Simplified and Optimized Immune Score for Colorectal Cancer Microenvironment
Hiroyuki Nakane1, Tomoya Sudo2, Akihiro Kawahara3
1Department of Surgery, Kurume University School of Medicine, Kurume, Japan nakane_hiroyuki@kurume-u.ac.jp.
Anticancer Research
|July 27, 2023
Summary
Simplified Immunoscore (IS) using tumor perimeter immune cell assessment, particularly with FOXP3, improves prognostic power for colorectal cancer (CRC) patients. This method offers a more accessible evaluation of the tumor immune microenvironment (TIME).
Area of Science:
- Oncology
- Immunology
- Pathology
Background:
- Immunoscore (IS) assesses the tumor immune microenvironment (TIME) but requires specialized tools.
- Formal IS analysis is complex, necessitating specific reagents and digital pathology software.
- Simplifying IS (s-IS) could enhance accessibility for TIME evaluation.
Purpose of the Study:
- To investigate if simplified IS (s-IS) can replace formal IS by modifying immune cell assessment locations.
- To determine if adding T cell subset markers to s-IS enhances prognostic impact in colorectal cancer (CRC).
Main Methods:
- Analyzed 82 CRC cases using immunohistochemistry for CD3, CD8, CD45RO, and FOXP3.
- Assessed immune cell expression in tumor centers and perimeters via digital pathology.
- Compared prognostic significance using concordance index for marker locations and combinations.
Main Results:
- CD3, CD8, and FOXP3 levels were significant prognostic factors in univariate analysis.
- Immune cell assessment at the tumor perimeter showed stronger prognostic power than at the center.
- Modified s-IS (including FOXP3) independently predicted recurrence-free and overall survival in multivariate analysis.
Conclusions:
- TIME evaluation in CRC can be simplified by assessing CD3 and CD8 T cells at the tumor perimeter.
- Incorporating FOXP3 evaluation into s-IS significantly enhances its prognostic capability.
- Simplified IS offers a more accessible and powerful tool for prognostic assessment in CRC.
