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Recent studies have identified myeloid-derived suppressor cells (MDSCs)that are potent suppressors of tumor immunity and therefore a significant impedimentto cancer immunotherapy. It has been reported that MDSCs are generated by malignantdiseases or inflammation. However, no systematic studies in patients have beendescribed. In order to clinically characterize MDSCs, we tested PBMCs from patientswith various types of cancer including cholangiocellular, hepatocellular and pancreaticcarcinoma, esophageal, gastric and colorectal cancer, breast cancer and thyroidcancer, and GIST, and those from normal volunteers using flow cytometry analysis.A significant increase was seen in the percentages of MDSCs in PBMCs from patientscompared with normal volunteers. Among these patients, MDSC level was higher inpatients with cancer of the digestive system and patients with breast cancer comparedwith normal volunteers. MDSC level was significantly and inversely correlatedto stimulation indices (SI) of PHA-blastogenesis of lymphocytes and serum concentrationof total protein, and positively correlated to neutrophil count. MDSC percentagein patients with gastric and colorectal cancer was also significantly correlatedto neutrophil count and inversely correlated with lymphocyte count, and showedhighly significant correlation to neutrophil/lymphocyte rate (NLR). In patientswith breast cancer, MDSC levels in preoperative patients was significantly increasedcompared to normal volunteers and significantly decreased in postoperative patients.Thus, it is clear that MDSCs are increased in patients with cancer and closelyrelated to suppression of cell-mediated immune responses. These data also suggestthat they are related to chronic inflammation and that their levels are increasedfurther in the terminal stages of patients whose nutritional status is impairedas observed in hypoproteinemia. MDSC levels have also been shown to decrease afterremoval of tumors in patients with breast cancer.

oncology reports

Circulating myeloid-derived suppressor cells are increased and correlate to immune suppression, inflammation and hypoproteinemia in patients with cancer