title: The prognostic value of tumor-infiltrating neutrophils in gastric adenocarcinoma after resection.
abstract: BACKGROUND
  Several pieces of evidence indicate that tumor-infiltrating neutrophils (TINs) are correlated to tumor progression. In the current study, we explore the relationship between TINs and clinicopathological features of gastric adenocarcinoma patients. Furthermore, we investigated the prognostic value of TINs.
  
  
  METHODS
  The study was comprised of two groups, training group (115 patients) and test group (97 patients). Biomarkers (intratumoral CD15+ neutrophils) were assessed by immunohistochemistry. The relationship between clinicopathological features and patient outcome were evaluated using Cox regression and Kaplan-Meier analysis.
  
  
  RESULTS
  Immunohistochemical detection showed that the tumor-infiltrating neutrophils (TINs) in the training group ranged from 0.00-115.70 cells/high-power microscopic field (HPF) and the median number was 21.60 cells/HPF. Based on the median number, the patients were divided into high and low TINs groups. Chi-square test analysis revealed that the density of CD15+ TINs was positively associated with lymph node metastasis (p = 0.024), distance metastasis (p = 0.004) and UICC (International Union Against Cancer) staging (p = 0.028). Kaplan-Meier analysis showed that patients with a lower density of TINs had a better prognosis than patients with a higher density of TINs (p = 0.002). Multivariate Cox's analysis showed that the density of CD15+ TINs was an independent prognostic factor for overall survival of gastric adenocarcinoma patients. Using another 97 patients as a test group and basing on the median number of TINs (21.60 cells/HPF) coming from the training group, Kaplan-Meier analysis also showed that patients with a lower density of TINs had a better prognosis than patients with a higher density of TINs (p = 0.032). The results verify that the number of CD15+ TINs can predict the survival of gastric adenocarcinoma surgical patients.
  
  
  CONCLUSIONS
  The presence of CD15+ TINs is an independent and unfavorable factor in the prognosis of gastric adenocarcinoma patients. Targeting CD15+ TINs may be a potential intervenient therapy in the future.
authors.affiliation: State Key Laboratory of Oncology in Southern China and Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Jing-jing
authors.initials: JJ
authors.lastname: Zhao
authors.forename: Ke
authors.initials: K
authors.lastname: Pan
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Ju-gao
authors.initials: JG
authors.lastname: Chen
authors.forename: Yan-heng
authors.initials: YH
authors.lastname: Wu
authors.forename: Lin
authors.initials: L
authors.lastname: Lv
authors.forename: Jian-jun
authors.initials: JJ
authors.lastname: Li
authors.forename: Yi-bing
authors.initials: YB
authors.lastname: Chen
authors.forename: Dan-dan
authors.initials: DD
authors.lastname: Wang
authors.forename: Qiu-zhong
authors.initials: QZ
authors.lastname: Pan
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: Li
authors.forename: Jian-chuan
authors.initials: JC
authors.lastname: Xia
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005647:Fucosyltransferases / Q000096:biosynthesis; D006801:Humans; D016256:Lewis X Antigen / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000096:biosynthesis; D020556:Neutrophil Infiltration; D009504:Neutrophils / Q000378:metabolism* / Q000473:pathology*; D013274:Stomach Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015996:Survival Rate
chemical_list: D016256:Lewis X Antigen; D009363:Neoplasm Proteins; C066693:FUT4 protein, human; D005647:Fucosyltransferases