Evaluation of Glasgow Microenvironment Score in Colorectal Carcinoma and Its Association with Prognostic Markers

Colorectal carcinoma (CRC) ranks among the most prevalent cancers worldwide, contributing significantly to cancer-related mortality. Despite advancements in understanding CRC's pathophysiology, traditional staging systems like tumour, node, and metastasis (TNM) lack comprehensive prognostic indicators, particularly regarding tumour microenvironment and host-related factors. The Glasgow Microenvironment Score (GMS) integrates inflammatory cell infiltration and stromal percentage, offering a potentially more comprehensive prognostic tool. This study aims to evaluate GMS in CRC and its correlation with established clinicopathological prognostic markers and pathological tumour, node, and metastasis (pTNM) staging. A retrospective study involving 68 CRC patients who underwent curative surgery between January 2022 and March 2024. Haematoxylin and eosin-stained sections were assessed for inflammatory infiltration (Klintrup-Mäkinen score) and tumour stromal percentage, forming the GMS. Statistical analyses evaluated associations between GMS and clinicopathological markers, including lymphovascular invasion (LVI), perineural invasion (PNI), nodal status, and histological grading. The study found significant correlations between GMS and poor prognostic markers. High GMS was associated with increased LVI, PNI, and nodal involvement. GMS showed significant associations with LVI (p<0.0003), PNI (p<0.026), and nodal involvement (p<0.002). GMS serves as a robust prognostic indicator in CRC, correlating with key pathological features that influence patient outcomes. This scoring system could enhance traditional prognostic models, aiding in better stratification of CRC patients for therapeutic interventions.