The ratio of intratumoral CD15+ neutrophils to CD8+ lymphocytes predicts recurrence in gastric cancer patients after resection

Abstract An elevated neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood is an independent prognostic indicator of various cancers. However, whether a similar immune cell balance in tumor tissues influences the prognosis of cancer patients is not well understood. This study aimed to investigate the prognostic relevance of the intratumoral immune cell balance in gastric cancer patients. The study included 82 consecutive patients who underwent curative resection for gastric cancer. Intratumoral Cluster of Differentiation (CD) 15- and CD8-positive cells were evaluated using immunohistochemical staining, and clinicopathological factors and prognoses were analyzed. The effects of these scores on overall survival (OS) and relapse-free survival (RFS) were estimated using Cox proportional hazards regression. Patients with high intratumoral CD15/CD8 ratios had significantly lower OS and RFS compared to those with low CD15/CD8 ratios (P ). In addition, a high CD15/CD8 ratio was associated with lymph node metastasis (P = 0.019). Patients with a high NLR had a significantly lower RFS than those with a low NLR (P = 0.0050). Multivariate analysis revealed that the intratumoral CD15/CD8 ratio was an independent prognostic indicator of RFS (Hazard ratio = 4.7, 95% confidence interval = 1.4–16.2). Therefore, an increased intratumoral CD15/CD8 ratio is an independent predictor of survival following gastric cancer resection and is associated with lymph node metastasis and microscopic lymph vessel invasion. Establishing the postoperative follow-up schedule and adjuvant therapy may be clinically advantageous.