Basic Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2023; 15(2): 303-317
Published online Feb 15, 2023. doi: 10.4251/wjgo.v15.i2.303
Increased CD4/CD8 Lymphocyte ratio predicts favourable neoadjuvant treatment response in gastric cancer: A prospective pilot study
Daniel Skubleny, Andrea Lin, Saurabh Garg, Ross McLean, Michael McCall, Sunita Ghosh, Jennifer L Spratlin, Daniel Schiller, Gina Rayat
Daniel Skubleny, Department of Surgery, University of Alberta, Edmonton T6G 2R3, AB, Canada
Andrea Lin, Saurabh Garg, Michael McCall, Daniel Schiller, Gina Rayat, Department of Surgery, University of Alberta, Edmonton T6G 2R3, Alberta, Canada
Ross McLean, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton T6G 2R3, Alberta, Canada
Sunita Ghosh, Department of Oncology, University of Alberta, Edmonton T6G 2R3, Alberta, Canada
Jennifer L Spratlin, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton T5G 1Z2, AB, Canada
Author contributions: Skubleny D, McCall M, Ghosh S, Spratlin JL, Schiller D and Rayat G designed and coordinated the study; Skubleny D, Lin A, Garg S, McLean R performed experiments, generated and analyzed data; McLean R evaluated biopsy pathology and presence of cancer; Skubleny D, Ghosh S, Schiller D and Rayat G interpreted the data; Skubleny D wrote the manuscript with editorial assistance from Ghosh S, Spratlin JL, Schiller D and Rayat G.
Institutional review board statement: All human clinical participants consented according to the approved ethics protocol granted by the Health Research Ethics Board of Alberta (Study ID: HREBA.CC-17-0228_REN5).
Informed consent statement: Informed consent according to an approved ethics protocol from the Health Research Ethics Board of Alberta (HREBA.CC-17-0228) was obtained for all patients.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: Raw data and code are available from the corresponding author at skubleny@ualberta.ca.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Daniel Skubleny, MD, PhD, Doctor, Department of Surgery, University of Alberta, 116 St & 85 Ave, Edmonton T6G 2R3, AB, Canada. skubleny@ualberta.ca
Received: October 3, 2022
Peer-review started: October 3, 2022
First decision: October 24, 2022
Revised: November 25, 2022
Accepted: January 12, 2023
Article in press: January 12, 2023
Published online: February 15, 2023
Core Tip

Core Tip: In the absence of treatment response, neoadjuvant chemotherapy for gastric cancer may contribute to adverse events without additional survival benefit compared to adjuvant treatment or surgery alone. Identifying patients that are likely to achieve favourable tumour response following neoadjuvant chemotherapy is of critical importance. In this pilot study, we investigate the utility of CD4, CD8, Galectin-3 and E-cadherin molecules in predicting which patients will benefit from neoadjuvant therapy using immunohistochemistry in pre-treatment biopsies. We demonstrate that an elevated ratio between CD4+ and CD8+ lymphocytes is a promising biomarker to predict treatment response to neoadjuvant chemotherapy in locally advanced gastric cancer.