Anaplastic thyroid carcinoma (ATC) is one of the most aggressive neoplasms in humans and myeloid-derived suppressor cells (MDSCs) contribute to the negative regulation of immune responses in the context of cancer and inflammation. In order to investigate the pathophysiology of thyroid cancer, peripheral blood mononuclear cells (PBMCs) were obtained from 49 patients with thyroid cancer, 18 patients with non-cancerous thyroid diseases and 22 healthy volunteers. The MDSC levels were found to be higher in patients with any type of thyroid cancer (P<0.05), patients with ATC (P<0.001) and patients with medullary thyroid carcinoma (P<0.05), when compared to patients with non-cancerous thyroid diseases. The MDSC levels were also higher in patients with stage III-IV thyroid cancer compared to those in patients with non-cancerous thyroid diseases (P<0.05). The stimulation index (SI) of phytohemagglutinin (PHA)-induced lymphocyte blastogenesis was significantly lower, the C-reactive protein (CRP) levels were significantly higher and the serum albumin levels were significantly lower in patients with ATC compared to those in patients with non-cancerous thyroid diseases. The SI was significantly lower in stage III and IV thyroid cancer compared to that in non-cancerous thyroid disease (P<0.05). Furthermore, the CRP levels were higher and the concentration of albumin was lower in stage IV thyroid cancer compared to those in non-cancerous thyroid disease (P<0.05). Patients with thyroid carcinoma were then classified into one of two groups according to a %PBMC of MDSC cut-off level of 1.578, which was the average %PBMC of MDSC of patients with any type of thyroid carcinoma. In patients with higher MDSC levels, the production of CRP and interleukin (IL)-10 was significantly higher (P<0.05) and the albumin levels were significantly lower (P<0.05) compared to those in patients with lower MDSC levels. These data indicate that MDSCs are increased in patients with ATC. Furthermore, these patients exhibited suppression of cell-mediated immune responses, chronic inflammation and nutritional impairment.

Background Prediction of post‐hepatectomy liver failure (PHLF) based on remnant liver function reserve is important for successful hepatectomy. The aim of this study was to investigate whether intraoperative indocyanine green (ICG) clearance in a future remnant liver was a predictor of PHLF. Methods This prospective study enrolled 31 consecutive patients who underwent anatomical hepatectomy between June 2016 and August 2019. Intraoperative ICG plasma disappearance rate (ICG‐PDR) and ICG retention rate at 15 min (ICG‐R15) were measured after clamping the selective hepatic inflow to the liver to be resected. The discriminative performance of the ICG‐associated variables for the prediction of PHLF grade B/C was evaluated by receiver operator curve (ROC) analysis. Results Of the operations performed, 87.1% were major hepatectomy. PHLF Grade B/C was observed in eight patients (25.8%) with no mortality. The concordance indices of intraoperative ICG‐PDR and ICG‐PDR for predicting PHLF were 0.834 (95% CI, 0.69–0.98) and 0.834 (95% CI, 0.69–0.98), respectively. A subgroup analysis of patients with preoperative biliary drainage (BD) (n = 17) showed that the concordance indices of intraoperative ICG‐PDR increased to 0.923 (95% CI, 0.79–1.00). Conclusions Intraoperative ICG clearance in the remnant liver was a promising predictor for PHLF in patients undergoing anatomical hepatectomy, especially in patients with BD.

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An elevated neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood is an independent prognostic indicator of various cancers. However, whether a similar immune cell balance in tumor tissues influences the prognosis of cancer patients is not well understood. This study aimed to investigate the prognostic relevance of the intratumoral immune cell balance in gastric cancer patients. The study included 82 consecutive patients who underwent curative resection for gastric cancer. Intratumoral Cluster of Differentiation (CD) 15- and CD8-positive cells were evaluated using immunohistochemical staining, and clinicopathological factors and prognoses were analyzed. The effects of these scores on overall survival (OS) and relapse-free survival (RFS) were estimated using Cox proportional hazards regression. Patients with high intratumoral CD15/CD8 ratios had significantly lower OS and RFS compared to those with low CD15/CD8 ratios (P ). In addition, a high CD15/CD8 ratio was associated with lymph node metastasis (P = 0.019). Patients with a high NLR had a significantly lower RFS than those with a low NLR (P = 0.0050). Multivariate analysis revealed that the intratumoral CD15/CD8 ratio was an independent prognostic indicator of RFS (Hazard ratio = 4.7, 95% confidence interval = 1.4–16.2). Therefore, an increased intratumoral CD15/CD8 ratio is an independent predictor of survival following gastric cancer resection and is associated with lymph node metastasis and microscopic lymph vessel invasion. Establishing the postoperative follow-up schedule and adjuvant therapy may be clinically advantageous.