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Metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus
Accumulating evidence suggests that metformin reduces the incidence and mortality of colorectal cancer (CRC). However, underlying mechanisms have not been fully clarified. The aim of this study was to examine the pathological characteristics of resected CRC from patients treated with metformin for t...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648042/ https://www.ncbi.nlm.nih.gov/pubmed/32794612 http://dx.doi.org/10.1111/cas.14615 |
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author | Saito, Akira Kitayama, Joji Horie, Hisanaga Koinuma, Koji Ohzawa, Hideyuki Yamaguchi, Hironori Kawahira, Hiroshi Mimura, Toshiki Lefor, Alan Kawarai Sata, Naohiro |
author_facet | Saito, Akira Kitayama, Joji Horie, Hisanaga Koinuma, Koji Ohzawa, Hideyuki Yamaguchi, Hironori Kawahira, Hiroshi Mimura, Toshiki Lefor, Alan Kawarai Sata, Naohiro |
author_sort | Saito, Akira |
collection | PubMed |
description | Accumulating evidence suggests that metformin reduces the incidence and mortality of colorectal cancer (CRC). However, underlying mechanisms have not been fully clarified. The aim of this study was to examine the pathological characteristics of resected CRC from patients treated with metformin for type 2 diabetes mellitus (DM). In total, 267 patients with DM underwent curative colectomy for Stage I‐III CRC and 53 (19.9%) patients had been treated medically including metformin. Pathological N‐stage was significantly lower in metformin‐treated patients (P < .05) with prolonged disease‐free survival (DFS) (P < .05). Immunohistochemistry showed that the densities of CD3(+) and CD8(+) tumor‐infiltrating lymphocytes (TILs) in the invasive front area were significantly higher in 40 patients treated with metformin compared with propensity score matched cases without metformin (P < .05). The density of tertiary lymphoid structures (TLS) in tumor stroma was markedly increased in metformin‐treated patients (P < .001). In those tumors, there were more CD68(+) tumor‐associated macrophages (TAM) infiltrated (P < .05), while the ratio of CD163(+) M2‐phenotype was markedly reduced (P < .001). Stromal fibrosis tended to be suppressed by metformin intake (P = .051). These findings suggested that metformin drastically changes the characteristics of infiltrating immune cells in CRC and reprograms the tumor microenvironment from immunosuppressive to immunocompetent status, which may lead to suppression of microscopic tumor spread and improve the outcomes of patients with CRC and type 2 DM. |
format | Online Article Text |
id | pubmed-7648042 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76480422020-11-16 Metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus Saito, Akira Kitayama, Joji Horie, Hisanaga Koinuma, Koji Ohzawa, Hideyuki Yamaguchi, Hironori Kawahira, Hiroshi Mimura, Toshiki Lefor, Alan Kawarai Sata, Naohiro Cancer Sci Original Articles Accumulating evidence suggests that metformin reduces the incidence and mortality of colorectal cancer (CRC). However, underlying mechanisms have not been fully clarified. The aim of this study was to examine the pathological characteristics of resected CRC from patients treated with metformin for type 2 diabetes mellitus (DM). In total, 267 patients with DM underwent curative colectomy for Stage I‐III CRC and 53 (19.9%) patients had been treated medically including metformin. Pathological N‐stage was significantly lower in metformin‐treated patients (P < .05) with prolonged disease‐free survival (DFS) (P < .05). Immunohistochemistry showed that the densities of CD3(+) and CD8(+) tumor‐infiltrating lymphocytes (TILs) in the invasive front area were significantly higher in 40 patients treated with metformin compared with propensity score matched cases without metformin (P < .05). The density of tertiary lymphoid structures (TLS) in tumor stroma was markedly increased in metformin‐treated patients (P < .001). In those tumors, there were more CD68(+) tumor‐associated macrophages (TAM) infiltrated (P < .05), while the ratio of CD163(+) M2‐phenotype was markedly reduced (P < .001). Stromal fibrosis tended to be suppressed by metformin intake (P = .051). These findings suggested that metformin drastically changes the characteristics of infiltrating immune cells in CRC and reprograms the tumor microenvironment from immunosuppressive to immunocompetent status, which may lead to suppression of microscopic tumor spread and improve the outcomes of patients with CRC and type 2 DM. John Wiley and Sons Inc. 2020-09-28 2020-11 /pmc/articles/PMC7648042/ /pubmed/32794612 http://dx.doi.org/10.1111/cas.14615 Text en © 2020 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Saito, Akira Kitayama, Joji Horie, Hisanaga Koinuma, Koji Ohzawa, Hideyuki Yamaguchi, Hironori Kawahira, Hiroshi Mimura, Toshiki Lefor, Alan Kawarai Sata, Naohiro Metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus |
title | Metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus |
title_full | Metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus |
title_fullStr | Metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus |
title_full_unstemmed | Metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus |
title_short | Metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus |
title_sort | metformin changes the immune microenvironment of colorectal cancer in patients with type 2 diabetes mellitus |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648042/ https://www.ncbi.nlm.nih.gov/pubmed/32794612 http://dx.doi.org/10.1111/cas.14615 |
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