The Impact of Microsatellite Instability and CD8+ Tumor Infiltrating Lymphocytes on Neoadjuvant Chemotherapy Response in Colorectal Cancer: A Prospective Observational Study.

IF 2.6 4区医学 Q3 ONCOLOGY

Cancer Management and Research Pub Date : 2026-09-10 eCollection Date: 2026-01-01 DOI:10.2147/CMAR.S629872

Prapanca Nugraha, Yunia Sribudiani, Reno Rudiman, Susanti Susanti, Hermin Aminah Usman, Afrida Helen, Etis Primastari, Bambang Am Am Setya Sulthana, Raden Yohana Azhar, Kiki Lukman

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引用次数: 0

Abstract

Background: Treatment of colorectal cancer includes surgery and chemotherapy, along with advances in personalised therapies, which focus on achieving safer and more effective outcomes. One of the processes underlying colorectal cancer is microsatellite instability (MSI), and CD8+ Tumor Infiltrating Lymphocytes (TILs) belong to the immune cell subset that shows high impact on cancerous cells. The purpose of this study is to determine whether MSI, CD8+ TILs expression, and chemotherapy response are related.

Methods: This is a retrospective cohort study of colorectal cancer patients who received chemotherapy in the neoadjuvant setting, prior to tumor resection, at a tertiary general hospital in West Java, Indonesia. The MSI examination was carried out using qPCR-HRM (BioColoMelt-Dx), and the TILs CD8+ expression was carried out using immunohistochemistry. The chemotherapy response was evaluated using response evaluation criteria for solid tumors (RECIST).

Results: Forty-one subjects were enrolled in this study. There were three subjects (7.3%) with microsatellite instability (1 MSI-L, 2 MSI-H) and 19 subjects (46.3%) with high CD8+ TILs expression. There were 28 (68.3%) subjects in stage III, followed by stage IV (22%) and stage II (9.8%). There were 10 subjects (24%) who showed progressive disease, and 16 subjects (39%) with high expression of CD8+ TILs showed partial chemotherapy response. MSI showed a significant association with age (P<0.05). The CD8+ TILs expression showed no significant association with sex, subtype, grade, or tumor location, but significantly associated with age, stage and chemotherapy response (P < 0.05). Subjects with MSI tend to have early onset disease. Colorectal cancer with high CD8+ TILs expression was less likely to have metastasis (stage IV) and had a better chemotherapy response when compared to those with low CD8+ TILs expression.

Conclusion: The MSI status showed no significant relationship with CD8+ TILs. Patients with high CD8+ TILs showing a relationship with a better chemotherapy response and a better prognosis in colorectal cancer patients.

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微卫星不稳定性和CD8+肿瘤浸润淋巴细胞对结直肠癌新辅助化疗反应的影响：一项前瞻性观察研究

背景：结直肠癌的治疗包括手术和化疗，以及个性化治疗的进展，其重点是实现更安全和更有效的结果。结直肠癌的潜在过程之一是微卫星不稳定性（MSI），而CD8+肿瘤浸润淋巴细胞（TILs）属于对癌细胞具有高度影响的免疫细胞亚群。本研究的目的是确定MSI、CD8+ TILs表达与化疗反应是否相关。方法：这是一项回顾性队列研究，在印度尼西亚西爪哇的一家三级综合医院，在肿瘤切除术前接受新辅助化疗的结直肠癌患者。采用qPCR-HRM （BioColoMelt-Dx）进行MSI检测，免疫组织化学检测TILs CD8+表达。采用实体瘤反应评价标准（RECIST）评价化疗反应。结果：本研究共纳入41名受试者。微卫星不稳定3例（7.3%）（1例MSI-L， 2例MSI-H）， CD8+ TILs高表达19例（46.3%）。III期28例（68.3%），其次是IV期（22%）和II期（9.8%）。10例（24%）出现进展性疾病，CD8+ TILs高表达的16例（39%）出现部分化疗反应。结论：MSI状态与CD8+ TILs无显著相关性。高CD8+ TILs患者与结直肠癌患者更好的化疗反应和更好的预后相关

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来源期刊

Cancer Management and Research Medicine-Oncology

CiteScore

7.40

自引率

0.00%

发文量

448

审稿时长

16 weeks

期刊介绍： Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include: ◦Epidemiology, detection and screening ◦Cellular research and biomarkers ◦Identification of biotargets and agents with novel mechanisms of action ◦Optimal clinical use of existing anticancer agents, including combination therapies ◦Radiation and surgery ◦Palliative care ◦Patient adherence, quality of life, satisfaction The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.