The relationships between cellular components of the peritumoural inflammatory response, clinicopathological characteristics and survival in patients with primary operable colorectal cancer

Abstract

Background:The host inflammatory response is an important determinant of cancer outcome. We examined different methods of assessing the local inflammatory response in colorectal tumours and explored relationships with both clinicopathological characteristics and survival.Methods:Cohort study of patients (n=130) with primary operable colorectal cancer and mature follow-up. Local inflammatory response at the invasive margin was assessed with: (1) a semi-quantitative assessment of peritumoural inflammation using Klintrup–Makinen (K–M) grading and (2) an assessment of individual immune cell infiltration (lymphocytes, plasma cells, neutrophils, macrophages and eosinophils).Results:The peritumoural inflammatory response was K–M low grade in 48% and high grade in 52%. Inflammatory cells were primarily macrophages, lymphocytes and neutrophils with relatively few plasma cells or eosinophils. On univariate analysis, K–M grade, lymphocyte infiltration and plasma cell infiltration were associated with cancer-specific survival. On multivariate analysis, only systemic inflammatory response, TNM (tumour, node and metastases) stage, venous invasion, tumour necrosis and K–M grade were independently associated with cancer-specific survival. There was no relationship between local infiltration of inflammatory cells and a systemic inflammatory response. However, high K–M grade, lymphocyte infiltration and plasma cell infiltration were associated with a number of favourable pathological characteristics, including an absence of venous invasion.Conclusion:Infiltration of inflammatory cells in the invasive margin of colorectal tumours is beneficial to survival. The adaptive immune response appears to have a prominent role in the prevention of tumour progression in patients with colorectal cancer.

Tumor-Infiltrating Plasma Cells Are Associated with Tertiary Lymphoid Structures, Cytolytic T-Cell Responses, and Superior Prognosis in Ovarian Cancer

“…Similar results have been reported in a variety of other cancers (12)(13)(14), suggesting that effective tumor immunity involves cooperative interactions between T cells and B cells. In our prior study (11), we found that CD8 þ and CD20 þ TIL often colocalized in lymphoid aggregates of various sizes and morphology.…”

Diagnostic value of inflammatory cell infiltrates, tumor stroma percentage and disease-free survival in patients with colorectal cancer

“…In our study, we noted the lack of weak inflammatory infiltration in the invasive front and in center of the tumor in 50% of cases comparable to a medium or large infiltration in both locations (45-46%). Richards et al (18) reported a low-grade inflammatory cell infiltrate in 48% and high-grade inflammatory cell infiltrate in 52% cases in peritumoral stroma. We also noted low-TSP in 65% of cases and high-TSP in 35% of cases.…”

“…Moreover, authors showed that peritumoral inflammatory cell infiltrate was higher in advanced stage than in intratumoral densities. Also, Richards et al (18,26) demonstrated the presence of the relationship between the inflammatory cell infiltrate and pT status, positive lymph node status, TNM stage, venous invasion, necrosis and character of tumor growth.…”

Peritumoral eosinophils predict recurrence in colorectal cancer

“…6 The latter scheme has been demonstrated to be associated with survival of colorectal cancer patients in several studies. 6,11,22,23 Herein, Roxburgh et al 22 have compared both scoring systems and found an independent association with patients' survival in node-negative colorectal cancers only for the Klintrup-Mäkinen scheme. Furthermore, the inter-observer concordance was superior for the Klintrup-Mäkinen scheme.…”

“…[7][8][9][10] Furthermore, the occurrence of eosinophil infiltration has been linked to the overall inflammatory cell reaction. 11 This raises the question whether the infiltration of eosinophils is a simple 'bystander' of an inflammatory host's reaction or might represent a selfcontained antitumoral mechanism that needs to be documented in routine pathology and promoted therapeutically?…”