Title: Tumor-Infiltrating Lymphocytes, Crohn's-Like Lymphoid Reaction, and Survival From Colorectal Cancer.
Authors: Rozek, Laura S; Schmit, Stephanie L; Greenson, Joel K; Tomsho, Lynn P; Rennert, Hedy S; Rennert, Gad; Gruber, Stephen B
Published In J Natl Cancer Inst, (2016 08)
Abstract: While clinical outcomes from colorectal cancer (CRC) are influenced by stage at diagnosis and treatment, mounting evidence suggests that an enhanced lymphocytic reaction to a tumor may also be an informative prognostic indicator.The roles of intratumoral T lymphocyte infiltration (TIL), peritumoral Crohn's-like lymphoid reaction (CLR), microsatellite instability (MSI), and clinicopathological characteristics in survival from CRC were examined using 2369 incident CRCs from a population-based case-control study in northern Israel. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC-specific and all-cause mortality in multivariable models adjusted for age, sex, ethnicity, grade, stage, and MSI. All statistical tests were two-sided.Tumors with TIL/high-powered field (HPF) of 2 or greater were associated with a statistically significant increase in CRC-specific (P < .001) and overall survival (P < .001) compared with tumors with TIL/HPF of less than 2. Similarly, tumors with a prominent CLR experienced better CRC-specific (P < .001) and overall survival (P < .001) as compared with those with no response. High TILs (HR = 0.76, 95% CI = 0.64 to 0.89, P < .001) and a prominent CLR (HR = 0.71, 95% CI = 0.62 to 0.80, P < .001), but not MSI, were associated with a statistically significant reduction in all-cause mortality after adjustment for established prognostic factors.TILs and CLR are both prognostic indicators for CRC after adjusting for traditional prognostic indicators.
PubMed ID: 27172903
MeSH Terms: Aged; Aged, 80 and over; Case-Control Studies; Cause of Death; Colorectal Neoplasms/genetics; Colorectal Neoplasms/immunology*; Colorectal Neoplasms/mortality*; Crohn Disease/immunology; Female; Humans; Immunity, Cellular; Israel/epidemiology; Kaplan-Meier Estimate; Lymphocytes, Tumor-Infiltrating/immunology*; Male; Microsatellite Instability*; Middle Aged; Prognosis; Proportional Hazards Models; Survival Rate