The Influences Of Dendritic Cells Infiltration On Prognosis And Biologic Characteristics Of Advanced Gastric Cancer

OBJIECTIVE: The objective of this study was to investigate the correlation between spontaneous apoptosis, proliferation and the infiltrating dendrtic cells in advanced gastric carcinoma. In addition, the relation betvveen clinicopathologic parameters and the above values of the gastric cancer are investigated. The significance of tumor infiltrating dendritic cells 籹pontaneous apoptosis and proliferation in gastric cancer were evaluated.METHODS: The occurrence of apoptotic li death (apoptotic index [AI]) in 61 patients vvith advanced gastric carcinoma was analyzed by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick end labeling method(TUNEL). The PCNA labeling index (PCNA-LI), density of dendritic cells (DCs) in tumors were analyzed by immunohistochemistry performed by the LSAB method using antibody against S100 protein and PC-10. The spontaneous apoptosis, proliferation were compared vvith the infiltration of dendrtic cells for each patients. The prognostic significance of dendritic cells infiltration ,spontaneous apoptosis, proliferation vvere evaluated.RESULTS: 1. DCs infiltration was negatively correlated vvith clinical lymph node metastasis, stage and. PCNA-LI, but positively vvith AI. The DCs in gastric cancer groups vvith and vvithout lymph node metastasis vvere 5.63?.37/HPF, 8.51?.57/HPF respectively, the statistica! significance was different,(P<0.05). The DCs in I,II,III stage were6.05?.62/HPF, 5.19?.34/HPF, 4.37?.77/HPF,respectively. There was a significant difference among each group( P<0.05). The PCNA-LI was significantiy higher(57.10?4.18%) in the low DCs group compared vvith that of high DCs group (48.15?0.59%) (P<0.01). AI were 3.77?.26% and 2.95?.07% respectively in highand low DCs groups (P<0.01). According to the Spearman correlation coefficient ,significant correlations between the DCs and the PCNA-LI(R= -0.47) and between the DCs and the AI(R=0.39)were detected, (P<0.01). Tumor with high DCs infiltration showed a decreased PCNA-LI but a increased AI. The prognosis of high DCs infiltration patients was significantly better than those with low DCs infiltration. 2> The mean PCNA-LI of the 61 tumors was 53.29?3.44 %(rangelO-85%). Statistica! analyses revealed significant correlations between the PCNA-LI and the lymph node metastasis, lymphatic invasion and clinical stages .The PCNA-LI of the tumors vvith lymph node metastasis(57.94?1.69%) was significantly higher than that of tumors without lymph node metastasis(49.59?3.47% , PO.05). As between lymphatic invasion group and without lymphatic invasion group,62.00?2.88% to 51.78?3.11% were observed respectively (P<0.05). PCNA-LI was gradually increased according to the progression of clinical stages. The PCNA-LI was significantly higher in stage III than that of stage I and II.( PO.05). In patients with low PCNA-LI the prognosis was significantly better than those vvith a high index. (PO.05) 3 > . The average AI ofthe cancerous tissue was 3.30?.39%(range 0.89-8.4%). The AI had no obvious correlation vvith patient's age, sex, si瀍 of the tumor, depth of invasion, lymph node metastasis and clinical stages ,but was higher in the cases of well /moderate(3.46?.27%,3.35?.10%) differentiated adenocarcinoma than poorly differentiated adenocarcinoma. (2.2?.74%),(PO.05). The AI had no influence on survial.CONCLUSIONS: The infiltrating DCs in and around tumor which represent the local immune station of the host may play an important role in immunological defense mechanisms of host against the tumor. DCs could inhibit the proliferation and induce the apoptosis of the tumor cells thus affect clinical features and improve the prognosisof the gastric cancer patients. PCNA-LI could be a powerful tool for providing information about the biologic characteristics and prognosis of the gastric cancer while the relationship betvveen AI and gastric cancer need to be further investigated.