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Factors Associated With Host Immune Response and Number of Lymph Nodes: A Large Retrospective Cohort Study

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

Abstract

Background

The host immune response (HIR) against tumor cells is one of the key players in antitumor activities. However, the relationship between HIR and regional lymph nodes (LN) and their impacts on prognosis have not been studied.

Methods

This study analyzed HIR and clinicopathologic factors for 8819 consecutive gastric cancer patients who underwent gastrectomy and D2 LN dissection. The findings confirmed Epstein–Barr virus (EBV) with Epstein–Barr encoding region in situ hybridization, HIR grading (G1, G2, and G3), LN numbers classified into seven groups, and performed ordinal regression analysis.

Results

The mean number of LNs was 41. A higher degree of HIR was significantly associated with male sex, EBV+, non-intestinal histology by Lauren classification, earlier American Joint Committee on Cancer (AJCC) stage, and greater number of LNs (P < 0.001). Female gender, younger age (< 60 years), EBV+, non-intestinal histology, higher HIR grade (G2 and G3), larger tumor size, and deeper invasion depth were significantly related to a higher number of LNs, with an odds ratio greater than 1. In cancer-specific survival analyses, EBV+, younger age, higher HIR grade (G3), and increased number of LNs were independent prognostic factors in addition to AJCC stage.

Conclusions

The HIR was associated with increased number of LNs was a significant favorable prognosticator.

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Acknowledgments

This work was supported by a grant from the National Research Foundation of Korea (NRF-2017R1D1A1B03032449 to KMK).

Author information

Author notes

  1. Kyoung-Mee Kim and Tae Sung Sohn have contributed equally to this work.

Authors and Affiliations

  1. Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea

    Sun-Ju Byeon MD, You Jeong Heo BS, Junhun Cho MD & Kyoung-Mee Kim MD, PhD

  2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Ji Yeong An MD, Min Gew Choi MD, Jun Ho Lee MD, Jae Moon Bae MD, Sung Kim MD & Tae Sung Sohn MD, PhD

  3. Statistics and Data Center, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea

    Min-Ji Kim MS & Insuk Sohn PhD

Authors
  1. Sun-Ju Byeon MD
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  2. You Jeong Heo BS
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  3. Junhun Cho MD
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  4. Ji Yeong An MD
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  9. Insuk Sohn PhD
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  11. Kyoung-Mee Kim MD, PhD
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  12. Tae Sung Sohn MD, PhD
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Corresponding authors

Correspondence to Kyoung-Mee Kim MD, PhD or Tae Sung Sohn MD, PhD.

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Byeon, SJ., Heo, Y.J., Cho, J. et al. Factors Associated With Host Immune Response and Number of Lymph Nodes: A Large Retrospective Cohort Study. Ann Surg Oncol 25, 3621–3628 (2018). https://doi.org/10.1245/s10434-018-6731-z

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  • DOI: https://doi.org/10.1245/s10434-018-6731-z

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