, Volume 10, Issue 1, pp 12-19
Date: 24 Dec 2012

Clinical significance of peritumoral mast cells in esophageal squamous cell carcinoma with neoadjuvant chemoradiotherapy

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Abstract

Background

Neoadjuvant chemoradiotherapy (CRT) followed by surgery is the standard approach for locally advanced esophageal cancer. Recently, the microenvironment (including the host immune response) after conventional chemo- and/or radiotherapy has been highlighted. The aim of this preliminary study was to evaluate peritumoral mast cells (MCs) in esophageal squamous cell carcinoma (ESCC) after neoadjuvant CRT.

Methods

We obtained a total of twenty specimens from patients with ESCC who underwent neoadjuvant CRT (30–40 Gy; 5-fluorouracil plus cisplatin) followed by surgery. We evaluated the expression of tryptase by MCs, Foxp3 by regulatory T cells, CD8 by cytotoxic T cells, and microvessel density (MVD) using immunohistochemistry. We investigated the correlation between the sizes of these marker-positive cell populations surrounding residual tumor nests, MVD and CRP, and clinical outcome.

Results

Patients with a low number of peritumoral MCs more frequently had lymphatic invasion (P = 0.0191). There was no significant correlation among the sizes of the marker-positive cell populations. We observed a significant negative correlation between the number of MCs and preoperative CRP levels (P = 0.009). Low numbers of peritumoral MCs, high MVD, and a preoperative C-reactive protein of >0.5 mg/dL were significantly associated with poor overall survival (MCs: P = 0.0239; MVD: P = 0.0317; CRP: P = 0.0395).

Conclusion

Our results suggest that peritumoral MCs may be associated with prognosis in patients with ESCC after neoadjuvant CRT.