Independent prognostic value of eosinophil and mast cell infiltration in colorectal cancer tissue

Abstract

Overall peritumoural inflammatory cell infiltration is a prognostic variable in solid tumours, but the survival‐related impact of the individual cell types within the infiltrate has still not been fully evaluated and compared with the conventional disease classification. In the present study, the prognostic value of individual white cell counts in the peritumoural inflammatory infiltrate in colorectal cancer was assessed. Intra‐operative tumour tissue samples from 584 patients undergoing elective surgery for colorectal cancer were included. None of the patients received pre‐ or post‐operative adjuvant chemotherapy. Tissue blocks were cut from the periphery of the tumours and embedded in paraffin. All blocks included both tumour tissue and normal bowel tissue. Serial sections of 4 µm were analysed for tumour tissue inflammatory cell infiltration using a computer‐ and video‐assisted microscope, which allowed semi‐automated quantification of cells within a fixed area. Total white cells and individual counts of eosinophils, neutrophils, mast cells, lymphocytes, and plasma cells were evaluated in every tumour specimen. Stratification into four groups with similar numbers of events was used to dichotomize the cell counts with respect to survival. The median observation period was 61 (49–75) months. In a multivariate analysis including Dukes' stage, gender, age, peri‐operative blood transfusion, tumour location, and counts of specific inflammatory cells, only advanced Dukes' stage ( p< 0·0001), high age ( p=0·0003), and tumour location in the rectum predicted poor survival, while high counts of eosinophils ( p=0·006) and mast cells ( p=0·02) predicted good survival. Tumour‐associated eosinophilia and mastocytosis appear to be independent prognostic variables in colorectal cancer. Future studies should investigate the potential biological role of tumour tissue eosinophils and mast cells in the modulation of tumour growth. Copyright © 1999 John Wiley & Sons, Ltd.

Tumour inflammatory infiltrate predicts survival following curative resection for node-negative colorectal cancer

“…A high-grade local immune response may represent effective host cellular immune responses preventing the invasive margin from developing an infiltrating or budding appearance. These results are consistent with the detailed analysis of the tumour immune response in patients with colorectal cancer by Nielsen and co-workers 13 and Galon and co-workers 15 . Furthermore, the results of the present study are consistent with the concept that the type, density, and location of a variety of immune cells, and not an individual immune cell type, is an important independent determinant of cancer specific survival in patients with colorectal cancer.…”

Influence of pathological tumour variables on long-term survival in resectable gastric cancer

“…Two recent larger reports on stromal eosinophilic infiltration of colorectal cancer document a similar beneficial effect on prognosis (Nielsen et al, 1999;Fernandez-Acenero et al, 2000). The improved prognosis associated with the presence of marked tumour-associated tissue eosinophilia (TATE) in two cancers at either end of the gut is interesting and merits further investigation even if this is only found in a small percentage (8% in the present study) of these gastrointestinal cancers.…”

Elevated tumour interleukin-1β is associated with systemic inflammation: a marker of reduced survival in gastro-oesophageal cancer

“…Tumour-associated macrophages have been associated with reduced disease-free survival among lung, head and neck, and endometrial cancer (Marcus et al, 2004;Ohno et al, 2004;Chen et al, 2005). In contrast, increased numbers of tumour-associated macrophages, eosinophils, mast cells, and lymphocytes have been linked with improved survival in colorectal cancer (Svennevig et al, 1984;Jass, 1986;Nielsen et al, 1999). The prognostic significance of tumour-associated inflammatory cells is less clear in gastro-oesophageal cancer.…”