Background and Aim Tumor cells escape host immunosurveillance and thus produce an advantageous environment for tumor progression. Recent studies have demonstrated that tumor‐infiltrating lymphocytes (TILs) play a principal role in the immune response to tumors. However, little is understood about numerical alterations in CD3+ TILs during tumor progression in patients with gastric cancer. The present study examines the density of CD3+ TILs to elucidate their clinical significance in gastric cancer. Methods The numbers of CD3+ TILs in 120 resected specimens from patients with gastric cancer and 27 endoscopic resected specimens from patients with gastric adenoma were immunohistochemically assessed using a CD3 polyclonal antibody. Results The mean number of CD3+ TILs (± SD) in the patients with gastric cancer and adenoma was 87.5 ± 59.8 and 379.6 ± 128.1, respectively. Significantly more CD3+ TILs were found in specimens from patients with gastric adenoma than with gastric cancer (P < 0.0001). The numbers of CD3+ TILs significantly correlated with depth of tumor invasion, lymph node metastasis, and stage (P = 0.022, P = 0.0004, and P = 0.011, respectively). The 5‐year survival rate was significantly poorer for patients with fewer CD3+ TILs (P = 0.004). Multivariate analysis selected the density of CD3+ TILs as an independent prognostic factor (P = 0.034). Conclusions Our results demonstrated that the density of CD3+ TILs decreases during tumor progression. The density of CD3+ TILs is an immunological predictor of lymph node metastasis and disease outcome in patients with gastric cancer.
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Arigami et al. (2014) studied this question.
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