Clinical Significance Of Mononuclear Macrophages In Evaluating The Efficacy Of Advanced Gastric Cancer

[Objective]To study the relationship between the expression of monocyte-macrophage in peripheral blood and chemotherapy efficacy and investigate the correlation between monocyte-macrophage and chemotherapy resistance.[Methods]To collect the peripheral blood of the first three times from twenty-two gastric cancer patients who were initially diagnosed or progressive after adjuvant treatment with stage IV before chemotherapy.Then we use the flow cytometry to analysis the proportion of CD 14 positive mononuclear macrophages.Before the third time of chemotherapy,the patient's condition was evaluated according to the Response Evaluation Criteria in Solid Tumors(RECIST)to estimate the correlation between CD14 positive mononuclear macrophages and the patients with advanced gastric cancer.The gastric cancer(MKN-45)cell line was cultured,and then in CCK8 assays,we detect the half-inhibitory concentration(IC50)concentration of oxaliplatin killing the gastric cancer cells(MKN-45).We obtained the cd14 positive mononuclear macrophages from normal human blood,then utilized CD 14 Microbeads to isolate CD 14 positive peripheral blood mononuclear cells.Co-culturing the cells with the gastric cancer cell line and then treated with oxaliplatin after about 24 hours.After that we detected apoptotic cell death by the flow cytometry.According to results of the apoptosis,the relationship between mononuclear macrophages and induction chemotherapy resistance was investigated.[Result]1.To analyze the relationship between the expression of CD 14 positive mononuclear macrophages and the clinical characteristics of the patients,we found no statistically significant difference between gender and the expression of CD 14 positive mononuclear macrophages(P=0.845).There was no statistically significant difference between the age and CD 14 positive mononuclear macrophages(P=0.108).There was no statistically significant difference between the pathological type and the expression of CD 14 positive mononuclear(P=0.693).There was no statistically significant difference between the history of gastric cancer surgery and the expression of CD 14 positive mononuclear macrophages(P=0.301).2.To analyze the relationship between the expression of CD 14 positive mononuclear macrophages and the white blood cell count and the lymphocyte count,the result shows that the expression of CD 14 positive mononuclear macrophages was not significantly correlated with white blood cell count in peripheral blood(R=0.118,P=0.396).The expression of cd14 positive mononuclear macrophages in patients was not significantly correlated with lymphocyte count in peripheral blood(R=0.066,P=0.636).3.Detected the percentage of CD 14 positive mononuclear macrophages in the peripheral blood which was collected before the first,second,and third time of chemotherapy,and it was decreased overall of the patients with stable and improved disease assessment after treatment,but there was no statistical significance difference(P=0.319).4.Detected the percentage of CD 14 positive mononuclear macrophages in the peripheral blood which was collected before the first,second and third time of chemotherapy,and it was increased of the patients with progression disease assessment after treatment and there is statistically significant(P<0.05).5.Compared with the gastric cancer cell line co-cultured with CD 14 positive mononuclear macrophages,the gastric cancer cell line cultured alone has lower apoptosis rate after treated with oxaliplatin for 24 hours.There is statistically significant(P=0.047).[Conclusion]1.The expression of mononuclear macrophages has no significant correlation with the age,gender,pathological type and surgical history of gastric cancer.2.The expression of mononuclear macrophages was not significantly correlated with the number of white blood cell and lymphocyte in peripheral blood of the patients with advanced gastric cancer.3.To a certain extent,the monocyte macrophage is correlated with the efficacy assessment of patients with advanced gastric cancer.4.The monocyte macrophage is significantly correlated with the chemotherapy resistance.