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A High RORγT/CD3 Ratio is a Strong Prognostic Factor for Postoperative Survival in Advanced Colorectal Cancer: Analysis of Helper T Cell Lymphocytes (Th1, Th2, Th17 and Regulatory T Cells)

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Tumor-infiltrating lymphocytes (TILs), part of the host immune response, have been widely reported as influential factors in the tumor microenvironment for the clinical outcome of colorectal cancer (CRC). However, the network of helper T cells is very complex, and which T-cell subtypes affect the progression of CRC and postoperative prognosis remains unclear. This study investigated the expression of several subtypes of TILs including T helper type 1 (Th1), Th2, Th17, and regulatory T (Treg) cells to determine their correlation with clinicopathologic features and postoperative prognosis.

Methods

The study investigated the expression of TILs using immunohistochemistry of tissue microarray samples for 199 CRC patients. The number of each T-cell subtype infiltrating tumors was counted using ImageJ software. The relationship between TIL marker expression, clinicopathologic features, and prognosis was analyzed.

Results

A high RORγT/CD3 ratio (Th17 ratio) was significantly correlated with lymph node metastasis (p = 0.002), and a high of Foxp3/CD3 ratio (Treg ratio) was correlated with tumor location in the colon (p = 0.04), as shown by the Chi square test. In multivariate analysis, a high RORγT/CD3 ratio was the only independent prognostic factor for overall survival (p = 0.04; hazard ratio [HR], 1.84; 95 % confidence interval [CI] 1.02–3.45).

Conclusions

This study confirmed a high RORγT/CD3 ratio as a strong prognostic marker for postoperative survival. The immunohistochemistry results suggest that Th17 may affect lymph node metastasis in CRC. If new immunotherapies reducing Th17 expression are established, they may improve the efficiency of cancer treatment and prolong the survival of patients with CRC.

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Authors and Affiliations

  1. Department of Surgery, Kurume University School of Medicine, Kurume-shi, Fukuoka, Japan

    Naohiro Yoshida MD, Tetsushi Kinugasa MD, PhD, Kotaro Yuge MD, Takafumi Ohchi MD, Shinya Fujino MD, Sachiko Shiraiwa MD, Mitsuhiro Katagiri MD & Yoshito Akagi MD, PhD

  2. Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan

    Hiroaki Miyoshi MD, PhD, Kensaku Sato PhD & Koichi Ohshima MD, PhD

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  1. Naohiro Yoshida MD
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  2. Tetsushi Kinugasa MD, PhD
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  3. Hiroaki Miyoshi MD, PhD
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Correspondence to Tetsushi Kinugasa MD, PhD.

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Yoshida, N., Kinugasa, T., Miyoshi, H. et al. A High RORγT/CD3 Ratio is a Strong Prognostic Factor for Postoperative Survival in Advanced Colorectal Cancer: Analysis of Helper T Cell Lymphocytes (Th1, Th2, Th17 and Regulatory T Cells). Ann Surg Oncol 23, 919–927 (2016). https://doi.org/10.1245/s10434-015-4923-3

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  • DOI: https://doi.org/10.1245/s10434-015-4923-3

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