The Immunoscore system predicts prognosis after liver metastasectomy in colorectal cancer liver metastases

Wang, Yun; Lin, Hao; Huang, Ming-Yang; Shao, Quanqin; Wang, Zhi qiang; Wang, Feng Hua; Yuan, Yunfei; Li, Bin kui; Wang, De Shen; Ding, Pei Rong; Chen, Gong; Wu, Xiao; Lü, Zhen; Li, Li Ren; Pan, Zhi Zhong; Sun, Peng; Shu, Yan; Wan, De Sen; Xu, Rui‐Hua; Li, Yu Hong

doi:10.1007/s00262-017-2094-8

Cited by 67 publications

(68 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also observed a significantly lower quantity of CD3 + , CD8 + , and Foxp3 + T cells in the intratumoural region than in the peritumoural region of liver metastases. In line with our results, the findings of Wang et al and those from the EORTC 40983 study also showed a lower TIL density in the intratumoural regions of liver metastases than in the peritumoural regions [21,23]. To the best of our knowledge, a high tumour burden in the intratumoural microenvironment might promote immunosuppression [26,27].…”

Section: Discussionsupporting

confidence: 92%

“…Similarly, Nazemalhosseini-Mojarad et al suggested that a high level of tumour-infiltrating CD8 + T lymphocytes was an independent prognostic factor for favourable patient survival [12]. Recently, Wang et al reported that a high immunoscore consisting of the densities of CD3 + and CD8 + T cells in the intratumoural and peritumoural regions had greater power to significantly predict longer RFS and OS compared to the conventional clinical risk score (CRS) system [23]. These findings suggest a role for CD3 + T cells in activating an immune response in CRLM, especially cytotoxic CD8 + T cells, which could act as direct mediators of tumour killing and enhanced activation status of TIL.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Immune Cell Infiltration in the Microenvironment of Liver Oligometastasis from Colorectal Cancer: Intratumoural CD8/CD3 Ratio Is a Valuable Prognostic Index for Patients Undergoing Liver Metastasectomy

Peng

Wang

Zhang

et al. 2019

Cancers

View full text Add to dashboard Cite

Background: A comprehensive investigation into immune cell infiltration provides more accurate and reliable prognostic information for patients with colorectal liver oligometastases (CLO) after liver metastasectomy. Methods: Simultaneous detection of the immune constituents CD3+, CD8+, Foxp3+ T, and α-SMA+ cells in the liver oligometastasis of 133 patients was conducted using a four-colour immunohistochemical multiplex technique. Immune cells were quantified, and tumour-infiltrating lymphocyte (TIL) ratios were subsequently calculated. Correlation analysis was performed using Pearson’s correlation. Recurrence-free survival (RFS) and overall survival (OS) for TIL ratios were analysed using the Kaplan–Meier method and Cox regression models. Results: Significantly fewer CD3+, CD8+, and Foxp3+ T cells were observed in the intratumoural region than in the peritumoural region of liver metastases. CD3+, CD8+, Foxp3+ T, and α-SMA+ cells showed significantly positive correlations with each other both in the intratumoural and peritumoural regions of liver metastases. Only the CD8/CD3 TIL ratio demonstrated a positive correlation between intratumoural and peritumoural regions of liver metastases (r = 0.541, p < 0.001). Patients with high intratumoural CD8/CD3 ratios had significantly longer 3-year RFS (59.0% vs. 47.4%, p = 0.035) and 3-year OS rates (83.3% vs. 65.8%, p = 0.007) than those with low intratumoural CD8/CD3 ratios. Multivariate analyses revealed that the intratumoural CD8/CD3 ratio was independently associated with RFS (HR = 0.593; 95% CI = 0.357–0.985; p = 0.043) and OS (HR = 0.391; 95% CI = 0.193–0.794; p = 0.009). Conclusion: These findings offer a better understanding of the prognostic value of immune cell infiltration on liver oligometastasis from colorectal cancer.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Immune Cell Infiltration in the Microenvironment of Liver Oligometastasis from Colorectal Cancer: Intratumoural CD8/CD3 Ratio Is a Valuable Prognostic Index for Patients Undergoing Liver Metastasectomy

Peng

Wang

Zhang

et al. 2019

Cancers

View full text Add to dashboard Cite

show abstract

“…Recurrence after primary resection is one of the important factors affecting the overall survival rate of patients, suggesting that it is essential to assess the relapse risk accurately for improving prognosis. Several immune score models based on immunohistochemistry have been built to quantify the immune structure and to provide a strong parameter for prognosis in patients with various tumors, including DSCs . However, immunohistochemistry was limited by small sample size and few cell types.…”

