Tumor-Infiltrating Lymphocytes in Primary Tumor and Bone Marrow in Patients with Gastric Cancer and Overweight

Immune infiltration in human tumors is a key prognostic factor. In this aspect it has to be noted that the publications concerning the tumor-infiltrating lymphocytes (TILs) under overweight and obesity are limited, especially in the clinical setting in particular concerning gastric cancer. This study has shown that density of TILs consistently associated with body mass index (BMI) and density of cancer-associated adipocytes (CAA) in tumors, decreased significantly in patients with BMI > 30 having high density of CAA. Hypoxia in tumor does not affect this process. Patients with BMI > 30 having high density of CAA with slight infiltrating of TILs in tumors demonstrated better overall survival than the same patients with BMI < 25 whereas the same patients with BMI < 25 but with low density of CAA have shown much longer overall survival. Presence of TILs in BM was not affected by both the high density of CAA and level of hypoxia in primary tumor; moreover it has not been associated with BMI as well as patients survival time. Understanding the metabolic changes that occur in obese individuals may help to pave the way for more effective treatments for patients with gastric cancer having overweight.