<b>Assessment of invasive growth pattern and lymphocytic infiltration in colorectal cancer</b>

Jass, Jeremy R.; Ajioka, Yoichi; Allen, J.P.; Chan, Yuen; Cohen, Ronald J.; Nixon, Joanna; Radojković, Milica; Restall, Antonia; Stables, Simon; Zwi, L. Jonathan

doi:10.1046/j.1365-2559.1996.d01-467.x

Cited by 127 publications

(132 citation statements)

References 16 publications

(34 reference statements)

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“…For instance, it has been shown that estimating the amount of tumor-infiltrating immune cells on HE sections is sensitive to interobserver variability 5 and underestimates the true number of leukocytes in a tumor. 6 In addition, it is difficult to characterize the tumor-infiltrating immune cells morphologically, that is, whether a particular cell is a T-helper (T H , CD4 þ ), cytotoxic T lymphocyte (CTL, CD8 þ ) or natural killer (NK) cell (CD3 À /CD56 þ , and subsets of CD8 þ or CD57 þ ).…”

mentioning

confidence: 99%

Immune system and prognosis in colorectal cancer: a detailed immunohistochemical analysis

Menon

Rhijn

Morreau

et al. 2004

Laboratory Investigation

199

172

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The efficacy of tumor cell-immune cell interactions depends on a number of factors, for example, the expression of HLA-I on tumor cells, the type of immune cell, the accessibility of tumor cells for immune cells and the expression of immunogenic epitopes. We assessed infiltration of CD4 þ , CD8 þ , CD56 þ and CD57 þ cells in the tumor epithelium, tumor stroma and advancing tumor margin of 93 colorectal carcinomas and correlated this to clinicopathological parameters, the expression of HLA-A and HLA-B/C on tumor cells, the presence of a basal membrane (BM)-like structure surrounding tumor nodules and the presence of microsatellite instability/ mutator phenotype (absent MLH-1 expression). The median intraepithelial CD4 þ , CD8 þ , CD56 þ and CD57 þ cell infiltrations were 3, 23, 0 and 0 cells/mm 2 tumor, respectively. HLA-A/BC expression by tumor cells was normal in 28/43%, heterogeneous in 59/48% and absent in 13/9% of the cases. A BM-like structure surrounding the tumor nodules was absent, present and thick in 47, 38 and 15% of the cases. Six cases lost MLH1 expression. There was a positive correlation between leukocyte infiltration in the three compartments for CD4 þ , CD8 þ , CD56 þ (partly) and CD57 þ (all Po0.05) cell infiltration. Intraepithelial CD8 þ cell infiltration inversely correlated with HLA-A (P ¼ 0.04) and HLA-B/C expression (P ¼ 0.04). Intraepithelial CD57 þ cell infiltration inversely correlated with HLA-B/C expression (P ¼ 0.04). Moreover, intraepithelial infiltration of CD8 þ and CD57 þ cells was inversely correlated to the presence of a BM-like structure (P ¼ 0.003 and 0.04, respectively). Uni-and multivariate analyses showed that a lower tumor stage (P ¼ 0.004) and marked infiltration of CD8 þ (P ¼ 0.04) and CD57 þ cells (P ¼ 0.05) at the advancing tumor margin were independent prognostic factors for a longer diseasefree survival. Loss of MLH1 expression was correlated with a significantly higher intraepithelial CD8 þ and CD57 þ cell infiltration. We conclude that infiltration of CD8 þ and CD57 þ cells are important prognostic factors in colorectal cancer. However, their interaction with tumor cells is inversely correlated to the presence of HLA-I on tumor cells and a thick BM-like structure around tumor islets. Our data indicate that NK cells might play an important role in the immune surveillance in colorectal cancer patients.

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mentioning

confidence: 99%

Immune system and prognosis in colorectal cancer: a detailed immunohistochemical analysis

Menon

Rhijn

Morreau

et al. 2004

Laboratory Investigation

199

172

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“…Although Jass_ new grading system was shown to have superior prognostic value to Dukes staging, it has not been recommended for routine usage in standard reporting protocols because some studies have raised the criticism of poor reproducibility and reliability of the growth pattern and lymphocytic infiltrate. 20,31,32 In two previously published studies, we have shown the lack of any prognostic significance of lymphocytic infiltrate but a strong correlation between tumor growth pattern and survival in patients with LNnegative and patients with LN-positive colorectal cancer. 3,33 In the present study, we reconfirmed these data in patients classified as Stage IIA, thus demonstrating, in accordance with the experience of other authors, 2,34-37 the reliability of the growth pattern as an objective predictor of prognosis.…”

