title: High expression of CD11c indicates favorable prognosis in patients with gastric cancer.
abstract: OBJECTIVE
  To determine the relationship between CD11c expression level and prognosis in patients with gastric cancer (GC).
  
  
  METHODS
  This retrospective survival study was performed from July 31, 2008 to June 30, 2014. Our study inclusion criteria included all the patients with GC who underwent surgical resection between January 1998 and December 2009 in the Third Affiliated Hospital of Soochow University. CD11c expression levels in 140 patients with GC at different UICC stages were evaluated using immunohistochemistry, and GC tissues from 16 cases were further verified by qRT-PCR. The χ (2) test was used to compare the patient- and disease-related factors between the low CD11c expression group and the high expression group. Univariate probabilities of overall survival (OS) and disease-free survival (DFS) were assessed using the Kaplan-Meier method. The log rank test was used to compare survival curves. Different multivariate COX models were used to estimate the association between CD11c expression and both death and recurrence risk in GC patients.
  
  
  RESULTS
  The average CD11c expression level was 5.1 ± 1.8/high power field (HPF) in 10 gastritis samples, 4.5 ± 2.3/HPF in 10 gastric polyp samples and 9.7 ± 6.3/HPF in 140 gastric cancer samples, respectively. The CD11c expression level was significantly decreased from UICC stage I to stage IV (stage I: 16.0 ± 7.4, stage II: 10.4 ± 5.5, stage III: 9.4 ± 6.1, stage IV: 5.3 ± 3.2, P < 0.001). Patients in the high CD11c expression group had a greater 3- and 5-year OS probability and longer median survival time compared with the low CD11c expression group, (67.7% vs 39.2%; 51.4% vs 29.0%; 67.0 mo vs 28.0 mo; χ(2) = 6.80, P = 0.009), and had a greater 3- and 5-year DFS probability and longer median DFS time (63.7% vs 24.0%; 49.1% vs 11.9%; 64.0 mo vs 18.0 mo; χ (2) = 15.39, P < 0.001). Patients with high CD11c high expression had a reduced risk of death (HR = 0.56, 95%CI: 0.33-0.98, P < 0.05) and relapse (HR = 0.39, 95%CI: 0.23-0.67, P < 0.01) compared with patients with low CD11c expression after adjustment of potential confounders, with the exception of tumor size. However, the protective effect related to death (HR = 0.90, 95%CI: 0.49-1.67, P = 0.749) and relapse (HR = 0.65, 95%CI: 0.36-1.19, P = 0.160) disappeared when tumor size was incorporated into the model.
  
  
  CONCLUSIONS
  High expression of CD11c decreased the risk of death and relapse, and may be regarded as an alternative indicator of favorable prognosis in patients with GC.
authors: Yuan Wang, Bin Xu, Wen-Wei Hu, Lu-Jun Chen, Chang-Ping Wu, Jing-Ting Jiang, Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China.
authors: Yuan
authors: Y
authors: Wang
authors: Yuan Wang, Bin Xu, Wen-Wei Hu, Lu-Jun Chen, Chang-Ping Wu, Jing-Ting Jiang, Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China.
authors: Bin
authors: B
authors: Xu
authors: Yuan Wang, Bin Xu, Wen-Wei Hu, Lu-Jun Chen, Chang-Ping Wu, Jing-Ting Jiang, Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China.
authors: Wen-Wei
authors: WW
authors: Hu
authors: Yuan Wang, Bin Xu, Wen-Wei Hu, Lu-Jun Chen, Chang-Ping Wu, Jing-Ting Jiang, Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China.
authors: Lu-Jun
authors: LJ
authors: Chen
authors: Yuan Wang, Bin Xu, Wen-Wei Hu, Lu-Jun Chen, Chang-Ping Wu, Jing-Ting Jiang, Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China.
authors: Chang-Ping
authors: CP
authors: Wu
authors: Yuan Wang, Bin Xu, Wen-Wei Hu, Lu-Jun Chen, Chang-Ping Wu, Jing-Ting Jiang, Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China.
authors: Bin-Feng
authors: BF
authors: Lu
authors: Yuan Wang, Bin Xu, Wen-Wei Hu, Lu-Jun Chen, Chang-Ping Wu, Jing-Ting Jiang, Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China.
authors: Yue-Ping
authors: YP
authors: Shen
authors: Yuan Wang, Bin Xu, Wen-Wei Hu, Lu-Jun Chen, Chang-Ping Wu, Jing-Ting Jiang, Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China.
authors: Jing-Ting
authors: JT
authors: Jiang
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D039521:CD11c Antigen / Q000032:analysis* / Q000235:genetics; D016009:Chi-Square Distribution; D002681:China; D018450:Disease Progression; D018572:Disease-Free Survival; D005743:Gastrectomy; D006785:Hospitals, University; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000235:genetics / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D039521:CD11c Antigen
keywords: CD11c; Dendritic cell; Gastric cancer; Tumor microenvironment