CD3+ cells at the invasive margin of deeply invading (pT3–T4) colorectal cancer and risk of post-surgical metastasis: a longitudinal study

摘要: Summary Background The density of tumour-infiltrating lymphocytes (TIL) has been proposed as an independent predictor outcome in patients with colorectal cancer. However, the relative roles TIL density, nodal status, and microsatellite instability (MSI) predicting tumour progression to metachronous metastasis remain be elucidated. aim this study was assess relationship between CD3+ postsurgical occurrence distant-organ metastases a large series deeply invading MSI-typed Methods Per cent areas immunoreactivity due at invasive margin (CD3+ IM ) were measured by computer-assisted image analysis 286 tissue specimens from pT3 or pT4 MSI-tested Tissue samples taken consecutive who underwent resection IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy, January, 1997, November, 2004, for cancer no evidence diagnosis. Occurrence metastasis, disease-specific survival (DSS), disease-free (DFS), assessed retrospectively relation per immunoreactivity. Findings higher MSI than mismatch repair-system-proficient tumours (6·53% vs 2·19%; p densities, colonic site, absence involvement significantly associated lower risk but only interaction N-stage significant on multivariate (p=0·002). On separate node-negative cancer, increasing percentage immunoreactive area progressively reduced ( 5%, 0·06, 0·01–0·48, p=0·008). Conversely, association seen node-positive Accordingly, better DSS (p=0·01) DFS (p=0·006) In primary that had progressed stage III densities II (p=0·0004). Interpretation Metachronous are unlikely arise cancers high-density , whereas high not Our data suggest cannot used clinical and, least now, tumour-node-metastasis classification should preferred prognostic system. findings consistent immunoevasion. Funding MIUR (Ministero dell'Istruzione, dell'Universita e della Ricerca), Target Project Oncologia 2006, Alleanza Contro il Cancro.