Assessment of Tumor-infiltrating Lymphocytes Using International TILs Working Group (ITWG) System Is a Strong Predictor of Overall Survival in Colorectal Carcinoma
Autor: | Mahsa Ahadi, Loretta Sioson, Juliana Andrici, Anthony J. Gill, Angela Chou, Kambin Jafari-Nejad, Amy Sheen, Christopher J Renaud, Talia L Fuchs |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male 0301 basic medicine Oncology medicine.medical_specialty Time Factors Colorectal cancer Context (language use) Adenocarcinoma Pathology and Forensic Medicine Young Adult 03 medical and health sciences Lymphocytes Tumor-Infiltrating 0302 clinical medicine Breast cancer Predictive Value of Tests Internal medicine medicine Humans Lymphocyte Count Colectomy Aged Aged 80 and over Observer Variation Staining and Labeling Tumor-infiltrating lymphocytes business.industry Reproducibility of Results Middle Aged medicine.disease Primary tumor digestive system diseases Treatment Outcome 030104 developmental biology 030220 oncology & carcinogenesis Predictive value of tests Cohort Intraepithelial lymphocyte Female Surgery Anatomy Colorectal Neoplasms business |
Zdroj: | American Journal of Surgical Pathology. 44:536-544 |
ISSN: | 0147-5185 |
Popis: | The presence of increased tumor-infiltrating lymphocytes (TILs) is established as a positive prognostic factor in many malignancies including colorectal carcinoma (CRC). However, multiple different approaches have been used to assess TILs. In 2014, the International TILs Working Group (ITWG) proposed a standardized methodology for evaluating TILs, initially in the context of breast cancer, but subsequently expanded to other malignancies. To date, the efficacy of the ITWG system has not been investigated in a large cohort of all-stage CRC. We, therefore, sought to validate this system in CRC. We used the ITWG system to assess the density of stromal TILs in an unselected cohort of 1034 CRC patients undergoing primary tumor resection at our institution. The percentage TILs' score was categorized into 3 groups: low (0% to 10%), intermediate (15% to 50%), and high (55% to 100%). The mean survival was 53, 67, and 75 months, respectively (P=0.0001). This survival benefit remained statistically significant in multivariate analyses (P=0.0001) and subgroup analyses of mismatch repair-proficient CRCs (P=0.0001), mismatch repair-deficient CRCs (P=0.031), BRAFV600E-mutant CRCs (P=0.0001), and BRAF wild-type CRCs (P=0.001). The predictive value of TILs assessed using the ITWG system was superior to the assessment of intraepithelial lymphocyte performed prospectively using a standard system requiring ≥5 lymphocytes per high-powered field in direct contact with tumor cells or between tumor clusters. We conclude that the ITWG system for assessing TILs is a powerful predictor of all-cause survival in CRC independent of many prognostic factors and superior to the assessment of intraepithelial lymphocytes using a traditional system. |
Databáze: | OpenAIRE |
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