Dynamics of indicators of systemic and local immunity during treatment in patients with gastric cancer

Background. Over the past 20-30 years, great advances in the treatment of gastric cancer (GC) have been made. An important step in the development of new therapeutic agents was the understanding of the role of prognostic and predictive factors, including the significance of the subpopulation composition of immunocompetent cells and tumor biology. Objective. Evaluation of the state of systemic and local immunity before and during drug treatment in patients with gastric adenocarcinoma. Methods. From 2017 to 2018 20 primary patients with metastatic gastric adenocarcinoma received drug therapy at the N.N. Blokhin National Medical Research Center of Oncology. The sampling of biological material (peripheral blood, tumor tissue) was carried out twice (before treatment and during the first control examination, after 3 courses). Using the method of flow cytometry, the degree of infiltration of tumor tissue by lymphocytes (CD45+CD14-TILs); T cells (CD3+CD19-TILs); B cells (CD3-CD19+TILs); NK cells (CD3-CD16+CD56+TILs); CD16 and CD8 effector cells and their cytotoxic potential (CTP) (CD16+Perforin+TILs; CD16CTPTILs), (CD8+Perforin+TILs; CD8CTPTILs); regulatory T cells - NKT cells (CD3+CD16+CD56+TILs), CD4 (CD4+CD25+CD127-TILs) and CD8 (CD8+CD11b-CD28-TILs) regulatory cells were assessed, as well as parameters of systemic and local immunity. Results. An increase in the number of CD8+ T-regulatory cells (5.1-12.1%; p=0.019) in the peripheral blood, and an increase in perforin potential of effector CD16 cells (0.5-4.9%; p=0.030) and their cytotoxic potential (13.2-55.7%; p=0.011) in tumor tissue were factors of a favorable prognosis for progression-free survival (PFS) in patients with metastatic gastric cancer (mGC), When assessing the nature of changes in the indicators of local immunity in the course of chemotherapy, a negative effect of an increase in the content of T cells (22.0- -9.7%; p=0.012), NKT-cells (207.9- -13.8%; p=0.002) and CD4+ T-regulatory cells (190.7- -25.2%; p=0.002) was revealed. On the contrary, an increase in the level of effector CD16 cells during chemotherapy increases the likelihood of surviving PFS - 9 months (-69.5-9.1%; p=0.013). Conclusion. Indicators of local and systemic immunity serve as additional prognostic factors in gastric cancer.

metastatic stomach cancer, cellular immunity, local immunity, chemotherapy