Tumor-Infiltrating Neutrophils after Neoadjuvant Therapy are Associated with Poor Prognosis in Esophageal Cancer.

Autor: Cabalag CS; Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. carloscabalag@gmail.com.; Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. carloscabalag@gmail.com.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia. carloscabalag@gmail.com., Prall OWJ; Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia., Ciciulla J; Department of Anatomical Pathology, Melbourne Pathology, Sonic Healthcare, Melbourne, VIC, Australia., Galea LA; Department of Anatomical Pathology, Melbourne Pathology, Sonic Healthcare, Melbourne, VIC, Australia., Thio N; Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia., Jayawardana M; Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia., Leong TYM; Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, VIC, Australia.; Department of Clinical Pathology, University of Melbourne, Parkville, VIC, Australia., Milne JV; Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia., Fujihara KM; Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia., Chong L; Department of Surgery (St Vincent's Hospital), University of Melbourne, Fitzroy, VIC, Australia.; Department of Upper GI and Hepatobiliary Surgery, St Vincent's Hospital, Fitzroy, Victoria, Australia., Hii MW; Department of Surgery (St Vincent's Hospital), University of Melbourne, Fitzroy, VIC, Australia.; Department of Upper GI and Hepatobiliary Surgery, St Vincent's Hospital, Fitzroy, Victoria, Australia., Arnau GM; Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia., Neeson PJ; Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia., Phillips WA; Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia.; Department of Surgery (St Vincent's Hospital), University of Melbourne, Fitzroy, VIC, Australia., Duong CP; Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia., Clemons NJ; Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. Nicholas.Clemons@petermac.org.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia. Nicholas.Clemons@petermac.org.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2023 Mar; Vol. 30 (3), pp. 1614-1625. Date of Electronic Publication: 2022 Oct 02.
DOI: 10.1245/s10434-022-12562-5
Abstrakt: Background: In esophageal cancer (EC), there is a paucity of knowledge regarding the interplay between the tumor immune microenvironment and response to neoadjuvant treatment and, therefore, which factors may influence outcomes. Thus, our goal was to investigate the changes in the immune microenvironment with neoadjuvant treatment in EC by assessing the expression of immune related genes and their association with prognosis.
Methods: We examined the transcriptome of paired pre- and post-neoadjuvant treated EC specimens. Based on these findings, we validated the presence of tumor-infiltrating neutrophils using CD15 + immunohistochemistry in a discovery cohort of patients with residual pathologic disease. We developed a nomogram as a predictor of progression-free survival (PFS) incorporating the variables CD15 + cell count, tumor regression grade, and tumor grade.
Results: After neoadjuvant treatment, there was an increase in genes related to myeloid cell differentiation and a poor prognosis associated with high neutrophil (CD15 + ) counts. Our nomogram incorporating CD15 + cell count was predictive of PFS with a C-index of 0.80 (95% confidence interval [CI] 0.68-0.9) and a concordance probability estimate (CPE) of 0.77 (95% CI 0.69-0.86), which indicates high prognostic ability. The C-index and CPE of the validation cohort were 0.81 (95% CI 0.69-0.91) and 0.78 (95% CI 0.7-0.86), respectively.
Conclusions: Our nomogram incorporating CD15 + cell count can potentially be used to identify patients at high risk of recurrent disease and thus stratify patients who will benefit most from adjuvant treatment.
(© 2022. The Author(s).)
Databáze: MEDLINE
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