Prognostic assessment of T‐cells in primary colorectal cancer and paired synchronous or metachronous liver metastasis

• Published in: International journal of cancer Vol. 156; no. 6; pp. 1282 - 1292
• Main Authors: Trailin, Andriy, Ali, Esraa, Ye, Wenjing, Pavlov, Sergii, Červenková, Lenka, Vyčítal, Ondřej, Ambrozkiewicz, Filip, Hošek, Petr, Daum, Ondřej, Liška, Václav, Hemminki, Kari
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 15.03.2025; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Aged, 80 and over; CD3 antigen; CD8 antigen; CD8-Positive T-Lymphocytes - immunology; CD8-Positive T-Lymphocytes - pathology; Cell density; Cell survival; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - immunology; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Female; Hepatocytes; Humans; Liver; Liver cancer; Liver Neoplasms - immunology; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Lymphocytes T; Male; Metastases; Metastasis; Middle Aged; Neoplasms, Multiple Primary - immunology; Neoplasms, Multiple Primary - pathology; Neoplasms, Second Primary - immunology; Neoplasms, Second Primary - pathology; Prognosis; RESEARCH ARTICLE; Retrospective Studies; survival; synchronous and metachronous liver metastases; T-Lymphocytes - immunology; T-Lymphocytes - pathology; tumor‐infiltrating lymphocytes; tumor‐infiltrating lymphocytes; colorectal cancer; survival; synchronous and metachronous liver metastases
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.35252

Prognostic value of T‐cells between primary colorectal cancer (pCRC) and its paired synchronous and metachronous liver metastasis (LM) is underinvestigated and is the subject of the present study. We enrolled into this retrospective cohort study patients, who underwent resection of both pCRC and synchronous LM (N = 55) or metachronous LM (N = 44). After immunohistochemical staining for CD3+, CD8+, and CD45R0+ whole slides were scanned and T‐cell densities were quantified using QuPath software in tumor center (TC), inner margin (IM), outer margin (OM), and peritumor zone (PT) of pCRC and LM. High densities of CD8+ T‐cells in TC, OM and PT of synchronous LM were associated with longer disease‐free survival (DFS). Greater densities of CD3+ T‐cells in IM and PT and CD8+ T‐cells in IM, OM and PT in synchronous LM over pCRC were associated with longer DFS. Greater densities of CD8+ T‐cells in the TC and IM and CD3+ T‐cells in the IM of pCRC were found in the metachronous over synchronous group. The first novel finding demonstrated that high density of CD8+ T cells in synchronous LM were associated with favorable outcome. The second finding of high CD8+ cell density in pCRC in metachronous over synchronous CRC may provide a mechanistic basis for the delay of metastatic spread. Both findings could be applied clinically with own reference values. What's new? Whether colorectal cancer with synchronous and metachronous liver metastases represent two distinct phenotypes of the disease remains unclear. This retrospective cohort study demonstrates that tumor‐infiltrating T cells contribute to different clinical courses and prognoses. In patients with synchronous liver metastases, high densities of CD8+ T cells in metastases were associated with favorable outcomes. In patients with metachronous liver metastases, greaterdensities of CD8+ T cells in primary colorectal cancer may be responsible for the delayed metastases. Evaluation of tumor‐infiltrating T‐cells in both primary colorectal cancer and liver metastases could help refine prognosis.