Peripheral low-density granulocytes after colorectal cancer surgery in predicting recurrence.
Journal
BJS open
ISSN: 2474-9842
Titre abrégé: BJS Open
Pays: England
ID NLM: 101722685
Informations de publication
Date de publication:
06 01 2023
06 01 2023
Historique:
received:
01
07
2022
revised:
13
10
2022
accepted:
20
10
2022
entrez:
19
1
2023
pubmed:
20
1
2023
medline:
21
1
2023
Statut:
ppublish
Résumé
Low-density granulocytes (LDGs) have been shown to be increased in the peripheral blood of patients with inflammatory and malignant diseases. This study evaluated LDGs in patients who underwent radical surgery for colorectal cancer (CRC) and their impact on survival. Patients who underwent radical colectomy between 2017 to 2021 were screened for enrolment in the study. Peripheral blood was obtained in the operating room before and after surgery and cells were recovered from the mononuclear layer after density gradient preparations. The ratio of CD66b(+) LDG to CD45(+) leukocytes was determined with flow cytometry, and the association of the ratios with patient outcomes was examined. The main outcome of interest was recurrence-free survival (RFS). Out of 228 patients treated, 176 were enrolled, including 108 colonic and 68 rectal cancers. Overall, 38 patients were stage I, 30 were stage II, 72 were stage 3, and 36 were stage IV. The number of LDGs was markedly increased immediately after surgery and the proportion of LDGs correlated positively with operating time (r = 0.2806, P < 0.001) and intraoperative blood loss (r = 0.1838, P = 0.014). Purified LDGs produced high amounts of neutrophil extracellular traps after short-term culture and efficiently trapped tumour cells in vitro. The proportion of postoperative LDGs was significantly higher in 13 patients who developed recurrence (median 9 (range 1.63-47.0)) per cent versus median 2.93 ((range 0.035-59.45) per cent, P = 0.013). When cut-off values were set at 4.9 per cent, a higher proportion of LDGs was strongly and independently associated with decreased RFS (P = 0.005). In patients with stage III disease, adjuvant chemotherapy significantly improved RFS of patients with high ratios of LDGs, but not low LDGs. LDGs are recruited to circulating blood by surgical stress early in the postoperative interval after colectomy for colonic cancer and their postoperative proportion is correlated with recurrence.
Sections du résumé
BACKGROUND
Low-density granulocytes (LDGs) have been shown to be increased in the peripheral blood of patients with inflammatory and malignant diseases. This study evaluated LDGs in patients who underwent radical surgery for colorectal cancer (CRC) and their impact on survival.
METHODS
Patients who underwent radical colectomy between 2017 to 2021 were screened for enrolment in the study. Peripheral blood was obtained in the operating room before and after surgery and cells were recovered from the mononuclear layer after density gradient preparations. The ratio of CD66b(+) LDG to CD45(+) leukocytes was determined with flow cytometry, and the association of the ratios with patient outcomes was examined. The main outcome of interest was recurrence-free survival (RFS).
RESULTS
Out of 228 patients treated, 176 were enrolled, including 108 colonic and 68 rectal cancers. Overall, 38 patients were stage I, 30 were stage II, 72 were stage 3, and 36 were stage IV. The number of LDGs was markedly increased immediately after surgery and the proportion of LDGs correlated positively with operating time (r = 0.2806, P < 0.001) and intraoperative blood loss (r = 0.1838, P = 0.014). Purified LDGs produced high amounts of neutrophil extracellular traps after short-term culture and efficiently trapped tumour cells in vitro. The proportion of postoperative LDGs was significantly higher in 13 patients who developed recurrence (median 9 (range 1.63-47.0)) per cent versus median 2.93 ((range 0.035-59.45) per cent, P = 0.013). When cut-off values were set at 4.9 per cent, a higher proportion of LDGs was strongly and independently associated with decreased RFS (P = 0.005). In patients with stage III disease, adjuvant chemotherapy significantly improved RFS of patients with high ratios of LDGs, but not low LDGs.
CONCLUSION
LDGs are recruited to circulating blood by surgical stress early in the postoperative interval after colectomy for colonic cancer and their postoperative proportion is correlated with recurrence.
Identifiants
pubmed: 36655328
pii: 6991922
doi: 10.1093/bjsopen/zrac154
pmc: PMC9849843
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Ministry of Education, Science, Sports and Culture of Japan
ID : 20K17629
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.
Références
Crit Care. 2014 Aug 01;18(4):R163
pubmed: 25084831
Oncotarget. 2016 May 10;7(19):27676-88
pubmed: 27050283
Front Immunol. 2015 Sep 14;6:471
pubmed: 26441976
J Surg Res. 2020 Feb;246:52-61
pubmed: 31561178
J Trauma. 2010 Apr;68(4):843-52
pubmed: 19996805
Nat Immunol. 2014 Jul;15(7):602-11
pubmed: 24940954
J Clin Oncol. 2011 Sep 1;29(25):3381-8
pubmed: 21788561
J Clin Oncol. 2009 Jul 1;27(19):3109-16
pubmed: 19451431
Ann Fam Med. 2016 May;14(3):215-20
pubmed: 27184991
J Clin Oncol. 2011 Oct 1;29(28):3768-74
pubmed: 21859995
Cancer Res. 2009 Feb 15;69(4):1553-60
pubmed: 19201693
J Clin Invest. 2012 Jan;122(1):327-36
pubmed: 22156198
J Clin Oncol. 2011 Apr 10;29(11):1465-71
pubmed: 21383294
Brain Behav Immun. 2013 Mar;30 Suppl:S32-40
pubmed: 22504092
J Leukoc Biol. 2011 Feb;89(2):311-7
pubmed: 21106641
Cancer Res. 2016 Mar 15;76(6):1367-80
pubmed: 26759232
Arthritis Rheum. 1986 Nov;29(11):1334-42
pubmed: 2430586
Cancer Treat Rev. 2019 May;75:1-11
pubmed: 30849607
Blood. 2013 Apr 11;121(15):2975-87
pubmed: 23321256
J Leukoc Biol. 2014 Nov;96(5):685-93
pubmed: 24929004
Cancer Res. 2001 Jun 15;61(12):4756-60
pubmed: 11406548
J Clin Oncol. 2008 May 10;26(14):2336-41
pubmed: 18467725
J Immunol. 2010 Mar 15;184(6):3284-97
pubmed: 20164424
CA Cancer J Clin. 2017 May 6;67(3):177-193
pubmed: 28248415
Int J Cancer. 2014 Mar 15;134(6):1466-73
pubmed: 23982901
Clin Exp Metastasis. 2018 Apr;35(4):347-358
pubmed: 28894976
J Am Coll Surg. 2003 Aug;197(2):254-60
pubmed: 12892809
J Clin Invest. 2013 Jul 1;:
pubmed: 23863628
Crit Care Med. 2013 Mar;41(3):820-32
pubmed: 23348516
Nat Rev Immunol. 2014 May;14(5):302-14
pubmed: 24751955
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
Nat Rev Clin Oncol. 2015 Apr;12(4):213-26
pubmed: 25601442
Immunity. 2017 Jan 17;46(1):15-28
pubmed: 28099862
Semin Immunopathol. 2013 Jul;35(4):455-63
pubmed: 23553215