University of Oulu

Kemi, N., Hiltunen, N., P. Väyrynen, J., Pohjanen, V.-M., Helminen, O., Junttila, A., … H. Kauppila, J. (2020). Immune Cell Infiltrate and Prognosis in Gastric Cancer. Cancers, 12(12), 3604. doi:10.3390/cancers12123604

Immune cell infiltrate and prognosis in gastric cancer

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Author: Kemi, Niko1; Hiltunen, Niko1; Väyrynen, Juha P.1,2;
Organizations: 1Cancer and Translational Medicine Research Unit, Medical Research Centre, University of Oulu and Oulu University Hospital, 90220 Oulu, Finland
2Department of Pathology, Central Finland Central Hospital, 40620 Jyväskylä, Finland
3Department of Surgery, Central Finland Central Hospital, 40620 Jyväskylä, Finland
4Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, 33520 Tampere, Finland
5Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 17177 Stockholm, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.9 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2020
Publish Date: 2021-01-20


Purpose: To examine and compare the prognostic value of immune cell score (ICS) and Klintrup–Mäkinen (KM) grade in gastric cancer. Methods: Gastric adenocarcinoma tissues from samples of 741 patients surgically treated in two hospitals in Finland were assessed for ICS and KM grade. Cox regression with adjustment for confounders provided hazard ratios (HRs) and 95% CIs. Subgroup analyses were performed in intestinal and diffuse type subgroups. The primary outcome was 5-year overall survival. Results: High ICS was associated to longer 5-year survival (adjusted HR 0.70, 95% CI 0.52–0.94), compared to low ICS. The difference was significant in intestinal type subgroup (adjusted HR 0.54, 95% CI 0.36–0.81) but not in diffuse type subgroup (adjusted HR 0.92, 95% CI 0.58–1.46). High KM grade was an independent prognostic factor for longer 5-year overall survival (adjusted HR 0.59, 95% CI 0.45–0.77) in both intestinal (adjusted HR 0.61, 95% CI 0.44–0.85) and diffuse subgroups (adjusted HR 0.52, 95% CI 0.31–0.86). ICS and KM grade were moderately correlated (ρ = 0.425). When both immune cell score and KM grade were included in the regression analysis, only KM grade remained prognostic. Conclusions: Both ICS and KM grade are prognostic factors in gastric adenocarcinoma, but immunohistochemistry-based ICS might not have additional prognostic value over hematoxylin–eosin-based KM grade.

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Series: Cancers
ISSN: 2072-6694
ISSN-E: 2072-6694
ISSN-L: 2072-6694
Volume: 12
Issue: 12
Article number: 3604
DOI: 10.3390/cancers12123604
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: This research was funded by Vatsatautien tutkimussäätiö grant number N/A, The Finnish Medical Foundation grant number N/A, Sigrid Jusélius Foundation grant number N/A, Finnish Cancer Foundation grant number N/A, Orion Research Foundation grant number N/A, Thelma Mäkikyrö Foundation grant number N/A, Mary and Georg C. Ehrnroot Foundation grant number N/A and Instrumentarium Science Foundation grant number N/A.
Copyright information: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (