Abstract
Objective: to study the state of cellular immunity in patients with gastric adenocarcinoma.Materials and methods. From 2017 to 2018, 45 previously untreated patients with gastric adenocarcinoma (25 with stage I–III, 20 with stage IV) received surgical / combined treatment or independent chemotherapy, respectively, at the N. N. Blokhin National Medical ResearchCenter of Oncology. Peripheral blood sampling was carried out before starting treatment. We studied the cellular composition of peripheral blood, as well as systemic immunity parameters determined by flow cytometry (CD3+CD4+; CD3+CD8+; CD4+CD8+; CD4+/CD8+; CD3–CD16+CD56+; CD3–CD19+), and their prognostic significance in relation to overall survival and progression-free survival.Results. The prognostic value of the relative indicator of platelet lymphocytic index was determined: progression-free survival in patients with a high level of platelet-lymphocytic index (>208.7) was higher: 8.1 months versus 4.5 months (p = 0.0027). A favorable prognosis for overall survival was an increase in the number of CD3–CD19+ lymphocytes (hazard ratio (HR) 0.91; 95 % confidence interval (CI) 0.85–0.97; p = 0.007), and an unfavorable prognosis was an increase in the number of neutrophils (HR 1.26; 95 % CI 1.05–1.50; p = 0.012), platelet count (HR 1.01; 95 % CI 1.0–1.01; p = 0.043), as well as an increase in the number of NK cells (HR 1.04, 95 % CI 1.0–1.09; p = 0.029).Conclusion. Indicators of the cellular composition of peripheral blood, characterizing a systemic inflammatory reaction, as well as indicators of systemic immunity, can serve as additional prognostic factors for gastric cancer.
Highlights
ФГБУ «Национальный медицинский исследовательский центр онкологии им
We studied the cellular composition of peripheral blood, as well as systemic immunity parameters determined by flow cytometry (CD3+CD4+; CD3+CD8+; CD4+CD8+; CD4+ / CD8+; CD3 – CD16+CD56+; CD3 – CD19+), and their prognostic significance in relation to overall survival and progression-free survival
A favorable prognosis for overall survival was an increase in the number of CD3 – CD19+ lymphocytes (hazard ratio (HR) 0.91; 95 % confidence interval (CI) 0.85–0.97; p = 0.007), and an unfavorable prognosis was an increase in the number of neutrophils (HR 1.26; 95 % CI 1.05–1.50; p = 0.012), platelet count (HR 1.01; 95 % CI 1.0–1.01; p = 0.043), as well as an increase in the number of NK cells (HR 1.04, 95 % CI 1.0–1.09; p = 0.029)
Summary
Исследовали клеточный состав периферической крови, а также параметры системного иммунитета, определенных методом проточной цитометрии (CD3+CD4+; CD3+CD8+; CD4+CD8+; CD4+ / CD8+; CD3 – CD16+CD56+; CD3 – CD19+), и их прогностическую значимость в отношении показателей общей выживаемости и выживаемости без прогрессирования. Анализ данных литературы последних лет показал несомненную прогностическую ценность системных воспалительных индексов, основанных на подсчете соотношений нейтрофилов, лимфоцитов и тромбоцитов в периферической крови пациентов с колоректальным раком [10], РЖ [11, 12] и гепатоцеллюлярным раком [13], что позволяет использовать эти показатели в клинической практике на этапе планирования комплексного лечения пациентов со злокачественными новообразованиями, а также максимально рано выявлять признаки развития рецидива заболевания. Анализ показателей субпопуляций лимфоцитов периферической крови осуществляли методом проточной цитометрии в целях определения структуры иммунных клеток CD3+CD4+; CD3+CD8+; CD4+CD8+; CD4+ / CD8+; CD3 – CD16+CD56+; CD3 – CD19+.
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