The relationships between cellular components of the peritumoural inflammatory response, clinicopathological characteristics and survival in patients with primary operable colorectal cancer
British Journal of Cancer, 07/30/2012
Richards CH et al. – Infiltration of inflammatory cells in the invasive margin of colorectal tumours is beneficial to survival. The adaptive immune response appears to have a prominent role in the prevention of tumour progression in patients with colorectal cancer.Methods
- Cohort study of patients (n=130) with primary operable colorectal cancer and mature follow-up.
- Local inflammatory response at the invasive margin was assessed with: (1) a semi-quantitative assessment of peritumoural inflammation using Klintrup–Makinen (K–M) grading and (2) an assessment of individual immune cell infiltration (lymphocytes, plasma cells, neutrophils, macrophages and eosinophils).
- The peritumoural inflammatory response was K–M low grade in 48% and high grade in 52%.
- Inflammatory cells were primarily macrophages, lymphocytes and neutrophils with relatively few plasma cells or eosinophils.
- On univariate analysis, K–M grade, lymphocyte infiltration and plasma cell infiltration were associated with cancer-specific survival.
- On multivariate analysis, only systemic inflammatory response, TNM (tumour, node and metastases) stage, venous invasion, tumour necrosis and K–M grade were independently associated with cancer-specific survival.
- There was no relationship between local infiltration of inflammatory cells and a systemic inflammatory response.
- However, high K–M grade, lymphocyte infiltration and plasma cell infiltration were associated with a number of favourable pathological characteristics, including an absence of venous invasion.