Deshpande Vikram, Lee Soo Hyun, Crabbe Andrew, Pankaj Amaya, Neyaz Azfar, Ono Yuho, Rickelt Steffen, Sonal Swati, Ferrone Cristina R, Ting David T, Patil Deepa, Yilmaz Omer, Berger David, Yilmaz Osman
Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Department of Pathology, Boston Medical Center, Boston, Massachusetts, USA.
J Clin Pathol. 2024 May 17;77(6):387-393. doi: 10.1136/jcp-2023-208895.
Micropapillary carcinoma (MPC) is a recognised WHO variant of colonic carcinoma (CC), although little is known about its prognosis, immune microenvironment and molecular alterations. We investigated its clinical, pathological and immunological characteristics.
We assessed 903 consecutive CCs and used the WHO definition to identify MPC. We recorded serrated and mucinous differentiation and mismatch repair (MMR) status. We performed immunohistochemistry and quantification on tissue microarrays for HLA class I/II proteins, beta-2-microglobulin (B2MG), CD8, CD163, LAG3, PD-L1, FoxP3, PD-L1and BRAF V600E.
We classified 8.6% (N=78) of CC as MPC. Relative to non-MPC, MPC was more often high grade (p=0.03) and showed serrated morphology (p<0.01); however, we found no association with extramural venous invasion (p=0.41) and American Joint Committee on Cancer stage (p=0.95). MPCs showed lower numbers of CD8 positive lymphocytes (p<0.01), lower tumour cell B2MG expression (p=0.04) and lower tumour cell PD-L1 expression (p<0.01). There was no difference in HLA class I/II, LAG3, FOXP3, CD163 and PD-L1 positive histiocytes. There was no association with MMR status or BRAF V600E relative to non-MPC. MPC was not associated with decreased disease-specific survival (p=0.36).
MPCs are associated with high-grade differentiation and a less active immune microenvironment than non-MPC. MPC is not associated with inferior disease-specific survival.
微乳头癌（MPC）是世界卫生组织（WHO）认可的结肠癌（CC）变体，尽管对其预后、免疫微环境和分子改变知之甚少。我们调查了其临床、病理和免疫学特征。
我们评估了903例连续的结肠癌病例，并采用WHO的定义来识别微乳头癌。我们记录了锯齿状和黏液性分化以及错配修复（MMR）状态。我们对组织微阵列进行免疫组织化学分析并定量检测HLA I/II类蛋白、β2-微球蛋白（B2MG）、CD8、CD163、淋巴细胞活化基因3（LAG3）、程序性死亡受体配体1（PD-L1）、叉头框蛋白3（FoxP3）、PD-L1和BRAF V600E。
我们将8.6%（n = 78）的结肠癌归类为微乳头癌。与非微乳头癌相比，微乳头癌更常为高级别（p = 0.03）且表现为锯齿状形态（p < 0.01）；然而，我们未发现其与壁外静脉侵犯（p = 0.41）和美国癌症联合委员会分期（p = 0.95）有关。微乳头癌的CD8阳性淋巴细胞数量较少（p < 0.01），肿瘤细胞B2MG表达较低（p = 0.04），肿瘤细胞PD-L1表达较低（p < 0.01）。HLA I/II类、LAG3、FoxP3、CD163和PD-L1阳性组织细胞无差异。与非微乳头癌相比，其与MMR状态或BRAF V600E无关。微乳头癌与疾病特异性生存率降低无关（p = 0.36）。
与非微乳头癌相比，微乳头癌与高级别分化及免疫微环境活性较低有关。微乳头癌与疾病特异性生存率较差无关。