Section: Discussionmentioning

confidence: 94%

Pathologic Determinants of Survival After Resection of T3N0 (Stage IIA) Colorectal Cancer: Proposal for a New Prognostic Model

Cianchi¹,

Messerini²,

Comin³

et al. 2007

Diseases of the Colon &Amp; Rectum

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PURPOSE: There is an increasing need for accurate prognostic stratification of patients with Stage II colorectal cancer to identify a subgroup of high-risk patients who may benefit from adjuvant therapies. This study was designed to evaluate the prognostic impact of a wide spectrum of pathologic parameters in a consecutive series of homogenously treated and well-characterized patients with Stage IIA (T3N0M0) colorectal cancer. METHODS: The study included 238 patients operated on by a single surgeon for Stage IIA colorectal tumors. The median postoperative follow-up was 110 (range, 96-120) months. At least 12 lymph nodes were harvested and examined in all the resection specimens. The prognostic value of 13 pathologic parameters, including lymph node occult disease (micrometastases) detected by immunohistochemistry, was investigated. RESULTS: Multivariate analysis identified tumor growth pattern (expanding or infiltrating; P = 0.01) and extent of tumor spread beyond muscularis propria (e5 mm or >5 mm; P = 0.04) as the only factors having independent prognostic value. The combination of these two easily determined parameters allowed us to identify two groups of patients at low risk or high risk of tumor recurrence. The eight-year survival rates were 83.3 and 53.4 percent for the two groups, respectively. The high-risk group comprised those patients with infiltrating tumors and extramural tumor spread > 5 mm. CONCLUSIONS: We propose a new and simple prognostic model to identify patients with high-risk Stage IIA colorectal cancer for whom adjuvant therapies may be justified and effective.

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“…O padrão infiltrativo é caracterizado por glân-dulas neoplásicas separadas por pouco tecido fibroso, as quais podem ser encontradas individualmente ou em pequenos grupos infiltrando a parede intestinal e associadas a um infiltrado linfocítico. As lesões pouco dife- renciadas e as de padrão infiltrativo estão em geral associadas a um prognóstico mais reservado (7,8,13,14,15) . Alguns casos de adenocarcinoma apresentam áre-as mucoprodutoras, que correspondem ao acúmulo de mucina principalmente no meio extracelular.…”

Section: Discussionunclassified

“…Pacientes com tumores do cólon direito podem apresentar anemia devido à perda sanguínea crônica. Durante a progressão do adenocarcinoma colorretal, há invasão neoplásica através das camadas do intestino, incluindo invasão neoplásica angiolinfática, podendo levar ao surgimento de metástases hepáticas e nodais (5,6,7,8) .…”

Section: Introductionunclassified

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A relação entre metástases em linfonodos regionais e fatores prognósticos no adenocarcinoma esporádico de intestino grosso

Madeira

Pêgas

Zettler

et al. 2009

Rev bras. colo-proctol.

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INTRODUÇÃOO carcinoma colorretal corresponde a uma das neoplasias malignas mais freqüentes no Brasil, sendo a terceira causa de óbito em mulheres e a quinta em homens, embora estas taxas sejam maiores na Améri-ca do Norte e Europa (1) . Estudos epidemiológicos indicam que a etiologia do adenocarcinoma de intestino grosso está associada a fatores genéticos e ambientais, como a dieta. A maioria dos pacientes, em áreas de risco, apresenta mais de 50 anos de idade no momento do diagnóstico. A incidência do adenocarcinoma colorretal é levemente maior no sexo masculino, acometendo em 40% dos casos o reto, em 30% dos casos o cólon esquerdo e em 30% o cólon direito. Em mulheres, há um predomínio de lesões no cólon direito (1,2,3,4,5) .Uma grande proporção de casos adenocarcinoma colorretal está relacionado à presença concomitante de adenomas, além da eventual associação com a polipose intestinal familiar, doença inflamatória intestinal crônica,

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Assessment of invasive growth pattern and lymphocytic infiltration in colorectal cancer

Cited by 127 publications

References 16 publications

Immune system and prognosis in colorectal cancer: a detailed immunohistochemical analysis

Immune system and prognosis in colorectal cancer: a detailed immunohistochemical analysis

Pathologic Determinants of Survival After Resection of T3N0 (Stage IIA) Colorectal Cancer: Proposal for a New Prognostic Model

A relação entre metástases em linfonodos regionais e fatores prognósticos no adenocarcinoma esporádico de intestino grosso

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