Relationship between Prognosis and Apoptotic Index of Tumor Infiltrating Lymphocytes and Cancer Cells in gastric Cancer

Toshihiro Yasue, Iwao Kumazawa, Yasuyuki Sugiyama, Katsuyuki Kunieda and Shigetoyo Saji

Second Department of Surgery, Gifu University School of Medicine

Aim: We clarified the relationship between host immuneresponse around the microenvironment of tumors and their prognosis, according to apoptosis in cancer cells and tumor-infiltrating lymphocytes (TIL) and discussed about clinicopathological significance. Methods: Surgical specimens from 49 patients undergoing gastrectomy for the stomach cancer in the 5 years from 1992 were immunohistochemically stained by UCHL-1 (TIL) and TUNEL (apoptosis), and also H.E. stain. The mean number of TILs, apoptotic index (AI) of cancer cells, and TILs on the 3 areas of marginal and deep were calculated. After evaluating the degree of TILs, we discuss the relationship of clinicopathological study and prognosis based on cumulative survival, etc. Results: (1) AI in the tumor cells showed higher in marginla area and that in deep layer was significantly lower according to the degree of stage, n and depth. (2) In the degree of TILs, higher density in the deep area were significantly shallow in depth (p=0.024). Higher numbers of TIL AI in the deep layer were significantly deeper in depth (p=0.024). (3) In the number of TIls, higher cases showing more than 180 cells per unit area had a significantly better prognosis (p<0.002). (4) In tumor cells, prognosis of showing higher AI value both in marginal and deep areas had significantly better prognosis (p<0.05). (5) In AI cutoff, cases showing less than 0.70 in marginal areas and 1.00 in deep areas had significantly better prognosis (p<0.03 and p<0.001). Conclusion: A close relationship exist between the apoptotic index of TILs in deep areas and cancer patient prognosis, and was useful in determinign patient prognosis and postoperative adjuvant thedrapy.

Key words
cancer microenvironment, tumor infiltrating lymphocyte, apoptotic index, gastric cancer, prognosis

Reprint requests
Toshihiro Yasue Second Department of Surgery, Gifu Univercity School of Medicine 40 Tsukasamachi, Gifu City, 501-8705 JAPAN

Accepted
May 1, 2002

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