RESUMO
PURPOSE: Adenocarcinomas of the esophagus (AEG) and stomach (AS) are among the most common cancers worldwide. Novel markers for risk stratification and guiding treatment are strongly needed. Activin is a multi-functional cytokine with context specific pro- and anti-tumorigenic effects. We aimed to investigate the prognostic role of activin tumor protein expression in AEG/ASs. METHODS: Tissue from a retrospective cohort of 277 patients with AEG/AS treated primarily by surgery at the Charité - Universitätsmedizin Berlin was collected and analyzed by immunohistochemistry using a specific antibody to the activin homodimer inhibin beta A. Additionally, we evaluated T-cell infiltration and PD1 expression as well as expression of PD-L1 by immunohistochemistry as possible confounding factors. Clinico-pathologic data were collected and correlated with activin protein expression. RESULTS: Out of 277 tumor samples, 72 (26.0%) exhibited high activin subunit inhibin beta A protein expression. Higher expression was correlated with lower Union for International Cancer Control (UICC) stage and longer overall survival. Interestingly, activin subunit expression correlated with CD4+ T-cell infiltration, and the correlation with higher overall survival was exclusively seen in tumors with high CD4+ T-cell infiltration, pointing towards a role of activin in the tumor immune response in AEG/ASs. CONCLUSION: In our cohort of AEG/AS, higher activin subunit levels were correlated with longer overall survival, an effect exclusively seen in tumors with high CD4+ cell infiltration. Further mechanistic research is warranted discerning the exact effect of this context specific cytokine.
Assuntos
Ativinas , Adenocarcinoma , Humanos , Adenocarcinoma/cirurgia , Citocinas , Neoplasias Esofágicas , Subunidades beta de Inibinas , Inibinas , Prognóstico , Estudos Retrospectivos , EstômagoRESUMO
The prognostic potential of anti-tumor immune responses is becoming increasingly important in adenocarcinoma of the gastroesophageal junction and stomach (AGE/S) especially regarding the use of immune checkpoint inhibitors. This study analyzes for the first time the prognostic impact of tumor-infiltrating lymphocytes (TILs) and checkpoint inhibitors in a large Caucasian cohort in patients with AGE/S. We screened tissue samples from 438 therapy-naïve patients with AGE/S undergoing surgery between 1992 and 2005, examined in a tissue microarray (TMA) and stained against human CD3, CD4, CD8, PD-1, and PD-L1. Out of 438 tissue samples, 210 were eligible for multivariate analysis. This revealed that high infiltration with CD3+, CD4+, or CD8+ TILs was associated with an increased overall survival in AGE/S patients, which could only be confirmed in multivariate analysis for CD3 (HR: 0.326; p = .023). Independent improved survival was limited to gastric cancer patients and to early tumor stages as long as TILs did not express PD-1 (HR: 1.522; p = .021). Subgroup analyses indicate that TIL-dependent anti-tumor immune response is only effective in gastric cancer patients in early stages of disease in PD-1 negative TILs. Combined analysis of PD-1 and CD3 could serve as a prognostic marker for the clinical outcome of gastric cancer patients and could also be of interest for immunotherapy.
Assuntos
Linfócitos do Interstício Tumoral , Neoplasias Gástricas , Humanos , Imunoterapia , Prognóstico , Receptor de Morte Celular Programada 1RESUMO
Increased plasma cortisol levels are found not only in patients with Cushing disease but also in patients suffering from endogenous depression. Because patients with endogenous depression fail to show any clinical signs of Cushing disease, it is supposed that the cells of these patients are relatively resistant to increased glucocorticoid levels. To test this hypothesis 20 patients with endogenous depression and 20 healthy controls were examined for plasma cortisol level and modulation of mitogen induced lymphocyte transformation by glucocorticoids. Results point to a relative resistance of patient's T-lymphocyte transformation to the inhibitory effect of glucocorticoids when compared with controls.
Assuntos
Transtorno Depressivo/sangue , Dexametasona , Hidrocortisona/sangue , Ativação Linfocitária/fisiologia , Metilprednisolona , Receptores de Glucocorticoides/fisiologia , Relação Dose-Resposta a Droga , HumanosRESUMO
Previous work described a biologically motivated object recognition system with Gabor wavelets as basic feature type. These features are robust against slight distortion, rotation and variation in illumination. We here describe extensions of the system that address image variance due to arbitrary in-plane rotation, substantial scale changes and moderate depth rotation of objects, and to background variation, using simple linear transformation of the Gabor filter responses. The performance of the system is enhanced significantly.