Kentaro Sekizawa1, Kazuya Nakagawa1, Yasushi Ichikawa2, Hirokazu Suwa3, Mayumi Ozawa1, Masashi Momiyama1, Atsushi Ishibe1, Jun Watanabe3, Mitsuyoshi Ota3, Ikuma Kato4, Itaru Endo5. 1. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. 2. Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 3. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan. 4. Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 5. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. endoit@yokohama-cu.ac.jp.
Abstract
BACKGROUND: In addition to the direct power of anticancer drugs, the effectiveness of anticancer therapy depends on the host immune function. The present study investigated whether or not the reduction rate and histological response of preoperative chemotherapy were related to the immune microenvironment surrounding a primary tumor of the rectum. METHODS: Sixty-five patients received preoperative chemotherapy followed by resection from 2012 to 2014; all of these patients were retrospectively analyzed. CD3, CD8, and FoxP3 were immunohistochemically examined as markers for T lymphocytes, cytotoxic T lymphocytes, and regulatory T lymphocytes (Treg), respectively. The correlation between the tumor-infiltrating lymphocyte composition and the tumor reduction rate and histological response to neoadjuvant chemotherapy was investigated. RESULTS: The average tumor reduction rate was 41.5% ± 18.8%. According to RECIST, 47 patients (72.3%) achieved a partial response (PR), and 1 patient (1.5%) achieved a complete response (CR). Eight patients (12.3%) showed a grade 2 histological response, and 2 (3.1%) showed a grade 3 response. A multivariate analysis demonstrated that a low Treg infiltration in stromal cell areas was significantly associated with the achievement of a PR or CR [odds ratio (OR) 7.69; 95% confidence interval (CI) 1.96-33.33; p < 0.01] and a histological grade 2 or 3 response (OR 11.11; 95% CI 1.37-98.04; p = 0.02). CONCLUSION: A low Treg infiltration in the stromal cell areas may be a marker of a good response to neoadjuvant chemotherapy in patients with locally advanced rectal cancer.
BACKGROUND: In addition to the direct power of anticancer drugs, the effectiveness of anticancer therapy depends on the host immune function. The present study investigated whether or not the reduction rate and histological response of preoperative chemotherapy were related to the immune microenvironment surrounding a primary tumor of the rectum. METHODS: Sixty-five patients received preoperative chemotherapy followed by resection from 2012 to 2014; all of these patients were retrospectively analyzed. CD3, CD8, and FoxP3 were immunohistochemically examined as markers for T lymphocytes, cytotoxic T lymphocytes, and regulatory T lymphocytes (Treg), respectively. The correlation between the tumor-infiltrating lymphocyte composition and the tumor reduction rate and histological response to neoadjuvant chemotherapy was investigated. RESULTS: The average tumor reduction rate was 41.5% ± 18.8%. According to RECIST, 47 patients (72.3%) achieved a partial response (PR), and 1 patient (1.5%) achieved a complete response (CR). Eight patients (12.3%) showed a grade 2 histological response, and 2 (3.1%) showed a grade 3 response. A multivariate analysis demonstrated that a low Treg infiltration in stromal cell areas was significantly associated with the achievement of a PR or CR [odds ratio (OR) 7.69; 95% confidence interval (CI) 1.96-33.33; p < 0.01] and a histological grade 2 or 3 response (OR 11.11; 95% CI 1.37-98.04; p = 0.02). CONCLUSION: A low Treg infiltration in the stromal cell areas may be a marker of a good response to neoadjuvant chemotherapy in patients with locally advanced rectal cancer.
Authors: Corrie A M Marijnen; Cornelis J H van de Velde; Hein Putter; Mandy van den Brink; Cornelis P Maas; Hendrik Martijn; Harm J Rutten; Theo Wiggers; Elma Klein Kranenbarg; Jan-Willem H Leer; Anne M Stiggelbout Journal: J Clin Oncol Date: 2005-03-20 Impact factor: 44.544
Authors: K C M J Peeters; C J H van de Velde; J W H Leer; H Martijn; J M C Junggeburt; E Klein Kranenbarg; W H Steup; T Wiggers; H J Rutten; C A M Marijnen Journal: J Clin Oncol Date: 2005-09-01 Impact factor: 44.544
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Authors: K Hiraoka; M Miyamoto; Y Cho; M Suzuoki; T Oshikiri; Y Nakakubo; T Itoh; T Ohbuchi; S Kondo; H Katoh Journal: Br J Cancer Date: 2006-01-30 Impact factor: 7.640