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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2019

01-02-2019 | Translational Research and Biomarkers

The Immunoscore is a Superior Prognostic Tool in Stages II and III Colorectal Cancer and is Significantly Correlated with Programmed Death-Ligand 1 (PD-L1) Expression on Tumor-Infiltrating Mononuclear Cells

Authors: Takato Yomoda, MD, Tomoya Sudo, MD, PhD, Akihiro Kawahara, CT, PhD, Takahiro Shigaki, MD, Susumu Shimomura, MD, Kensuke Tajiri, MD, Sachiko Nagasu, MD, PhD, Fumihiko Fujita, MD, PhD, Tetsushi Kinugasa, MD, PhD, Yoshito Akagi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2019

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Abstract

Background

In colorectal cancer (CRC), the indication for immune checkpoint inhibitors is determined by the microsatellite instability status of the tumors. However, an optimal biomarker for their indication has not been fully identified to date. This study aimed to establish the clinicopathologic importance of the Immunoscore (IS) in CRC and to clarify the relationships between the IS, programmed death-ligand 1 (PD-L1) expression, and tumor-associated macrophages.

Methods

In 132 cases, CRC was diagnosed and surgically treated in our department from 2009 to 2010. Immunohistochemical staining using primary antibodies PD-L1, CD3, CD8, CD68, and CD163 was performed. The IS was determined according to the proposal of an international task force. Statistical analyses were performed to investigate the correlation between the IS, clinicopathologic variables, and expression of immune checkpoint molecules.

Results

The overall survival (OS) and relapse-free survival (RFS) in the high-IS group (I3–4) were significantly better than in the low-IS group (I0–2) (OS: P = 0.0420; RFS: P = 0.0226). The positivity rate for PD-L1 on tumor cells (tPD-L1) was only 0.8%, whereas that for PD-L1 on interstitial tumor-infiltrating mononuclear cells (iPD-L1) was 18.2%. The iPD-L1-positive group showed significantly better survival in terms of both OS and RFS than the iPD-L1-negative group (OS: P = 0.0278; RFS: P = 0.0253). The findings showed significant correlation between the IS and iPD-L1 expression (P < 0.0001).

Conclusions

The study found that a high IS was a good indicator of a better prognosis and significantly correlated with iPD-L1 expression in CRC.
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Metadata
Title
The Immunoscore is a Superior Prognostic Tool in Stages II and III Colorectal Cancer and is Significantly Correlated with Programmed Death-Ligand 1 (PD-L1) Expression on Tumor-Infiltrating Mononuclear Cells
Authors
Takato Yomoda, MD
Tomoya Sudo, MD, PhD
Akihiro Kawahara, CT, PhD
Takahiro Shigaki, MD
Susumu Shimomura, MD
Kensuke Tajiri, MD
Sachiko Nagasu, MD, PhD
Fumihiko Fujita, MD, PhD
Tetsushi Kinugasa, MD, PhD
Yoshito Akagi, MD, PhD
Publication date
01-02-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-07110-z

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