To study the state of systemic immunity and local immunity before and during chemotherapy in patients with gastric adenocarcinoma.
From 2017 to 2018 at the Tashkent city branch of the Republican specialized scientific and practical medical center of oncology and radiology 20 primary metastatic patients with gastric adenocarcinoma received chemotherapy. The sampling of biological material (peripheral blood, tumor tissue) was carried out twice (before treatment and during the first control examination, after 3 courses). The percentage of the degree of infiltration of tumor tissue by lymphocytes (CD45+CD14-TILs) was estimated by flow cytometry; T cells (CD3+CD19-TILs); B cells (CD3-CD19+TILs); NK cells (CD3-CD16+CD56+TILs); CD16 and CD8 effector cells and their cytotoxic potential (CTP) (CD16+Perforin+TILs; CD16CTPTILs), (CD8+Perforin+TILs; CD8CTPTILs); regulatory T cells - NKT cells (CD3+CD16+CD56+TILs), CD4 (CD4+CD25+CD127-TILs) and CD8 (CD8+CD11b-CD28-TILs) regulatory cells and these parameters of systemic results. The factor of a favorable prognosis for PFS in patients with metastatic gastric cancer in the peripheral blood was an increase in the number of CD8 + T-regulatory cells (5.1% - 12.1%, p = 0.019), and in tumor tissue - an increase in the perforin potential of effector CD16 cells (0.5% - 4.9%, p = 0.030) and their cytotoxic potential (13.2% - 55.7%, p = 0.011). When assessing the changes in the indices of local immunity during chemotherapy, it was noted a negative effect of an increase of T cells (22.0% - -9.7%, p = 0.012), NKT - cells (207.9% - -13.8%, p = 0.002) and CD4 + T-regulatory cells (190.7% - -25.2%, p = 0.002). In contrast, an increase in the level of effector CD16 cells during chemotherapy increases the likelihood of surviving PFS - 9 months (-69.5% - 9.1%, p = 0.013).
Indicators of local and systemic immunity serve as additional prognostic factors for gastric cancer.
