Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2023; 29(40): 5582-5592
Published online Oct 28, 2023. doi: 10.3748/wjg.v29.i40.5582
Expression characteristics of peripheral lymphocyte programmed death 1 and FoxP3+ Tregs in gastric cancer during surgery and chemotherapy
Hao Li, Guan-Mei Cao, Guo-Li Gu, Song-Yan Li, Yang Yan, Ze Fu, Xiao-Hui Du
Hao Li, Ze Fu, Graduate School, Medical School of Chinese People’s Liberation Army, Beijing 100039, China
Hao Li, Guo-Li Gu, Department of General Surgery, Air Force Medical Center, Air Force Medical University, Beijing 100142, China
Guan-Mei Cao, Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Song-Yan Li, Yang Yan, Xiao-Hui Du, Department of General Surgery, Chinese PLA General Hospital, Beijing 100039, China
Co-first authors: Hao Li and Guan-Mei Cao.
Author contributions: Li H, Cao GM, and Du XH were the guarantor of integrity of entire study, and contributed to the study concepts; Li H, Cao GM, Gu GL, Li SY, and Du XH designed the study; Li H, Cao GM, Gu GL, and Li SY involved in the literature research; Li H and Cao GM contributed to the data acquisition; Li H, Cao GM, and Fu Z contributed to the statistical analysis/interpretation and manuscript preparation; Li H, Cao GM, Gu GL, Li SY, Fu Z, and Du XH contributed to the manuscript definition of intellectual content; Li H, Cao GM, Gu GL, and Du XH edited the manuscript; Li H and Cao GM contributed equally to this work as co-first authors; Li H and Cao GM are designated as co-first authors due to their equal and substantial contributions to the study conception, design, data acquisition, and analysis, as well as manuscript preparation and editing, each playing pivotal roles in ensuring the integrity and quality of the research.
Supported by the National Natural Science Foundation of China, No. 81871317; and Military Medical Innovation Project, No. 18CXZ025.
Institutional review board statement: The study was reviewed and approved by the Ethics Commission of the General Hospital of PLA (Approval No. S2009-051-02).
Informed consent statement: All patients and donors provided signed informed consent.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Hui Du, MD, PhD, Chief Doctor, Deputy Director, Professor, Surgeon, Department of General Surgery, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100039, China. duxiaohui3011@sina.com
Received: August 7, 2023
Peer-review started: August 7, 2023
First decision: August 28, 2023
Revised: August 31, 2023
Accepted: October 11, 2023
Article in press: October 11, 2023
Published online: October 28, 2023
ARTICLE HIGHLIGHTS
Research background

Programmed death 1 (PD-1) and CD4+CD25+FoxP3+ expression in peripheral blood T-cells have been identified in multiple cancer types, but their variation during surgery and chemotherapy in gastric cancer remains elusive. Understanding this could illuminate tumor recurrence mechanisms and guide optimal anti-PD-1 antibody treatment strategies.

Research motivation

Despite known PD-1 and CD4+CD25+FoxP3+ expression in various cancers, the specific changes during surgery and chemotherapy, and their relationship in gastric cancer, remain undefined. This study seeks to shed light on these variations, potentially offering insights into tumor recurrence, immune evasion, and the clinical application of anti-PD-1 antibodies in gastric cancer.

Research objectives

The study aims to observe and analyze the expression characteristics of peripheral lymphocyte PD-1 and FoxP3+ regulatory T cells (FoxP3+Tregs) in gastric cancer patients, both prior to and following surgery or chemotherapy, to better understand their roles and implications in gastric cancer treatment.

Research methods

In this study, 29 gastric cancer patients, post-D2 gastrectomy and undergoing chemotherapy, provided 10 mL peripheral blood samples during various perioperative phases. PD-1 expression was analyzed on specific lymphocyte subsets, with an additional 29 age-matched healthy donors serving as a control group.

Research results

The study found a significant elevation in PD-1 expression and FoxP3+ Tregs in gastric cancer patients, which decreased notably post-D2 gastrectomy. A positive correlation was identified between PD-1 expression and the number of activated FoxP3high Tregs in peripheral lymphocytes, especially during postoperative chemotherapy.

Research conclusions

Alterations in PD-1 expression and regulatory T cell activation during gastric cancer treatment could provide valuable insights for understanding tumor immune evasion. These findings may also influence the clinical application of anti-PD-1 antibodies in gastric cancer therapy.

Research perspectives

The changes observed in PD-1 expression and regulatory T cell activation during gastric cancer treatments pave the way for deeper exploration into tumor immune evasion mechanisms. These findings could also shape the future clinical application and optimization of anti-PD-1 antibodies in treating gastric cancer.