Circulating follicular helper T (cTfh) cells are a novel subset of cluster of differentiation (CD)4+ helper T cells.
Interleukin (IL)-21 and C-X-C motif
chemokine ligand (CXCL)13 are the principal effectors and chemotactic regulatory factors of Tfh. However, the roles of
IL-21 and CXCL13 in
gastric cancer have not yet been completely elucidated. The aim of the present study was to investigate the distribution of cTfh cells, and the expression of
IL-21 and CXCL13 in patients with
gastric cancer was evaluated in order to ascertain the significance and potential mechanisms of these effectors in
gastric cancer. A total of 50 patients with
gastric cancer were enrolled as the study subjects, with 30 healthy individuals selected as controls. The percentage of cTfh cells (cTfh%) in the peripheral blood was calculated using flow cytometry. They are identified in the present study as CD4+
chemokine C-X-C receptor (CXCR)5+
inducible T cell co-stimulator (ICOS)+ cells. The serum levels of
IL-21 and CXCL13 were determined by ELISA. The cTfh% in the peripheral blood and the concentration of
IL-21 and CXCL13 in the serum were significantly higher in patients with
gastric cancer compared with the control group. cTfh% was significantly higher in patients with
lymph node metastasis,
Tumor-Node-
Metastasis (TNM) stage III-IV and low differentiation. The concentrations of
IL-21 and CXCL13 in patients with
lymph node metastasis and/or TNM III-IV were significantly higher than in those without
lymph node metastasis or with TNM I-II. There was a positive correlation between cTfh%/CXCL13 and IL-21/CXCL13, while there was no correlation between cTfh%/IL-21. cTfh cells and associated factors (IL-21/CXCL13) may be involved in the development and progression of
gastric cancer. There may be mutual regulation among cTfh cells,
IL-21 and CXCL13.