Section: Discussionmentioning

confidence: 99%

Immune cell infiltration as a biomarker for the diagnosis and prognosis of digestive system cancer

et al. 2019

View full text Add to dashboard Cite

The digestive system cancers are aggressive cancers with the highest mortality worldwide. In this study, we undertook a systematic investigation of the tumor immune microenvironment to identify diagnostic and prognostic biomarkers. The fraction of 22 immune cell types of patients were estimated using CIBERSORT. The least absolute shrinkage and selection operator (LASSO) analysis was carried out to identify important immune predictors. By comparing immune cell compositions in 801 tumor samples and 46 normal samples, we constructed the diagnostic immune score (DIS), showing high specificity and sensitivity in the training (area under the receiver operating characteristic curve [AUC] = 0.929), validation (AUC = 0.935), and different cancer type cohorts (AUC > 0.70 for all).We also established the prognostic immune score (PIS), which was an effective prognostic factor for relapse-free survival in training, validation, and entire cohorts (P < .05). In addition, PIS provided a higher net benefit than TNM stage. A composite nomogram was built based on PIS and patients' clinical information with well-fitted calibration curves (c-index = 0.84). We further used other cohorts from Gene Expression Omnibus databases and obtained similar results, confirming the reliability and validity of the DIS and PIS. In addition, the unsupervised clustering analysis using immune cell proportions revealed 6 immune subtypes, suggesting that the immune types defined as having relatively high levels of M0 or/and M1 macrophages were the high-risk subtypes of relapse. In conclusion, this study comprehensively analyzed the tumor immune microenvironment and identified DIS and PIS for digestive system cancers. K E Y W O R D Sdiagnosis, digestive system cancer, immune cell, prognosis, TCGA

show abstract

“…Eighty-six studies were identified that assessed rectal, colon or colorectal cancer survival according to T-cell marker assessment using immunohistochemistry. However, many of these studied overlapping cohorts or assessed more than one marker [21,30,54,[56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75]. In terms of independent cohorts studied in relation to different T-cell markers, there was a total of 63 studies, encompassing 14700 patients [9,13,37,39,.…”

Section: T-lymphocyte Subsetsmentioning

confidence: 99%

The local inflammatory response in colorectal cancer – Type, location or density? A systematic review and meta-analysis

Alexander

McMillan

Park

2020

Cancer Treatment Reviews

View full text Add to dashboard Cite

The host anti-tumour inflammatory response is a strong prognostic indicator, and tumour infiltrating lymphocytes (TILs) are believed to have a complimentary role alongside TNM assessment in dictating future management. However, there is wide disagreement regarding the most efficacious and cost-effective method of assessment. Methods: A comprehensive literature search was performed of EMBASE, MedLine and PubMed as well as an assessment of references to identify all relevant studies relating to the assessment of the peri-tumoural inflammatory response or TILs and prognosis in colorectal cancer (CRC). A meta-analysis was performed of 67 studies meeting the REMARK criteria using RevMan software. Results: Intratumoural assessment of both CD3 and CD8 in CRC were significant for disease-free survival (DFS) (combined HRs 0.46; 95%CI: 0.39-0.54 and 0.54; 95%CI: 0.45-0.65), as well as overall survival (OS) and disease-specific survival (DSS). The same was true for assessment of CD3 and CD8 at the invasive margin (DFS: combined HRs 0.45; 95%CI: 0.33-0.61 and 0.51; 95%CI: 0.41-0.62). However, similar fixed effects summaries were also observed for H&E-based methods, like Klintrup-Makinen grade (DFS: HR 0.62; 95%CI: 0.43-0.88). Furthermore, inflammatory assessments were independent of MSI status. Conclusion: The evidence suggests that it is the density of a coordinated local inflammatory infiltrate that confers survival benefit, rather than any individual immune cell subtype. Furthermore, the location of individual cells within the tumour microenvironment does not appear to influence survival. The authors advocate a standardised assessment of the local inflammatory response, but caution against emphasizing the importance of any individual immune cell subtype.

show abstract

The Immunoscore system predicts prognosis after liver metastasectomy in colorectal cancer liver metastases

Abstract: The Immunoscore of liver metastases can be applied to predict the prognosis of CRCLM patients following liver resection.

Cited by 67 publications

References 30 publications

Immune Cell Infiltration in the Microenvironment of Liver Oligometastasis from Colorectal Cancer: Intratumoural CD8/CD3 Ratio Is a Valuable Prognostic Index for Patients Undergoing Liver Metastasectomy

Immune Cell Infiltration in the Microenvironment of Liver Oligometastasis from Colorectal Cancer: Intratumoural CD8/CD3 Ratio Is a Valuable Prognostic Index for Patients Undergoing Liver Metastasectomy

Immune cell infiltration as a biomarker for the diagnosis and prognosis of digestive system cancer

The local inflammatory response in colorectal cancer – Type, location or density? A systematic review and meta-analysis

Contact Info

Product

Resources

About