1
|
Li X, Wang Y, Zhai Z, Mao Q, Chen D, Xiao L, Xu S, Wu Q, Chen K, Hou Q, He Q, Shen Y, Yang M, Peng Z, He S, Zhou X, Tan H, Luo S, Fang C, Li G, Chen T. Predicting response to immunotherapy in gastric cancer via assessing perineural invasion-mediated inflammation in tumor microenvironment. J Exp Clin Cancer Res 2023; 42:206. [PMID: 37563649 PMCID: PMC10416472 DOI: 10.1186/s13046-023-02730-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/06/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND The perineural invasion (PNI)-mediated inflammation of the tumor microenvironment (TME) varies among gastric cancer (GC) patients and exhibits a close relationship with prognosis and immunotherapy. Assessing the neuroinflammation of TME is important in predicting the response to immunotherapy in GC patients. METHODS Fifteen independent cohorts were enrolled in this study. An inflammatory score was developed and validated in GC. Based on PNI-related prognostic inflammatory signatures, patients were divided into Clusters A and B using unsupervised clustering. The characteristics of clusters and the potential regulatory mechanism of key genes were verified by RT-PCR, western-blot, immunohistochemistry and immunofluorescence in cell and tumor tissue samples.The neuroinflammation infiltration (NII) scoring system was developed based on principal component analysis (PCA) and visualized in a nomogram together with other clinical characteristics. RESULTS Inflammatory scores were higher in GC patients with PNI compared with those without PNI (P < 0.001). NII.clusterB patients with PNI had abundant immune cell infiltration in the TME but worse prognosis compared with patients in the NII.clusterA patients with PNI and non-PNI subgroups. Higher immune checkpoint expression was noted in NII.clusterB-PNI. VCAM1 is a specific signature of NII.clusterB-PNI, which regulates PD-L1 expression by affecting the phosphorylation of STAT3 in GC cells. Patients with PNI and high NII scores may benefit from immunotherapy. Patients with low nomogram scores had a better prognosis than those with high nomogram scores. CONCLUSIONS Inflammation mediated by PNI is one of the results of tumor-nerve crosstalk, but its impact on the tumor immune microenvironment is complex. Assessing the inflammation features of PNI is a potential method in predicting the response of immunotherapy effectively.
Collapse
Affiliation(s)
- Xunjun Li
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Yiyun Wang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - ZhongYa Zhai
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Qingyi Mao
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong Province, China
| | - Dianjie Chen
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Luxi Xiao
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Shuai Xu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Qilin Wu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Keming Chen
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Qiantong Hou
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Qinglie He
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Yuyang Shen
- Medical Image Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong Province, China
| | - Manchun Yang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Zishan Peng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong Province, China
| | - Siqing He
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Xuanhui Zhou
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Haoyang Tan
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China
| | - Shengwei Luo
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong Province, China
| | - Chuanfa Fang
- Department of Gastrointestinal and Hernia Surgery, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, 341000, Jiangxi, China.
| | - Guoxin Li
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China.
| | - Tao Chen
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong Province, China.
- Department of Gastrointestinal and Hernia Surgery, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, 341000, Jiangxi, China.
| |
Collapse
|