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第56回・2018年・横浜
 

食道癌DCF療法の効果予測と予後因子としての骨髄由来免疫抑制細胞(MDSC)の検討

演題番号 : P70-1

[筆頭演者]
演者)武岡 奉均:1 
[共同演者]
和田 尚:3、松野 裕旨:1、田中 晃司:2、牧野 知紀:2、岡田 一幸:1、小西 健:1、高橋 剛:2、太田 英夫:1、黒川 幸典:2、山崎 誠:2、福永 睦:1、小林 研二:1、森 正樹:2、土岐 祐一郎:2

1:兵庫県立西宮病院・消化器外科、2:大阪大学・消化器外科、3:大阪大学・腫瘍免疫学

 

For esophageal cancer patients, combination chemotherapy with docetaxel, cisplatin, and 5FU (DCF therapy) is adopted for neoadjuvant chemotherapy (NAC). Although the response rate is high (72.5%), further investigation of indicators to predict its therapeutic effects is needed because of its side effects, and few have been reported. In this study, we obtained peripheral blood before and after the DCF therapy, analyzed various immune related cells by flow cytometry and tried to identify indicators to predict its therapeutic effects.
Peripheral blood were obtained from 24 esophageal cancer patients before and after preoperative DCF therapy. During two cycles of one-week-on and three-week-off administration, peripheral blood was collected before and after each "on" and before and after the surgical treatment followed by. By flow cytometry, CD11b+CD14+CD33+HLA-DRlow M-MDSC (monocyte-myeloid derived suppressor cell) was observed. The effectiveness of NAC was determined histopathologically in accordance with the grading system of the Japanese Classification of Esophageal Carcinoma.
Of 24 patients with esophageal cancer, 11patients were responders and 13 patients were non-responders to the DCF therapy. Before the DCF therapy, the ratio of M-MDSC to monocytes was observed in 6.73% in the non-responders and 23.9 % in the responders (p=0.058). The numbers of M-MDSC calculated were 24.7 /mL in the non-responders and 132.5 /mL in the responders (p=0.021). Patients with better pathological or clinical responses showed lower ratio of M-MDSC to monocytes and fewer number of M-MDSC in peripheral blood. Patients with high M-MDSC after DCF therapy had significantly shorter relapse-free survival (p= 0.033).
These results suggest that analyzing immune related cells in peripheral blood might be useful for identification of predictive indicators for the response of preoperative DCF therapy.

キーワード

臓器別:食道

手法別:腫瘍免疫

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