Pre-operative, biopsy-based assessment of the tumour microenvironment in patients with primary operable colorectal cancer

Park, J. H. , van Wyk, H. , McMillan, D. C. , Edwards, J. , Orange, C., Horgan, P. G. and Roxburgh, C. S.D. (2019) Pre-operative, biopsy-based assessment of the tumour microenvironment in patients with primary operable colorectal cancer. Journal of Pathology: Clinical Research, 6(1), pp. 30-39. (doi: 10.1002/cjp2.143) (PMID:31486287) (PMCID:PMC6966701)

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Abstract

The tumour microenvironment (TME) is recognised as an important prognostic characteristic and therapeutic target in patients with colorectal cancer (CRC). However, assessment generally utilises surgically resected specimens, precluding neoadjuvant targeting. The present study investigated the feasibility of intra‐epithelial CD3+ T‐lymphocyte density and tumour stroma percentage (TSP) assessment using preoperative colonoscopic biopsies from 115 patients who had undergone resection of stages I–III CRC, examining the relationship between biopsy and surgically resected specimen‐based assessment, and the relationship with cancer‐specific survival (CSS). High biopsy CD3+ density was associated with high CD3+ density in the invasive margin, cancer stroma and intra‐epithelial compartments of surgically resected specimens (area under the curve > 0.62, p < 0.05 for all) and with high Immunoscore. High biopsy TSP predicted high TSP in resected specimens (p = 0.001). Intra‐class correlation coefficient for both measures was >0.7 (p < 0.001), indicating excellent concordance between individuals. Biopsy CD3+ density (hazard ratio [HR] 0.23, p = 0.002) and TSP (HR 2.23, p = 0.029) were independently associated with CSS; this was comparable to the prognostic value of full section assessment (HR 0.21, p = 0.004, and HR 2.25, p = 0.033 respectively). These results suggest that assessment of the TME is comparable in biopsy and surgically resected specimens from patients with CRC, and biopsy‐based assessment could allow for stratification prior to surgery or commencement of therapy targeting the TME.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Park, Mr James and Horgan, Professor Paul and McMillan, Professor Donald and Orange, Miss Clare and Roxburgh, Dr Campbell and Edwards, Professor Joanne and Van Wyk, Dr Hester
Authors: Park, J. H., van Wyk, H., McMillan, D. C., Edwards, J., Orange, C., Horgan, P. G., and Roxburgh, C. S.D.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Pathology: Clinical Research
Publisher:Wiley
ISSN:2056-4538
ISSN (Online):2056-4538
Published Online:04 September 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Journal of Pathology: Clinical Research 6(1):30-39
Publisher Policy:Reproduced under a Creative Commons license

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