{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:38:56Z","timestamp":1790667536450,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2019,10,20]],"date-time":"2019-10-20T00:00:00Z","timestamp":1571529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Fund of China","doi-asserted-by":"crossref","award":["81502309"],"award-info":[{"award-number":["81502309"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Tianjin Medical University Natural Science Funds","award":["2016KYZM02"],"award-info":[{"award-number":["2016KYZM02"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The tumor microenvironment represents an abnormal niche containing numerous factors, such as T cells, dendritic cells (DCs), regulatory T cells (Tregs), and indoleamine 2,3\u2010dioxygenase (IDO), involved in maintaining immune homeostasis and tolerance. All these factors may influence the choice of therapy and the clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Flow cytometry was performed to identify CD4+\/CD8\u00a0+\u00a0T cells and DCs, and immunohistochemistry was used to evaluate IDO and Forkhead Box P3 (Foxp3) expression; these experiments were performed in order to explore the clinical and prognostic significance of CD4\/CD8\u00a0+\u00a0T cells, DCs, Tregs, and IDO expression in gastric carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Smaller tumor size was correlated with higher expression levels of peripheral CD4\u00a0+\u00a0T cells (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.003) and CD8\u00a0+\u00a0T cells (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002), and lower IDO expression (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.044) in tumors. Well\u2010differentiated gastric carcinomas displayed higher peripheral (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.029) and tumor\u2010infiltrating CD4\u00a0+\u00a0T cell (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.009) populations and a higher tumor\u2010infiltrating DC1\/DC2 ratio (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.048). Gastric cancer in the early T stages exhibited higher populations of peripheral DC2s (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.044) and a higher tumor\u2010infiltrating DC1\/DC2 ratio (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.012). Gastric cancer at the N0 stage had lower tumor\u2010infiltrating DC2s (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.032) and a higher DC1\/DC2 ratio (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.037). IDO expression was positively correlated with tumor\u2010infiltrating Foxp3\u00a0+\u00a0Tregs (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) as well as DC2s (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), whereas it was negatively correlated with the tumor\u2010infiltrating CD4\/CD8\u00a0+\u00a0T cell ratio (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.023). Tumor\u2010infiltrating Foxp3\u00a0+\u00a0Treg was positively correlated with tumor\u2010infiltrating DC2s (<jats:italic>r<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.772; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). At T, N, and TNM stages, the expression levels of peripheral DC2s, tumor\u2010infiltrating DC1\/DC2 ratios, Foxp3\u00a0+\u00a0Tregs, and IDO were significantly correlated with prognosis (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). The T stage and peripheral DC2s were significant risk factors for overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Immunocompetent cells and humoral immune factors, including DC2s, CD4+\/CD8 + T cells, Foxp3 + Tregs, and IDO, interact with each other to compose a complex community of tumor immune microenvironment, ultimately affecting tumor progression and survival of gastric cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.2596","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T02:30:45Z","timestamp":1571625045000},"page":"7330-7344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":118,"title":["CD4\/CD8\u00a0+\u00a0T cells, DC subsets, Foxp3, and IDO expression are predictive indictors of gastric cancer 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinchao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cancer Prevention Tianjin Medical University Cancer Institute and Hospital Tianjin China"},{"name":"Department of Molecular Imaging and Nuclear Medicine Tianjin Medical University Cancer Institute and Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wengui","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Molecular Imaging and Nuclear Medicine Tianjin Medical University Cancer Institute and Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7256-197X","authenticated-orcid":false,"given":"Juntian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cancer Prevention Tianjin Medical University Cancer Institute and Hospital Tianjin 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