The majority of patients with microsatellite stable (MSS) colorectal cancer (CRC) do not benefit from the immunotherapies directed at rescuing T‐cell functions. Therefore, complete understanding of T‐cell phenotypes and functional status in the CRC microenvironment is desirable. Here, we applied single‐cell mass cytometry to mold the T‐cell phenotype in 18 patients with MSS CRC for better understanding of CRC as a systemic disease and to search for tumor‐driven T‐cell profile changes. We show interpatient and intrapatient phenotypic diversity of T‐cell subsets. We revealed increased immunosuppressive/exhausted T‐cell phenotypes at tumor lesions. CD8+ CD28− immunosenescent T cells with impaired proliferation capacity dominate the T‐cell compartment. As per the transcriptome and quantitative real time‐PCR analysis, the accumulation of immunosuppressive cells is driven by the tumor microenvironment. T‐cell profiles are similar between patients at early and late stages, indicating that the immunosuppressive microenvironment is formulated early during CRC development. Mapping of T‐cell infiltration and understanding of the mechanisms underlying their regulation may provide valuable information to boost the immune response in patients with MSS CRC.

Background: This study aimed to explore the risk factors associated with esophagojejunal anastomotic leakage (EJAL) in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer.Methods: 390 consecutive patients receiving Roux-en-Y esophagojejunostomy reconstruction after surgery were reviewed. Multivariate analysis was performed using a logistic regression model to identify independent risk factors for EJAL.Results: Of the 390 patients enrolled in this study, EJAL occurred in 10 patients (2.6%). One patient (1/10) with EJAL died. Univariate analysis identified age (P = 0.025), alcohol consumption (P = 0.019), pulmonary insufficiency (P = 0.049), and intraoperative blood loss (P = 0.015) as risk factors for EJAL. Of these four risk factors, age (P = 0.043) and alcohol consumption (P = 0.043) were retained as independent risk factors by multivariate analysis.Conclusions: Surgeons should be very careful about anastomotic leakage during the perioperative period, especially in patients with advanced age and a history of alcohol consumption. Pulmonary insufficiency and intraoperative blood loss, although not being identified as independent risk factors, should also be considered.

The present study aimed to investigate the safety and short-term outcome of laparoscopy-assisted distal radical gastrectomy in treating gastric cancer among obese patients. Perioperative outcomes were compared between 67 gastric cancer patients with a body mass index (BMI) ≥25 kg/m2 (obese group) and 198 ones with BMI <25 kg/m2 (non-obese group). All the cases underwent laparoscopic radical resection between April 2009 and October 2013. The value of BMI was 27.3 ± 2.67 kg/m2 in the obese group and 21.3 ± 2.64 kg/m2 in non-obese group. There were no significant differences between 2 groups in age, sex, presence of diabetes, tumor size, number of metastatic lymph nodes, or metastatic lymph node ratio. Postoperative complications did not differ between the 2 groups (P > .05). There were significant differences between the 2 groups in operation time (non-obese: [234.2 ± 67.1] minutes vs obese group: [259.4 ± 78.5]; P = .017), postoperative hospital stay (obese group [19.7 ± 14.8] day vs non-obese [15.4 ± 7.1], P = .002), and retrieved lymph nodes ([27.6 ± 11.0] day vs non-obese [31.9 ± 12.5] day, P = .002). Obesity may prolong operation time and postoperative hospital stay, and cause less retrieved lymph nodes, but does not increase the incidence of postoperative complications. The experienced center can properly conduct laparoscopic assisted radical gastrectomy in obese patients.