Immunophenotype based on inflammatory cells, PD-1/PD-L1 signalling pathway and M2 macrophages predicts survival in gastric cancer
Junttila, A., Helminen, O., Väyrynen, J. P., Ahtiainen, M., Kenessey, I., Jalkanen, S., Mecklin, J.-P., Kellokumpu, I., Kuopio, T., Böhm, J., & Mrena, J. (2020). Immunophenotype based on inflammatory cells, PD-1/PD-L1 signalling pathway and M2 macrophages predicts survival in gastric cancer. British Journal of Cancer, 123(11), 1625-1632. https://doi.org/10.1038/s41416-020-01053-7
Published inBritish Journal of Cancer
© The Author(s), under exclusive licence to Cancer Research UK 2020
Background: Immune response against cancer has prognostic impact but its role in gastric cancer is poorly known. The aim of the study was to assess the prognostic significance of immune cell score (CD3+, CD8+), tumour immune escape (PD-L1, PD-1) and immune tolerance (Clever-1). Methods: After exclusion of Epstein-Barr virus positive (n = 4) and microsatellite instable (n = 6) tumours, the study included 122 patients with GC undergoing D2 gastrectomy. CD3+ and CD8+ based ICS, PD-L1, PD-1 and Clever-1 expressions were evaluated. Differences in survival were examined using Cox regression adjusted for confounders. The primary outcome was 5-year survival. Results: The 5-year overall survival rate was 43.4%. High ICS was associated with improved overall survival (adjusted HR 0.48 (95% CI 0.26-0.87)) compared to low ICS. In the high ICS group, patients with PD-L1 expression (5-year survival 69.2 vs. 53.1%, p = 0.317), high PD-1 (5-year survival 70.6 vs. 55.3% p = 0.312) and high Clever-1 (5-year survival 72.0% vs. 45.5% (p = 0.070) had poor prognosis. Conclusions: High ICS was associated with improved survival. In the high ICS group, patients with high PD-L1, PD-1 and Clever-1 had poor prognosis highlighting the importance of immune escape and immune tolerance in GC. ...
PublisherNature Publishing Group
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Additional information about fundingThis study was funded by the Finnish State Research Funding (O.H.), the Instrumentarium Science Foundation (O.H.) and the Mary and Georg C. Ehrnrooth Foundation (O.H.).
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