Journal of Experimental & Clinical Cancer Research (Aug 2023)

Predicting response to immunotherapy in gastric cancer via assessing perineural invasion-mediated inflammation in tumor microenvironment

  • Xunjun Li,
  • Yiyun Wang,
  • ZhongYa Zhai,
  • Qingyi Mao,
  • Dianjie Chen,
  • Luxi Xiao,
  • Shuai Xu,
  • Qilin Wu,
  • Keming Chen,
  • Qiantong Hou,
  • Qinglie He,
  • Yuyang Shen,
  • Manchun Yang,
  • Zishan Peng,
  • Siqing He,
  • Xuanhui Zhou,
  • Haoyang Tan,
  • Shengwei Luo,
  • Chuanfa Fang,
  • Guoxin Li,
  • Tao Chen

DOI
https://doi.org/10.1186/s13046-023-02730-0
Journal volume & issue
Vol. 42, no. 1
pp. 1 – 19

Abstract

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Abstract Background The perineural invasion (PNI)-mediated inflammation of the tumor microenvironment (TME) varies among gastric cancer (GC) patients and exhibits a close relationship with prognosis and immunotherapy. Assessing the neuroinflammation of TME is important in predicting the response to immunotherapy in GC patients. Methods Fifteen independent cohorts were enrolled in this study. An inflammatory score was developed and validated in GC. Based on PNI-related prognostic inflammatory signatures, patients were divided into Clusters A and B using unsupervised clustering. The characteristics of clusters and the potential regulatory mechanism of key genes were verified by RT-PCR, western-blot, immunohistochemistry and immunofluorescence in cell and tumor tissue samples.The neuroinflammation infiltration (NII) scoring system was developed based on principal component analysis (PCA) and visualized in a nomogram together with other clinical characteristics. Results Inflammatory scores were higher in GC patients with PNI compared with those without PNI (P < 0.001). NII.clusterB patients with PNI had abundant immune cell infiltration in the TME but worse prognosis compared with patients in the NII.clusterA patients with PNI and non-PNI subgroups. Higher immune checkpoint expression was noted in NII.clusterB-PNI. VCAM1 is a specific signature of NII.clusterB-PNI, which regulates PD-L1 expression by affecting the phosphorylation of STAT3 in GC cells. Patients with PNI and high NII scores may benefit from immunotherapy. Patients with low nomogram scores had a better prognosis than those with high nomogram scores. Conclusions Inflammation mediated by PNI is one of the results of tumor-nerve crosstalk, but its impact on the tumor immune microenvironment is complex. Assessing the inflammation features of PNI is a potential method in predicting the response of immunotherapy effectively.

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