title: Tumor-infiltrating Neutrophils is Prognostic and Predictive for Postoperative Adjuvant Chemotherapy Benefit in Patients With Gastric Cancer.
abstract: This study was aimed to investigate the prognostic value of tumor-infiltrating neutrophils (TINs) and to generate a predictive model to refine postoperative risk stratification system for patients with gastric cancer.
  
  
  
  TIN presents in various malignant tumors, but its clinical significance in gastric cancer remains obscure.
  
  
  
  The study enrolled 3 independent sets of patients with gastric cancer from 2 institutional medical centers of China. TIN was estimated by immunohistochemical staining of CD66b, and its relationship with clinicopathological features and clinical outcomes were evaluated. Prognostic accuracies were evaluated by C-index and Akaike information criterion.
  
  
  
  TINs in gastric cancer tissues ranged from 0 to 192 cells/high magnification filed (HPF), 0 to 117 cells/HPF, and 0 to 142 cells/HPF in the training, testing, and validation sets, respectively. TINs were negatively correlated with lymph node classification (P = 0.007, P = 0.041, and P = 0.032, respectively) and tumor stage (P = 0.019, P = 0.013, and P = 0.025, respectively) in the 3 sets. Moreover, multivariate analysis identified TINs and tumor node metastasis (TNM) stage as 2 independent prognostic factors for overall survival. Incorporation of TINs into well-established TNM system generated a predictive model that shows better predictive accuracy for overall survival. More importantly, patients with higher TINs were prone to overall survival benefit from postoperative adjuvant chemotherapy. These results were validated in the independent testing and validation sets.
  
  
  
  TIN in gastric cancer was identified as an independent prognostic factor, which could be incorporated into standard TNM staging system to refine risk stratification and predict for overall survival benefit from postoperative chemotherapy in patients with gastric cancer.
authors.affiliation: Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Zhenbin
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Lin
authors.affiliation: Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Xuefei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Qin
authors.affiliation: Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China.
authors.forename: Jiejie
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Yihong
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D017024:Chemotherapy, Adjuvant; D005743:Gastrectomy; D006801:Humans; D007150:Immunohistochemistry; D015999:Multivariate Analysis; D009504:Neutrophils / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor