2022 Fiscal Year Final Research Report
Mechanisms and clinical relevance of egress of low density neutrophils in postoperative patients
Project/Area Number |
21K20958
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Research Category |
Grant-in-Aid for Research Activity Start-up
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Allocation Type | Multi-year Fund |
Review Section |
0905:Surgery of the organs maintaining homeostasis and related fields
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Research Institution | Jichi Medical University |
Principal Investigator |
Kumagai Yuko 自治医科大学, 医学部, 助教 (30625554)
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Project Period (FY) |
2021-08-30 – 2023-03-31
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Keywords | 低比重好中球 / 大腸癌 / 再発 / フローサイトメトリー / 予後因子 |
Outline of Final Research Achievements |
In 176 patients who underwent radical colectomy, the number oflow density neutrophils (LDN) was markedly increased after surgery and their ratio correlated positively with operative time and intraoperative blood loss. The LDN showed immature phenotype and produced high amount of neutrophil extracellular traps (NETs) which efficiently trapped tumor cells in vitro. The ratio of postoperative LDN was significantly higher in 13 patients who developed recurrence. When cut-off value was determined as 4.9%, high ratio of the LDG was a strong and independent prognostic factors for worse relapse free survival (RFS). Adjuvant chemotherapy significantly improved RFS in stage III patients with high ratio of the LDG, but not in low LDG group. Surgical stress recruit many LDN, which may assist the development of recurrence. The ratio of LDN after surgery can be used as a biomarker to select the high risk group of recurrence in patients who underwent curative surgery for colorectal cancer.
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Free Research Field |
消化器外科学
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Academic Significance and Societal Importance of the Research Achievements |
腫瘍免疫における好中球の果たす役割については未知な部分が多い。本研究にて、術後早期の手術ストレスによって多数に未熟型 LDNが循環血液中に補充され、標的臓器の血管床でNETsを産生し、循環癌細胞を着床させることを介して再発の進行を助長している可能性があることを新たに指摘することができた。手術後のLDNの比率は治癒手術を受けた大腸癌患者において再発の高リスク群を選択するためのバイオマーカーとして有用性があること、とくに術後補助療法の適応を判断する上で重要な情報になることが証明できたという点で臨床的意義は大きい。
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