Research on Disseminated Tumor Cells in Bone Marrow in Gastric Cancer Patients with Obesity

Background: Obesity is a risk factor for cancer development and is associated with poor prognosis in
multiple tumor types. There is emerging evidence of a strong association between obesity and
gastrointestinal cancer. The molecular mechanism underlying gastric cancer invasion and metastasis
is still poorly understood. Problem of disseminated tumor cells (DTCs) in gastric cancer remains to be
relevant for clinics and less is known concerning this problem for patients with obesity.
Aim: This study was aimed to evaluate how incidence of DTCs in bone marrow is conditioned by
excess of adipocites in tumor microenvironment of patients with gastric cancer and obesity.
Results: There was not found the associations between availability of DTCs in BM as well CXCR4-
positive cells in tumor and body mass index (BMI) but incidence of DTC in BM was associated with
high density of cancer-associated adipocytes (CAAs) as well with high number of CXCR4-positive
cells in tumor of patients with BMI<25 and BMI>25<30 but it was not true for patients with BMI>30
where frequency of DTCs finding in BM was significantly decreased and that was statistically
significant. Overall survival of patients with obesity was significantly longer (P=0.0270) than that of the
patients with BMI<30.
Conclusion: In patients with BMI>30 high density of CAAs and high number of CXCR4-positive cells
in tumor may create specific tumor microenvironment that prevent tumor cells to leave primary lesion.
OS of patients with gastric cancer is mainly influenced by CAAs density in tumors and such influence
depends essentially on the BMI.