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Yonsei Criteria, a Potential Linkage to Intratumoral Foxp3+/CD8+ Ratio for the Prediction of Oncologic Outcomes in Resected Left-Sided Pancreatic Cancer

Yonsei Medical Journal 2020년 61권 4호 p.291 ~ 300
황호경, 이성환, 김형일, 김세훈, 최준정, 강창무, 이우정,
소속 상세정보
황호경 ( Hwang Ho-Kyoung ) - Yonsei University College of Medicine Department of Surgery
이성환 ( Lee Sung-Hwan ) - CHA University School of Medicine CHA Bundang Medical Center Department of Surgery
김형일 ( Kim Hyoung-Il ) - Yonsei University College of Medicine Severance Hospital Department of Gastrointestinal Surgery
김세훈 ( Kim Se-Hoon ) - Yonsei University College of Medicine Severance Hospital Department of Pathology
최준정 ( Choi Jun-Jeong ) - Yonsei University College of Pharmacy Department of Pharmacy
강창무 ( Kang Chang-Moo ) - Yonsei University College of Medicine Department of Surgery
이우정 ( Lee Woo-Jung ) - Yonsei University College of Medicine Department of Surgery

Abstract


Purpose: This study sought to investigate associations among Yonsei criteria (tumor confined to the pancreas, intact fascia layer between the distal pancreas and the left adrenal gland and kidney, and tumor located more than 1?2 cm from the celiac axis) and tumor infiltrating lymphocytes in pancreatic cancer.

Materials and Methods: Patients who underwent curative distal pancreatectomy due to left-sided pancreatic cancer from January 2000 to December 2011 were enrolled. Follow-up was completed September 30, 2015.

Results: Fifty patients were enrolled. Having ≥ two metastatic lymph nodes (LNs, p=0.002), intraoperative transfusion (p=0.011), low levels of tumor infiltrating CD8+ T-cells (p=0.001), and a high Foxp3+/CD8+ ratio (p=0.009) were independent risk factors for disease-free survival. Not satisfying the Yonsei criteria (p=0.021), having ≥ two metastatic LNs (p=0.032), low levels of tumor infiltrating CD8+ T-cells (p=0.040) and a high Foxp3+/CD8+ ratio (p=0.032) were associated with unfavorable overall survival. High levels of CA19-9 and not satisfying the Yonsei criteria were significantly associated with a high Foxp3+/CD8+ ratio [Exp(β)=3.558; 95% confidence inverval: 1.000?12.658; p=0.050].

Conclusion: Yonsei criteria may be clinically detectable biologic marker with which to predict immunologic status and survival in pancreatic cancer patients.

키워드

Pancreatic cancer; tumor infiltrating lymphocyte; cytotoxic T lymphocyte; regulatory T lymphocyte

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