Prognostic implications of adaptive immune features in MMR-proficient colorectal liver metastases classified by histopathological growth patterns
Menée à partir de 276 échantillons de métastases hépatiques issues de 176 patients atteints d'un cancer colorectal avec non dysfonctionnement du système MMR, cette étude analyse, en fonction du type de croissance des métastases, la corrélation entre des marqueurs de l'adaptation du système immunitaire et le pronostic
Background : After resection, colorectal cancer liver metastases (CRLM) surrounded by a desmoplastic rim carry a better prognosis than the metastases replacing the adjacent liver. However, these histopathological growth patterns (HGPs) are insufficient to guide clinical decision-making. We explored whether the adaptive immune features of HGPs could refine prognostication.
Methods : From 276 metastases resected in 176 patients classified by HGPs, tissue microarrays were used to assess intratumoral T cells (CD3), antigen presentation capacity (MHC class I) and CD73 expression producing immunosuppressive adenosine. We tested correlations between these variables and patient outcomes.
Results : The 101 (57.4%) patients with dominant desmoplastic HGP had a median recurrence-free survival (RFS) of 17.1 months compared to 13.3 months in the 75 patients (42.6%) with dominant replacement HGP (p = 0.037). In desmoplastic CRLM, high vs. low CD73 was the only prognostically informative immune parameter and was associated with a median RFS of 12.3 months compared to 26.3, respectively (p = 0.010). Only in dominant replacement CRLM, we found a subgroup (n = 23) with high intratumoral MHC-I expression but poor CD3+ T cell infiltration, a phenotype associated with a short median RFS of 7.9 months.
Conclusions : Combining the assessments of HGP and adaptive immune features in resected CRLM could help identify patients at risk of early recurrence.
British Journal of Cancer , résumé, 2022