Prognostic Significance of Immune and Stromal Components in Colorectal Cancer: Practical Tools for Routine Pathologic Assessment.

Mi Jang, Yongki Hong, Soojung Hong, Eun Kyung Kim
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Abstract

Context.—: In colorectal cancer (CRC), the tumor microenvironment includes cancer-associated fibroblasts and a variety of immune cells, which are increasingly recognized for their prognostic significance.

Objective.—: To evaluate the tumor microenvironment in CRC using methodologies applicable in routine pathologic practice.

Design.—: A comprehensive evaluation of the local immune response and tumor to stroma ratio (TSR) was performed in 930 CRC cases by thoroughly reviewing the whole hematoxylin-eosin (H&E) slides. Local immune responses were assessed using peritumoral inflammatory infiltration (Klintrup-Mäkinen and modified Klintrup-Mäkinen methods), intratumoral stromal tumor-infiltrating lymphocytes (TILs; International TILs Working Group system and deep stromal TIL system), and Crohn-like lymphoid reaction (CLR).

Results.—: In the multivariate analysis, age (>68 years), stage III-IV, microsatellite stability, signet ring cell/undifferentiated carcinoma, extramural venous invasion, high TSR (>50%), and CLR were independent prognostic factors for disease-specific survival. Excluding microsatellite stability, these factors also served as significant prognostic indicators for progression-free survival. Among the 4 methods for measuring local immune response, evaluating the proportion of TILs within the deepest intratumoral stroma was an independent predictor of progression-free survival.

Conclusions.—: We suggest that evaluating CLR, TSR, and stromal TILs on hematoxylin-eosin-stained slides represent a practical and straightforward approach with significant prognostic value.

免疫和基质成分在结直肠癌中的预后意义:常规病理评估的实用工具。
上下文。-:在结直肠癌(CRC)中,肿瘤微环境包括癌症相关成纤维细胞和多种免疫细胞,它们的预后意义日益被认识。目的:利用常规病理实践中适用的方法评估结直肠癌的肿瘤微环境。通过对930例结直肠癌患者的苏木精-伊红(H&E)全片检查,对其局部免疫反应和肿瘤间质比(TSR)进行了综合评价。局部免疫反应通过瘤周炎症浸润(Klintrup-Mäkinen和改进的Klintrup-Mäkinen方法)、瘤内基质肿瘤浸润淋巴细胞(TILs;国际TIL工作组系统和深基质TIL系统)和克罗恩样淋巴反应(CLR)。-:在多变量分析中,年龄(> - 68岁)、III-IV期、微卫星稳定性、印戒细胞/未分化癌、外静脉浸润、高TSR(>50%)和CLR是疾病特异性生存的独立预后因素。除微卫星稳定性外,这些因素也可作为无进展生存期的重要预后指标。在4种测量局部免疫反应的方法中,评估肿瘤最深处间质中til的比例是无进展生存的独立预测指标。-:我们建议在苏木精-伊红染色的载玻片上评估CLR、TSR和间质TILs是一种实用且直接的方法,具有重要的预后价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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