Abstract
A good prediction model is useful to accurately predict patient prognosis. Tumor–node–metastasis (TNM) staging often cannot accurately predict prognosis when used alone. Some researchers have shown that the infiltration of M2 macrophages in many tumors indicates poor prognosis. This approach has the potential to predict prognosis more accurately when used in combination with TNM staging, but there is less research in gastric cancer. A multivariate analysis demonstrated that CD163 expression, TNM staging, age, and gender were independent risk factors for overall survival. Thus, these parameters were assessed to develop the nomogram in the training data set, which was tested in the validation and whole data sets. The model showed a high degree of discrimination, calibration, and good clinical benefit in the training, validation, and whole data sets. In conclusion, we combined CD163 expression in macrophages, TNM staging, age, and gender to develop a nomogram to predict 3- and 5-year overall survivals after curative resection for gastric cancer. This model has the potential to provide further diagnostic and prognostic value for patients with gastric cancer.
Highlights
More than one million new cases and 783,000 deaths from gastric cancer occurred in 2018
The pathological diagnostic results were confirmed by two independent gastroenterology pathology doctors, and the gastric cancer classifications were made based on the 8th Tumor–node– metastasis (TNM) staging classification for gastric cancer
The results showed that CD68, human leukocyte antigen DR isotype (HLA-DR) (M1 macrophage marker), and CD163 (M2 macrophage marker) were expressed in the cell membrane and cytoplasm
Summary
More than one million new cases and 783,000 deaths from gastric cancer occurred in 2018. Gastric cancer is the third leading cause of cancer death [1]. The degree of tumor invasiveness, number of positive lymph nodes, and distant metastasis are important factors influencing the prognosis of patients with gastric cancer. As the concept of precision medicine gains popularity, we need to more comprehensively explore the factors that influence and predict the prognosis of patients with gastric cancer. Emerging studies have highlighted that macrophages are important regulators of therapeutic responses and tumor progression, including proliferation, invasion, and apoptosis [1,2,3,4,5]. Macrophages are usually of two different subtypes: M1 and M2. M1 macrophages secrete proinflammatory cytokines that suppress pathogenic infection and fight against malignancy. M1 macrophage surface markers include the human leukocyte antigen DR isotype (HLA-DR), Abbreviations: M1, M1-type tumor-associated macrophage; M2, M2-type tumor-associated macrophage; HR, Hazard ratio
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