Annals of Surgical Oncology

, Volume 18, Issue 9, pp 2585–2593 | Cite as

Association of Intra-tumoral Infiltrating Macrophages and Regulatory T Cells Is an Independent Prognostic Factor in Gastric Cancer after Radical Resection

  • Bo Wang
  • Dazhi Xu
  • Xingjuan Yu
  • Tong Ding
  • Huilan Rao
  • Youqing Zhan
  • Limin Zheng
  • Lian Li
Gastrointestinal Oncology



Macrophages (Mφ) and regulatory T cells (Tregs) are the major components of the inflammatory infiltrate in virtually all tumors. The objective of this study was to investigate the prognostic significance of Mφ and Tregs infiltration in advanced gastric cancer after radical resection.


CD68+ Mφ and FOXP3+ Tregs were assessed by immunohistochemistry in tissues from 107 patients with surgically advanced gastric cancer. The microlocalization of Mφ and Tregs cells with respect to the development of gastric cancer were given special concern. Prognostic value of normal, peritumoral, and intratumoral Mφ and Tregs densities was evaluated by Kaplan–Meier analysis and Cox regression.


The results showed that the presence of intratumoral CD68+ Mφ was an independent prognostic factor for overall survival (OS) (P = 0.02). Moreover, the combination of high numbers of intratumoral CD68+ Mφ and FOXP3+ Tregs was associated with improved survival (P = 0.041). Five-year OS rate was only 27% for patients with low intratumoral Mφ and intratumoral Tregs compared with 62% for patients with high intratumoral Mφ and intratumoral Tregs. In addition, advanced intestinal-type gastric cancers were more likely to have fewer infiltrating Mφ than diffuse-type cancers (P = 0.024).


Association of intratumoral Mφ and Tregs is a promising independent predictor for survival in advanced gastric cancer. The results suggested that a combination of concomitant stimulation of intratumoral Mφ and Tregs may be an effective strategy for treatment of patients with advanced gastric cancer after radical resection.


Gastric Cancer Overall Survival Advanced Gastric Cancer Atypical Hyperplasia Peritumoral Tissue 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported by National Natural Science Foundation of China (No. 30801095) and the “863” program (2006AA02A402).


No potential conflicts of interest were disclosed.

Supplementary material

10434_2011_1609_MOESM1_ESM.doc (8.8 mb)
Supplementary material 1 (DOC 9059 kb)


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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Bo Wang
    • 1
  • Dazhi Xu
    • 2
    • 3
  • Xingjuan Yu
    • 2
  • Tong Ding
    • 2
  • Huilan Rao
    • 4
  • Youqing Zhan
    • 2
    • 3
  • Limin Zheng
    • 1
    • 2
  • Lian Li
    • 1
    • 5
  1. 1.State Key Laboratory of BiocontrolSun Yat-sen (Zhongshan) UniversityGuangzhouPeople’s Republic of China
  2. 2.State Key Laboratory of Oncology in South ChinaSun Yat-sen (Zhongshan) UniversityGuangzhouPeople’s Republic of China
  3. 3.Department of Abdominal Surgery, Cancer CenterSun Yat-sen (Zhongshan) UniversityGuangzhouPeople’s Republic of China
  4. 4.Department of Pathology, Cancer CenterSun Yat-sen (Zhongshan) UniversityGuangzhouPeople’s Republic of China
  5. 5.Department of Biochemistry, College of Life SciencesSun Yat-sen (Zhongshan) UniversityGuangzhouPeople’s Republic of China

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