Prognostic value of CD83-positive mature dendritic cells and their relation to vascular endothelial growth factor in advanced human gastric cancer

Mature dendritic cells (DCs) play an important role as antigen-presenting cells in tumor immunity. The angiogenic factor, vascular endothelial growth factor (VEGF), inhibits DC maturation. In this study, 174 gastric cancer patients were assessed by immunohistochemistry using anti-S-100 antibody for total DCs, anti-CD83 antibody for mature DCs and anti-VEGF antibody for VEGF expression, and the relationships between total DC density (TDD), mature DC density (MDD), clinicopathological factors, VEGF expression and prognosis were examined. The MDD (count/cm2) was significantly lower in gastric cancer tissue (2.07, median value) than in normal gastric tissue (8.06) (p=0.0067), and also significantly lower in advanced stage gastric cancer tissue (1.55) than in early stage gastric cancer tissue (2.22) (p=0.0374). Among the 104 advanced gastric cancer patients, the MDD was significantly lower in older patients, and in those with a larger or histologically differentiated-type tumor or strong VEGF expression (p<0.05). The 5-year survival rate was significantly higher in the high TDD group than the low TDD group, and also significantly higher in the high MDD group than the low MDD group (p<0.05). By multivariate analysis, blood vessel invasion (p=0.0001, hazard ratio =3.464) and MDD (p=0.0171, hazard ratio =2.179) were revealed to be independent prognostic factors in advanced gastric cancer. These results suggest that the maintenance of MDD could prolong the survival of patients with advanced gastric cancer.