Saitama Medical University, Saitama, Japan
Masahiko Shibata , Kenji Gonda , Takahiro Nakajima , Yoshiko Matsumoto , Izumi Nakamura , Shinji Ohki , Tohru Ohtake , Kensuke Kumamoto , Tatsuo Shimura , Seiichi Takenoshita , Noriko Abe , Tomoyuki Momma
Background: A suppression of cell mediated immunity and malnutrition are commonly seen in patients with advanced cancer and it has been reported that chronic inflammation plays a key role in induction of these conditions. We have reported that MDSC: myeloid-derived suppressor cells, found as a new type of immune suppressor cells that is closely related to chronic inflammation, is increased in patients with various types of cancer including gastrointestinal, hepatopancreatic, breast, thyroid and ovarian cancers, and the levels of MDSC were closely related to systemic inflammation, immunosuppression and nutritional impairment. Methods: Peripheral blood mononuclear cells (PBMC) were collected from 123 preoperative patients with gastrointestinal cancer including 18 patients with esophageal, 43 with gastric, 62 with colorectal cancers, and these cells were used for the detection of MDSC (CD11b+CD14-CD33+) by flow cytometry. The circulating levels of MDSC were divided with 1.02% of PBMC which is the median level in healthy volunteer, and the prognosis of these patients was analysed with Kaplan-Meier method. Results: In patients with stage IV disease, the overall survival (OS) was significantly shorter (p<0.05) in patients with high MDSC levels than in those with low MDSC levels. Although in patients with high MDSC levels, both of OS and DFS (disease free survival) of the patients with stage IV diseases were shorter (both p<0.001) than those with stages I, II, and III diseases, there were no significant difference in those with low MDSC levels. Furthermore, in patients with colorectal cancer, the OS was shorter in stage IV patients with high MDSC levels than in stage IV patients with low MDSC levels. However, OS was not significantly different with MDSC levels in patients with Stages I, II, and III diseases. Conclusions: Therefore, the pretreatment levels of MDSC is effective as a good prognostic indicator especially in patients with advanced gastrointestinal cancers.
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Abstract Disclosures
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