric cancer patients with peritoneal metastasis. It is necessary to modify the immune microenvironment result to increase the level of CD8+ lymphocytes in the peritoneal metastatic lesions.
Subject(s)
CD8 Antigens/immunology , CD8-Positive T-Lymphocytes/immunology , Gastrectomy/mortality , Lymphocytes, Tumor-Infiltrating/immunology , Peritoneal Neoplasms/secondary , Sialic Acid Binding Ig-like Lectin 3/metabolism , Stomach Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/analysis , CD8 Antigens/metabolism , Female , Follow-Up Studies , Humans , Male , Middle Aged , Peritoneal Neoplasms/immunology , Peritoneal Neoplasms/metabolism , Peritoneal Neoplasms/surgery , Prognosis , Retrospective Studies , Stomach Neoplasms/immunology , Stomach Neoplasms/metabolism , Stomach Neoplasms/surgery , Survival Rate , T-Lymphocytes, Regulatory/immunology , Tumor MicroenvironmentABSTRACT
We report a case of ascending colon cancer with right extra iliac lymph node metastases. A 60s-year-old woman underwent right hemicolectomy with lymph node dissection in July 2011. Pathological diagnosis was T4 (SE), N1 (2/42), M0, stage â ¢A. Adjuvant chemotherapy with tegafur/uracil was administered after the operation for 6 months. One year after the operation, the serum carcinoembryonic antigen (CEA) level was gradually increasing. Three years after the operation, positron emission tomography-computed tomography (PET-CT) delineated a 3 cm mass with an abnormal signal on the right lower abdominal side of the external iliac vessels. The diagnosis was an isolated remnant tumor in the right extra iliac vessels area from the primary ascending colon cancer. Other recurrent lesions were not found; therefore, resection of this mass was performed. Pathological findings confirmed lymph node metastases from the ascending colon cancer. This type of metastasis is extremely rare, and more case reports are needed to determine the mechanism behind these metastases.
Subject(s)
Colon, Ascending/pathology , Colonic Neoplasms/pathology , Lymph Nodes/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant , Colon, Ascending/surgery , Colonic Neoplasms/drug therapy , Colonic Neoplasms/secondary , Female , Humans , Lymph Node Excision , Lymphatic Metastasis , Prognosis , Tegafur/administration & dosage , Uracil/administration & dosageABSTRACT
A 70s-year-old man was referred to our hospital because of sigmoid colon cancer. Computed tomography (CT) revealed a large mass in the right lobe of the liver and small masses in Couinaud segments â £ and â ¥. We started systemic chemotherapy with mFOLFOX6 and panitumumab. After 6 courses of the treatment, the size and number of the liver metastases was remarkably reduced on CT. We performed a simultaneous laparoscopic resection for the primary tumor and synchronous liver metastases. The postoperative course was uneventful and he had no signs of recurrence 12 months after surgery.
