TY - JOUR
T1 - Intraepithelial tumour infiltrating lymphocytes are associated with absence of tumour budding and immature/myxoid desmoplastic reaction, and with better recurrence-free survival in stages I–III colorectal cancer
AU - González, I. A.
AU - Bauer, P. S.
AU - Liu, J.
AU - Chatterjee, Deyali
N1 - Funding Information:
The authors thank the reviewers for their valuable comments, which led to substantial improvement in the presentation of our findings. The expenses of this project were covered by the Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO. REDCap supported by Clinical and Translational Science Award (CTSA) grant (UL1 TR000448).
Funding Information:
The authors thank the reviewers for their valuable comments, which led to substantial improvement in the presentation of our findings. The expenses of this project were covered by the Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO. REDCap supported by Clinical and Translational Science Award (CTSA) grant (UL1 TR000448).
Publisher Copyright:
© 2020 John Wiley & Sons Ltd
PY - 2021/1
Y1 - 2021/1
N2 - Aims: Tumour budding (TB), desmoplastic reaction (DR) and intraepithelial tumour infiltrating lymphocytes (iTILs) are recently recognised prognostic factors in colorectal cancer (CRC). In this study, we evaluated their significance and relationship to each other and their cumulative effect on survival. Methods and results: A total of 372 stages I–III CRC cases from 2013 to 2016 were included. Low TB was identified in 302 (81%) cases, immature/myxoid DR in 67 (18%) cases and iTILs in 130 (35.0%) cases. iTILs was associated with low budding (P = 0.0247), non-myxoid DR (P = 0.0004), poorly differentiated histology (P = 0.0015), absence of perineural invasion (P = 0.0367) and loss of mismatch repair proteins (P = 0.0002). Absence of iTILs and presence of immature/myxoid DR were associated with a worse recurrence-free survival (RFS) [hazard ratio (HR) = 2.191, 95% confidence interval (CI) = 1.232–3.895; and HR = 5.706, 95% CI = 3.632–8.964, respectively]. A competing risk analysis showed statistically significant prognostic groups combining iTILs and TB (P < 0.0001). Cases with iTILs and low TB were associated with better RFS compared to cases without iTILs and with intermediate/high TB (HR = 0.214, 95% CI = 0.109–0.421). Similarly, combining iTILs and DR revealed statistically significant prognostic groups (P < 0.0001). Cases with iTILs and a non-myxoid DR had better RFS compared to cases without iTILs and immature/myxoid DR (HR = 0.113, 95% CI = 0.056–0.230). On multivariate cause-specific analysis, patients’ age (P = 0.0045), iTILs (P = 0.0345), DR (P < 0.0001) and pTNM prognostic groups (P < 0.0001) were associated with RFS. Conclusions: Our study validates the association of iTILs and DR as independent prognostic finding in CRC, and propose a prognostic model using the combinations of iTILs with TB and stromal reaction in CRC.
AB - Aims: Tumour budding (TB), desmoplastic reaction (DR) and intraepithelial tumour infiltrating lymphocytes (iTILs) are recently recognised prognostic factors in colorectal cancer (CRC). In this study, we evaluated their significance and relationship to each other and their cumulative effect on survival. Methods and results: A total of 372 stages I–III CRC cases from 2013 to 2016 were included. Low TB was identified in 302 (81%) cases, immature/myxoid DR in 67 (18%) cases and iTILs in 130 (35.0%) cases. iTILs was associated with low budding (P = 0.0247), non-myxoid DR (P = 0.0004), poorly differentiated histology (P = 0.0015), absence of perineural invasion (P = 0.0367) and loss of mismatch repair proteins (P = 0.0002). Absence of iTILs and presence of immature/myxoid DR were associated with a worse recurrence-free survival (RFS) [hazard ratio (HR) = 2.191, 95% confidence interval (CI) = 1.232–3.895; and HR = 5.706, 95% CI = 3.632–8.964, respectively]. A competing risk analysis showed statistically significant prognostic groups combining iTILs and TB (P < 0.0001). Cases with iTILs and low TB were associated with better RFS compared to cases without iTILs and with intermediate/high TB (HR = 0.214, 95% CI = 0.109–0.421). Similarly, combining iTILs and DR revealed statistically significant prognostic groups (P < 0.0001). Cases with iTILs and a non-myxoid DR had better RFS compared to cases without iTILs and immature/myxoid DR (HR = 0.113, 95% CI = 0.056–0.230). On multivariate cause-specific analysis, patients’ age (P = 0.0045), iTILs (P = 0.0345), DR (P < 0.0001) and pTNM prognostic groups (P < 0.0001) were associated with RFS. Conclusions: Our study validates the association of iTILs and DR as independent prognostic finding in CRC, and propose a prognostic model using the combinations of iTILs with TB and stromal reaction in CRC.
KW - colorectal cancer
KW - intraepithelial tumour infiltrating lymphocytes
KW - myxoid stromal reaction
KW - recurrence-free survival
KW - tumour budding
UR - http://www.scopus.com/inward/record.url?scp=85090958326&partnerID=8YFLogxK
U2 - 10.1111/his.14211
DO - 10.1111/his.14211
M3 - Article
C2 - 32654226
AN - SCOPUS:85090958326
SN - 0309-0167
VL - 78
SP - 252
EP - 264
JO - Histopathology
JF - Histopathology
IS - 2
ER -