TUMOR MICROENVIRONMENT AND BODY MASS INDEX IN GASTRIC CANCER PATIENTS: FORMATION OF GROUPS AT RISK OF ADVERSE COURSE
- R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, National Academy of Sciences of Ukraine, Kyiv, Ukraine
Overweight and obesity are often accompanied by the development of serious concomitant diseases. Obesity increases the risk of developing malignant tumors and worsens the course of the disease. The study of obesity in an oncology clinic requires both a study of the adipose tissue state and an assessment of its negative impact on the tumor, in particular, identification of the tumor microenvironment factors associated with obesity (taking into account the age and gender of patients). Aim: the purpose of this study is to reveal the relationships between a number of indicators of the gastric cancer (GC) microenvironment and body mass index (BMI), taking into account the age and gender of patients; identify groups of patients whose tumors are characterized by an aggressive phenotype based on the characteristics of their microenvironment. Objects and methods: tumors of 246 patients with GC with obesity and normal body weight were studied. EPR spectrometry, 31P NMR spectroscopy, polyacrylamide gel zymography, immunohistochemical and statistical methods were used. Results: tumors of overweight/obese patients (BMI >25 kg/m2) generally have significantly higher protumor values of microenvironment indicators compared to tumors of patients with normal weight (BMI ≤25 kg/m2). However, a group of overweight middle-aged women stands out among them, in whose tumors only 2 microenvironment indicators have a protumor value. At the same time, among patients with normal weight, there are groups of middle-aged men and elderly women, in whose tumors half of the determined indicators have a protumor value. In elderly men, compared to elderly women, as well as compared to middle-aged men, the GC tumor microenvironment has more aggressive characteristics regardless of the obesity presence. Antitumor values of tumor microenvironment indicators prevail in elderly men with normal weight. The most aggressive (in terms of the number of protumor characteristics) GC microenvironment is observed in middle-aged men and elderly women with overweight/obesity. Conclusions: probably, the presence of excess weight, in case of an oncological disease, does not unambiguously lead to the protumor effect of adipose tissue. Identification of the tumor microenvironment factors associated with obesity will allow forming groups of patients according to the risk of an adverse course of the disease, improving personalized prognosis and the effectiveness of anticancer therapy.