To evaluate whether the level of myeloid-derived suppressor cells is related to the complication of sepsis after esophageal cancer surgery and whether changing the myeloid-derived suppressor cells levels can improve the prognosis of patients cancer-related sepsis.

A total of 178 esophageal cancer patients from Harbin Medical University Cancer Hospital were included in this study. Blood samples were taken from the patients for the analysis of the levels of G-MDSCs and M-MDSCs by flow cytometry. The conditions of the patients was recorded. Male C57BL/6 mice were implanted with Lewis lung cancer cells (2 × 10⁶/mice) by subcutaneous injection into the iliac fossa. Three weeks later, we performed CLP in the mice. All-trans-retinoic acid (ATRA) was intraperitoneally injected at 20 mg/kg, and the control group was injected with 0.9 % NS. We observed the mortality of the mice with cancer-related sepsis.

In all, 95 % of the esophageal cancer patients had a high level of G-MDSCs (>50 %). A high level of G-MDSCs (>82.5 %) can lead to high morbidity from sepsis after surgery. The increase in M-MDSCs was suggestive of a poor prognosis in patients with cancer-related sepsis. ATRA can improve the survival of patients with cancer-related sepsis.

A high level of G-MDSCs can be used to determine the incidence of sepsis in preoperative esophageal cancer patients, M-MDSCs might be effective prognostic indicators for cancer-sepsis patients, and changing the MDSC levels can improve the mortality of patients with cancer-related sepsis.