TY - JOUR
T1 - Crohn’s-Like Lymphoid Reaction is Associated with Oncological Prognosis and Nutritional Status in Patients with Pathological Stage II/III Gastric Cancer
AU - Omura, Yusuke
AU - Toiyama, Yuji
AU - Okugawa, Yoshinaga
AU - Yamamoto, Akira
AU - Yin, Chengzeng
AU - Kusunoki, Kurando
AU - Kusunoki, Yukina
AU - Shigemori, Tsunehiko
AU - Ide, Shozo
AU - Kitajima, Takahito
AU - Fujikawa, Hiroyuki
AU - Yasuda, Hiromi
AU - Hiro, Junichiro
AU - Yoshiyama, Shigeyuki
AU - Ohi, Masaki
AU - Kusunoki, Masato
N1 - Publisher Copyright:
© 2019, Society of Surgical Oncology.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Peritumoral lymphoid aggregates, termed Crohn’s-like lymphoid reaction (CLR), are markers of an antitumor immune response, which is an important predictor of patient outcome. In this study, we investigated the prognostic utility of CLR and its relationship with nutritional status in patients with gastric cancer (GC). Methods: The study included 170 patients who underwent curative surgery for pathological stage (pStage) II/III GC. The maximum diameters of peritumoral and normal mucosal CLR aggregates were measured, and the median peritumoral diameter (0.57 mm) was used to stratify patients into two groups (large-CLR and small-CLR). The relationships between CLR size and preoperative nutritional status (body mass index, body composition status, Onodera’s prognostic nutritional index), tumor-infiltrating CD8+ T-lymphocyte count, and survival were evaluated. Results: Peritumoral CLR aggregates were significantly larger than aggregates in the normal mucosa. Clinicopathological variables were not significantly different between the two patient groups; however, the large-CLR group had better cancer-specific survival (p = 0.018) and recurrence-free survival (p = 0.03) than the small-CLR group. Multivariate analysis revealed that CLR size was an independent prognostic factor for cancer-specific survival [hazard ratio (HR) 2.13, 95% confidence interval (CI) 1.3–3.56, p = 0.002] and recurrence-free survival (HR 1.96, 95% CI 1.22–3.19, p = 0.005). Nutritional status markers were significantly poorer for the small-CLR group than the large-CLR group. CD8+ T-cell tumor infiltration was positively correlated with CLR size but not with patient survival. Conclusions: CLR size correlated with patient nutritional status and prognosis and may be helpful in identifying high-risk populations of pStage II/III GC patients.
AB - Background: Peritumoral lymphoid aggregates, termed Crohn’s-like lymphoid reaction (CLR), are markers of an antitumor immune response, which is an important predictor of patient outcome. In this study, we investigated the prognostic utility of CLR and its relationship with nutritional status in patients with gastric cancer (GC). Methods: The study included 170 patients who underwent curative surgery for pathological stage (pStage) II/III GC. The maximum diameters of peritumoral and normal mucosal CLR aggregates were measured, and the median peritumoral diameter (0.57 mm) was used to stratify patients into two groups (large-CLR and small-CLR). The relationships between CLR size and preoperative nutritional status (body mass index, body composition status, Onodera’s prognostic nutritional index), tumor-infiltrating CD8+ T-lymphocyte count, and survival were evaluated. Results: Peritumoral CLR aggregates were significantly larger than aggregates in the normal mucosa. Clinicopathological variables were not significantly different between the two patient groups; however, the large-CLR group had better cancer-specific survival (p = 0.018) and recurrence-free survival (p = 0.03) than the small-CLR group. Multivariate analysis revealed that CLR size was an independent prognostic factor for cancer-specific survival [hazard ratio (HR) 2.13, 95% confidence interval (CI) 1.3–3.56, p = 0.002] and recurrence-free survival (HR 1.96, 95% CI 1.22–3.19, p = 0.005). Nutritional status markers were significantly poorer for the small-CLR group than the large-CLR group. CD8+ T-cell tumor infiltration was positively correlated with CLR size but not with patient survival. Conclusions: CLR size correlated with patient nutritional status and prognosis and may be helpful in identifying high-risk populations of pStage II/III GC patients.
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U2 - 10.1245/s10434-019-07709-w
DO - 10.1245/s10434-019-07709-w
M3 - Article
C2 - 31414294
AN - SCOPUS:85070723031
SN - 1068-9265
VL - 27
SP - 259
EP - 267
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 1
ER -