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Intratumoural leukocyte infiltration is a prognostic indicator among pancreatic cancer patients with type 2 diabetes

Karnevi, Emelie LU ; Sasor, Agata; Hilmersson, Katarzyna Said LU ; Ansari, Daniel LU ; Erjefält, Jonas S. LU ; Rosendahl, Ann H. LU and Andersson, Roland LU (2018) In Pancreatology 18(1). p.85-93
Abstract

Background: The life expectancy of pancreatic cancer patients remains minimal. The disease progression may be influenced by type 2 diabetes (T2D) and inflammatory status, although important gaps persist around their joint effects on disease outcome. The aim of this study was to investigate the clinical significance of the tumour immune microenvironment on pancreatic cancer prognosis in relation to T2D status. Method: Tumour-infiltrating macrophages, neutrophils and eosinophils were studied in primary pancreatic tumours and paired lymph node metastases in relation to patient and tumour characteristics, T2D status and overall survival in a retrospective cohort of patients with resectable pancreatic cancer in Sweden. Results: Of the 80... (More)

Background: The life expectancy of pancreatic cancer patients remains minimal. The disease progression may be influenced by type 2 diabetes (T2D) and inflammatory status, although important gaps persist around their joint effects on disease outcome. The aim of this study was to investigate the clinical significance of the tumour immune microenvironment on pancreatic cancer prognosis in relation to T2D status. Method: Tumour-infiltrating macrophages, neutrophils and eosinophils were studied in primary pancreatic tumours and paired lymph node metastases in relation to patient and tumour characteristics, T2D status and overall survival in a retrospective cohort of patients with resectable pancreatic cancer in Sweden. Results: Of the 80 included pancreatic cancer patients, 22 (27.2%) had T2D. The diabetic pancreatic cancer patients had significantly higher systemic high white blood cell count than those without diabetes (P = 0.028). Macrophage infiltration levels were higher in lymph node metastases compared with primary tumours (P = 0.040) among pancreatic cancer patients with diabetes. Type 2 diabetes or intra-tumoural leukocyte (macrophage, neutrophil or eosinophil) infiltration alone did not significantly influence pancreatic cancer prognosis. However, among cancer patients with T2D high macrophage or neutrophil tumour-infiltration was associated with a significant reduction in overall survival (adjusted hazard ratio [HR] 7.2; 95% CI 1.5-35.0 and HR 5.4; 95% CI 1.1-26.3, respectively). Conclusion: These results demonstrate associations between T2D and enhanced inflammatory processes with significant implications on survival among pancreatic cancer patients with T2D. Validation in larger independent patient cohorts may identify additional prognostic tools and improved treatment strategies for specific patient subsets.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Macrophages, Neutrophils, Pancreatic cancer, Type 2 diabetes
in
Pancreatology
volume
18
issue
1
pages
85 - 93
publisher
Karger
external identifiers
  • scopus:85034028566
ISSN
1424-3903
DOI
10.1016/j.pan.2017.11.003
language
English
LU publication?
yes
id
edcc4d6a-428b-4fc1-97ef-3465deacdc68
date added to LUP
2017-12-27 13:59:39
date last changed
2018-03-29 03:00:15
@article{edcc4d6a-428b-4fc1-97ef-3465deacdc68,
  abstract     = {<p>Background: The life expectancy of pancreatic cancer patients remains minimal. The disease progression may be influenced by type 2 diabetes (T2D) and inflammatory status, although important gaps persist around their joint effects on disease outcome. The aim of this study was to investigate the clinical significance of the tumour immune microenvironment on pancreatic cancer prognosis in relation to T2D status. Method: Tumour-infiltrating macrophages, neutrophils and eosinophils were studied in primary pancreatic tumours and paired lymph node metastases in relation to patient and tumour characteristics, T2D status and overall survival in a retrospective cohort of patients with resectable pancreatic cancer in Sweden. Results: Of the 80 included pancreatic cancer patients, 22 (27.2%) had T2D. The diabetic pancreatic cancer patients had significantly higher systemic high white blood cell count than those without diabetes (P = 0.028). Macrophage infiltration levels were higher in lymph node metastases compared with primary tumours (P = 0.040) among pancreatic cancer patients with diabetes. Type 2 diabetes or intra-tumoural leukocyte (macrophage, neutrophil or eosinophil) infiltration alone did not significantly influence pancreatic cancer prognosis. However, among cancer patients with T2D high macrophage or neutrophil tumour-infiltration was associated with a significant reduction in overall survival (adjusted hazard ratio [HR] 7.2; 95% CI 1.5-35.0 and HR 5.4; 95% CI 1.1-26.3, respectively). Conclusion: These results demonstrate associations between T2D and enhanced inflammatory processes with significant implications on survival among pancreatic cancer patients with T2D. Validation in larger independent patient cohorts may identify additional prognostic tools and improved treatment strategies for specific patient subsets.</p>},
  author       = {Karnevi, Emelie and Sasor, Agata and Hilmersson, Katarzyna Said and Ansari, Daniel and Erjefält, Jonas S. and Rosendahl, Ann H. and Andersson, Roland},
  issn         = {1424-3903},
  keyword      = {Macrophages,Neutrophils,Pancreatic cancer,Type 2 diabetes},
  language     = {eng},
  number       = {1},
  pages        = {85--93},
  publisher    = {Karger},
  series       = {Pancreatology},
  title        = {Intratumoural leukocyte infiltration is a prognostic indicator among pancreatic cancer patients with type 2 diabetes},
  url          = {http://dx.doi.org/10.1016/j.pan.2017.11.003},
  volume       = {18},
  year         = {2018},
}