The inflammatory microenvironment in screen-detected premaligant adenomatous polyps: early results from the integrated technologies for improved polyp surveillance (INCISE) project

Mansouri, D. , McSorley, S. T. , Park, J. H. , Orange, C., Horgan, P. G. , McMillan, D. C. and Edwards, J. (2021) The inflammatory microenvironment in screen-detected premaligant adenomatous polyps: early results from the integrated technologies for improved polyp surveillance (INCISE) project. European Journal of Gastroenterology and Hepatology, 33(7), pp. 983-989. (doi: 10.1097/MEG.0000000000002202) (PMID:34034277)

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Abstract

Introduction: Around 40% of patients who attend colonoscopy following a positive stool screening test have adenomatous polyps. Identifying which patients have a higher propensity for malignant transformation is currently poorly understood. The aim of the present study was to assess whether the type and intensity of inflammatory infiltrate differ between screen-detected adenomas with high-grade dysplasia (HGD) and low-grade dysplasia (LGD). Methods: A representative sample of 207 polyps from 134 individuals were included from a database of all patients with adenomas detected through the first round of the Scottish Bowel Screening Programme in NHS Greater Glasgow and Clyde (April 2009-April 2011). Inflammatory cell phenotype infiltrate was assessed by immunohistochemistry for CD3+, CD8+, CD45+ and CD68+ in a semi-quantitative manner at 20x resolution. Immune-cell infiltrate was graded as absent, weak, moderate or strong. Patient and polyp characteristics and inflammatory infiltrate were then compared between HGD and LGD polyps. Results: CD3+ infiltrate was significantly higher in HGD polyps compared to LGD polyps (74 vs. 69%; P < 0.05). CD8+ infiltrate was significantly higher in HGD polyps compared to LGD polyps (36 vs. 13%; P < 0.001) whereas CD45+ infiltrate was not significantly different (69 vs. 64%; P = 0.401). There was no significant difference in CD68+ infiltrate (P = 0.540) or total inflammatory cell infiltrate (calculated from CD3+ and CD68+) (P = 0.226). Conclusions: This study reports an increase in CD3+ and CD8+ infiltrate in HGD colonic adenomas when compared to LGD adenomas. It may therefore have a use in the prognostic stratification and treatment of dysplastic polyps.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Orange, Miss Clare and Park, Mr James and Edwards, Professor Joanne and Mansouri, Dr David and Horgan, Professor Paul and McMillan, Professor Donald and McSorley, Dr Stephen
Authors: Mansouri, D., McSorley, S. T., Park, J. H., Orange, C., Horgan, P. G., McMillan, D. C., and Edwards, J.
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:European Journal of Gastroenterology and Hepatology
Publisher:Lippincott, Williams & Wilkins
ISSN:0954-691X
ISSN (Online):1473-5687
Published Online:25 May 2021

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
167844An investigation into the role of the local inflammatory response in screen-detected non-malignant disease from the colorectal cancer screening programme in the West of ScotlandDavid MansouriCunningham Trust (CUNNINGT)ACC/KWF/CT12/21Med - Surgery