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Relationship between stromal regulatory T cells and the response to neoadjuvant chemotherapy for locally advanced rectal cancer

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Abstract

Background

In addition to the direct power of anticancer drugs, the effectiveness of anticancer therapy depends on the host immune function. The present study investigated whether or not the reduction rate and histological response of preoperative chemotherapy were related to the immune microenvironment surrounding a primary tumor of the rectum.

Methods

Sixty-five patients received preoperative chemotherapy followed by resection from 2012 to 2014; all of these patients were retrospectively analyzed. CD3, CD8, and FoxP3 were immunohistochemically examined as markers for T lymphocytes, cytotoxic T lymphocytes, and regulatory T lymphocytes (Treg), respectively. The correlation between the tumor-infiltrating lymphocyte composition and the tumor reduction rate and histological response to neoadjuvant chemotherapy was investigated.

Results

The average tumor reduction rate was 41.5% ± 18.8%. According to RECIST, 47 patients (72.3%) achieved a partial response (PR), and 1 patient (1.5%) achieved a complete response (CR). Eight patients (12.3%) showed a grade 2 histological response, and 2 (3.1%) showed a grade 3 response. A multivariate analysis demonstrated that a low Treg infiltration in stromal cell areas was significantly associated with the achievement of a PR or CR [odds ratio (OR) 7.69; 95% confidence interval (CI) 1.96–33.33; p < 0.01] and a histological grade 2 or 3 response (OR 11.11; 95% CI 1.37–98.04; p = 0.02).

Conclusion

A low Treg infiltration in the stromal cell areas may be a marker of a good response to neoadjuvant chemotherapy in patients with locally advanced rectal cancer.

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Acknowledgements

We would like to give many thanks to H. Sakurada for performing skillful laboratory work.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Kentaro Sekizawa, Kazuya Nakagawa, Mayumi Ozawa, Masashi Momiyama, Atsushi Ishibe & Itaru Endo

  2. Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Yasushi Ichikawa

  3. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan

    Hirokazu Suwa, Jun Watanabe & Mitsuyoshi Ota

  4. Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Ikuma Kato

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  1. Kentaro Sekizawa
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Correspondence to Itaru Endo.

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Sekizawa, K., Nakagawa, K., Ichikawa, Y. et al. Relationship between stromal regulatory T cells and the response to neoadjuvant chemotherapy for locally advanced rectal cancer. Surg Today 52, 198–206 (2022). https://doi.org/10.1007/s00595-021-02311-8

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  • DOI: https://doi.org/10.1007/s00595-021-02311-8

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