Immune Cell Infiltrate and Prognosis in Gastric Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Collection
2.3. Tissue Microarray
2.4. Immunohistochemical Stainings
2.5. Immune Cell Score
2.6. KM Grade
2.7. Outcomes
2.8. Statistical Analysis
3. Results
3.1. Patients
3.2. Assessment of ICS
3.3. ICS and Survival
3.4. Assessment of Klintrup–Mäkinen Grade
3.5. Klintrup–Mäkinen Grade and Survival
3.6. Comparison of ICS and Klintrup–Mäkinen Grade
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Data Availability Statement
References
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Clinicopathological Variable | Low Immune Cell Score (n = 119) | Intermediate Immune Cell Score (n = 384) | High Immune Cell Score (n = 155) | p-Value |
---|---|---|---|---|
Year of surgery | 0.11 | |||
≥2000 | 55 (46.2%) | 218 (56.8.2%) | 88 (56.8%) | |
<2000 | 64 (53.8%) | 166 (43.2%) | 67 (43.2%) | |
Mean age at diagnosis | 68.7 | 66.5 | 67.7 | 0.14 |
Sex | 0.67 | |||
Man | 69 (58.0%) | 226 (58.9%) | 97 (62.6%) | |
Woman | 50 (42.0%) | 158 (41.1%) | 58 (37.4%) | |
Neoadjuvant chemotherapy | 0.93 | |||
Yes | 4 (3.4%) | 16 (4.2%) | 7 (4.5%) | |
No | 115 (96.6%) | 368 (95.8%) | 148 (95.5%) | |
Tumor stage | 0.048 | |||
1 or 2 | 64 (53.8%) | 238 (62.0%) | 106 (68.4%) | |
3 or 4 | 55 (46.2%) | 146 (38.0%) | 49 (31.6%) | |
Lauren class | 0.001 | |||
Intestinal | 59 (49.6%) | 170 (44.3%) | 100 (64.5%) | |
Diffuse | 56 (47.1%) | 200 (52.1%) | 52 (33.5%) | |
Mixed | 4 (3.4%) | 14 (3.6%) | 3 (1.9%) | |
Histological grade in intestinal type | 0.004 | |||
I or II | 42 (71.2%) | 116 (68.2%) | 50 (50.0%) | |
III | 17 (28.8%) | 54 (31.8%) | 50 (50.0%) | |
Radicality of resection | 0.002 | |||
R0 | 82 (68.9%) | 300 (78.1%) | 134 (86.5%) | |
R1 or R2 | 37 (31.1%) | 84 (21.9%) | 21 (13.5%) |
Survival Model | Number of Patients | Low Immune Cell Score HR (95% CI) | Intermediate Immune Cell Score HR (95% CI) | High Immune Cell Score HR (95% CI) |
---|---|---|---|---|
5-year survival | ||||
All patients (Crude) | 658 | 1.00 (Reference) | 0.74 (0.58–0.94) | 0.59 (0.44–0.79) |
All patients (Model 1) a | 658 | 1.00 (Reference) | 0.86 (0.67–1.09) | 0.70 (0.52–0.94) |
All patients (Model 2) b | 658 | 1.00 (Reference) | 0.90 (0.70–1.15) | 0.87 (0.63–1.20) |
Subgroup analysis | ||||
Intestinal-type (Crude) | 329 | 1.00 (Reference) | 0.81 (0.57–1.14) | 0.53 (0.36–0.79) |
Intestinal-type (Model 1) c | 329 | 1.00 (Reference) | 0.80 (0.56–1.14) | 0.54 (0.36–0.81) |
Intestinal-type (Model 2) d | 329 | 1.00 (Reference) | 0.85 (0.60–1.22) | 0.68 (0.43–1.07) |
Diffuse-type (Crude) | 308 | 1.00 (Reference) | 0.74 (0.53–1.04) | 0.74 (0.47–1.17) |
Diffuse-type (Model 1) e | 308 | 1.00 (Reference) | 0.95 (0.67–1.35) | 0.92 (0.58–1.46) |
Diffuse-type (Model 2) f | 308 | 1.00 (Reference) | 0.97 (0.68–1.39) | 1.05 (0.66–1.69) |
Overall survival | ||||
All patients (Crude) | 658 | 1.00 (Reference) | 0.71 (0.57–0.89) | 0.65 (0.50–0.84) |
All patients (Model 1) a | 658 | 1.00 (Reference) | 0.80 (0.64–1.00) | 0.71 (0.55–0.93) |
All patients (Model 2) b | 658 | 1.00 (Reference) | 0.84 (0.67–1.05) | 0.85 (0.64–1.14) |
Subgroup analysis | ||||
Intestinal-type (Crude) | 329 | 1.00 (Reference) | 0.78 (0.57–1.07) | 0.64 (0.45–0.91) |
Intestinal-type (Model 1) c | 329 | 1.00 (Reference) | 0.81 (0.59–1.12) | 0.64 (0.45–0.92) |
Intestinal-type (Model 2) d | 329 | 1.00 (Reference) | 0.86 (0.62–1.19) | 0.78 (0.52–1.16) |
Diffuse-type (Crude) | 308 | 1.00 (Reference) | 0.69 (0.50–0.95) | 0.70 (0.46–1.06) |
