Microenvironment, systemic inflammatory response and tumor markers considering consensus molecular subtypes of...

Area of Science:

• Oncology
• Cancer Biology
• Inflammation Research

Background:

• Colorectal cancer (CRC) is a major global health concern.
• CRC exhibits heterogeneity, classified into four consensus molecular subtypes (CMS).
• Tumor microenvironment (TME) and systemic inflammatory response (SIR) significantly impact CRC patient outcomes.

Purpose of the Study:

• To investigate the interrelationships between CMS, TME, and SIR in CRC.
• To assess the correlation of these factors with established tumor markers (CEA, CA19-9).
• To evaluate their prognostic value in predicting CRC patient outcomes.

Main Methods:

• Analysis of Formalin Fixed Paraffin Embedded (FFPE) samples from 185 CRC patients.
• TME assessment using tumor-stroma ratio (TSR), Klintrup-Makinen (KM) grade, and Glasgow Microenvironment Score (GMS).
• CMS classification via immunohistochemical staining; retrieval of pre-operative tumor markers and inflammatory markers (CRP, albumin, ANC, ALC, APC).

Main Results:

• Tumor-stroma ratio (TSR) strongly correlated with adverse clinicopathological features and reduced overall survival.
• Elevated C-reactive protein (CRP) and modified Glasgow Prognostic Score (mGPS) indicated worse outcomes, similar to CEA and CA19-9.
• The novel Stroma-Tumor Marker (STM) score (CA19-9 and TSR) showed strong prognostication. CMS4 associated with high TSR and specific laboratory markers, but not CEA/CA19-9.

Conclusions:

• Routinely available TME, SIR, and tumor markers provide reliable prognostic information for high-risk CRC patients.
• CMS4 is associated with a high TSR and poor prognosis.
• Overall, CMS classification demonstrated limited impact on SIR and tumor markers in this study.