Article

Inflammation and prognosis in colorectal cancer

Department of Surgery, Oulu University Hospital, Oulu, Finland.
European Journal of Cancer (Impact Factor: 4.82). 12/2005; 41(17):2645-54. DOI: 10.1016/j.ejca.2005.07.017
Source: PubMed

ABSTRACT Previous work has indicated that quantification of inflammatory cell reaction is of prognostic value in colorectal cancer. We evaluated the prognostic significance of inflammatory cell reaction patterns in colorectal cancer and developed a grading method which could be used in the routine assessment of tumours.
The intensity of overall inflammatory cell reaction, numbers of neutrophilic and eosinophilic granulocytes, lymphoid cells and macrophages in both the central region and the invasive margin were estimated in 386 colorectal cancer patients. Prognostic significance was analysed by uni- and multivariate analysis.
Our method for classification of inflammatory reaction was reliable. High-grade inflammation at the invasive margin in Dukes' stage A and B cancers (pT1-2N0 and pT3N0, respectively) was associated with better 5-year-survival (87.6%) than low-grade inflammation (47.0%).
Inflammatory cell response at the invasive border is a relevant prognostic indicator and could be easily incorporated into the routine evaluation of histopathological specimens.

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    • "Briefly, tumours were scored on four-point scores based on appearances at the tumour invasive margin. A score of 0 signified that there were no inflammatory cells at tumour's invasive margin; score 1 indicated a mild and patchy inflammatory cells; score 2 denoted a prominent band-like inflammatory reaction at the invasive margin; and score 3 revealed a florid cup-like inflammatory infiltrate at the invasive edge (Klintrup et al, 2005; Mohammed et al, 2012a). Individual immune cell types were assessed using IHC staining on TMA sections for macrophages, helper and cytotoxic T-lymphocytes and plasma cells using CD68, CD4, CD8 and CD138 antibodies, respectively (Mohammed et al, 2013). "
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    • "In our meta-analysis, we did not include some of the mentioned studies because of the following reasons. (1) absence of time-to-event (survival) data for high-grade over low-grade immune cell inflammation (Klintrup et al, 2005); (2) "
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    • "This is done using a four-degree scale that takes into consideration the numbers of neutrophilic and eosinophilic granulocytes, lymphoid cells, and macrophages and their relation to the invading tumor (with or without destruction of cancer-cell islets) (Figure 3B). Klintrup et al84 demonstrated that high-grade inflammation at the invasive margin in node-negative CRC is associated with better 5-year-survival compared to low-grade inflammation (87.6% versus 47.0%, P<0.0001). The beneficial effect of high peritumoral inflammation according to Klintrup’s criteria was confirmed in several studies.79,85,86 "
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