Diffuse-type (Model 1) e | 308 | 1.00 (Reference) | 0.85 (0.61–1.18) | 0.82 (0.53–1.25) |
Diffuse-type (Model 2) f | 308 | 1.00 (Reference) | 0.87 (0.63–1.21) | 0.93 (0.60–1.44) |
Clinicopathological Variable | Low KM Grade (n = 599) | High KM Grade (n = 142) | p-Value |
---|---|---|---|
Year of surgery | 0.26 | ||
≥2000 | 331 (55.3%) | 71 (50.0%) | |
<2000 | 268 (44.7%) | 71 (50.0%) | |
Mean age at diagnosis | 66.4 | 69.3 | 0.009 |
Sex | |||
Man | 359 (59.9%) | 80 (56.3%) | 0.45 |
Woman | 240 (40.1%) | 62 (43.7%) | |
Neoadjuvant chemotherapy | 0.28 | ||
Yes | 32 (5.3%) | 4 (2.8%) | |
No | 567 (96.6%) | 138 (97.2%) | |
Tumour stage | <0.001 | ||
1 or 2 | 349 (58.3%) | 116 (81.7%) | |
3 or 4 | 250 (41.7%) | 26 (18.3%) | |
Lauren class | <0.001 | ||
Intestinal | 271 (45.2%) | 91 (64.1%) | |
Diffuse | 309 (51.6%) | 46 (32.4%) | |
Mixed | 19 (3.2%) | 5 (3.5%) | |
Histological grade in intestinal type | 0.08 | ||
I or II | 180 (66.4%) | 51 (56.0%) | |
III | 91 (33.6%) | 40 (44.0%) | |
Radicality of resection | <0.001 | ||
R0 | 450 (75.1%) | 129 (90.8%) | |
R1 or R2 | 149 (24.9%) | 13 (9.2%) |
Survival Model | Number of Patients | Low KM Grade HR (95% CI) | High KM Grade HR (95% CI) |
---|---|---|---|
5-year survival | |||
All patients (Crude) | 741 | 1.00 (Reference) | 0.51 (0.39–0.66) |
All patients (Model 1) a | 741 | 1.00 (Reference) | 0.59 (0.45–0.77) |
All patients (Model 2) b | 658 | 1.00 (Reference) | 0.60 (0.44–0.82) |
Subgroup analysis | |||
Intestinal type (Crude) | 362 | 1.00 (Reference) | 0.59 (0.43–0.81) |
Intestinal type (Model 1) c | 362 | 1.00 (Reference) | 0.61 (0.44–0.85) |
Intestinal type (Model 2) d | 329 | 1.00 (Reference) | 0.66 (0.45–0.97) |
Diffuse type (Crude) | 355 | 1.00 (Reference) | 0.40 (0.25–0.67) |
Diffuse type (Model 1) e | 355 | 1.00 (Reference) | 0.52 (0.31–0.86) |
Diffuse type (Model 2) f | 308 | 1.00 (Reference) | 0.57 (0.33–1.00) |
Overall survival | |||
All patients (Crude) | 741 | 1.00 (Reference) | 0.60 (0.49–0.75) |
All patients (Model 1) a | 741 | 1.00 (Reference) | 0.66 (0.53–0.82) |
All patients (Model 2) b | 658 | 1.00 (Reference) | 0.69 (0.53–0.89) |
Subgroup analysis | |||
Intestinal type (Crude) | 362 | 1.00 (Reference) | 0.70 (0.54–0.91) |
Intestinal type (Model 1) c | 362 | 1.00 (Reference) | 0.69 (0.53–0.91) |
Intestinal type (Model 2) d | 329 | 1.00 (Reference) | 0.72 (0.52–1.00) |
Diffuse type (Crude) | 355 | 1.00 (Reference) | 0.47 (0.32–0.70) |
Diffuse type (Model 1) e | 355 | 1.00 (Reference) | 0.56 (0.38–0.85) |
Diffuse type (Model 2) f | 308 | 1.00 (Reference) | 0.61 (0.39–0.97) |
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Kemi, N.; Hiltunen, N.; P. Väyrynen, J.; Pohjanen, V.-M.; Helminen, O.; Junttila, A.; Mrena, J.; Böhm, J.; Huhta, H.; Leppänen, J.; et al. Immune Cell Infiltrate and Prognosis in Gastric Cancer. Cancers 2020, 12, 3604. https://doi.org/10.3390/cancers12123604
Kemi N, Hiltunen N, P. Väyrynen J, Pohjanen V-M, Helminen O, Junttila A, Mrena J, Böhm J, Huhta H, Leppänen J, et al. Immune Cell Infiltrate and Prognosis in Gastric Cancer. Cancers. 2020; 12(12):3604. https://doi.org/10.3390/cancers12123604
Chicago/Turabian StyleKemi, Niko, Niko Hiltunen, Juha P. Väyrynen, Vesa-Matti Pohjanen, Olli Helminen, Anna Junttila, Johanna Mrena, Jan Böhm, Heikki Huhta, Joni Leppänen, and et al. 2020. "Immune Cell Infiltrate and Prognosis in Gastric Cancer" Cancers 12, no. 12: 3604. https://doi.org/10.3390/cancers12123604