title: Prognostic potential of an immune score based on the density of CD8+T cells, CD20+B cells, and CD33+/p-STAT1+double-positive cells and HMGB1 expression within cancer nests in stage IIIA gastric cancer patients.
abstract: OBJECTIVE
  There is heterogeneity in the prognosis of gastric cancers staged according to the tumornodes- metastasis (TNM) system. This study evaluated the prognostic potential of an immune score system to supplement the TNM staging system.
  
  
  METHODS
  An immunohistochemical analysis was conducted to assess the density of T cells, B cells, and myeloid-derived suppressor cells (MDSCs) in cancer tissues from 100 stage IIIA gastric cancer patients; the expression of the high-mobility group protein B1 (HMGB1) was also evaluated in cancer cells. The relationship between the overall survival (OS), disease-free survival (DFS), and immunological parameters was analyzed.
  
  
  RESULTS
  An immune score system was compiled based on the prognostic role of the density of T cells, B cells, MDSCs, and the expression of HMGB1 in cancer tissues. The median 5-year survival of this group of patient was 32%. However, the 5-year survival rates of 80.0%, 51.7%, 0%, 5.8%, and 0% varied among the patients with an immune score of 4 to those with an immune score of 0 based on the immune score system, respectively. Similarly, differences in DFS rates were observed among the immune score subgroups.
  
  
  CONCLUSIONS
  An immune score system could effectively identify the prognostic heterogeneity within stage IIIA gastric cancer patients, implying that this immune score system may potentially supplement the TNM staging system, and help in identifying a more homogeneous group of patients who on the basis of prognosis can undergo adjuvant therapy.
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine; Biotherapy Center, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China; Department of Oncology.
authors.forename: Jun
authors.initials: J
authors.lastname: Dong
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Cardiovascular Disease, Guangzhou 510260, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Cardiovascular Disease, Guangzhou 510260, China.
authors.forename: Shiming
authors.initials: S
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine; Biotherapy Center, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China.
authors.forename: Xingyu
authors.initials: X
authors.lastname: Feng
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine; Department of Gastric & Pancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China.
authors.forename: Shi
authors.initials: S
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine; Biotherapy Center, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine; Department of Gastric & Pancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China.
authors.forename: Yingbo
authors.initials: Y
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine; Biotherapy Center, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China.
authors.forename: Xiaoshi
authors.initials: X
authors.lastname: Zhang
keywords: B cell; CD33; Immune score; STAT1; T cell; gastric cancer; high-mobility group protein B1 (HMGB1)