Feliciangeli Eduardo, Albaladejo-González Ana, García-Rodríguez José, Lázaro-Sánchez Antonio, Borg Rosanna, Pimentel-Cáceres Paola, Soriano-Polo Diego, Rodríguez-Braun Edith, Balsalobre-Yago José, Martínez-Ortiz María José, Wikström-Fernández Sofía, Murillo-Herrera Andrés, García-García Teresa, García-Solano José, Conesa-Zamora Pablo, Luengo-Gil Ginés
Medical Oncology Department, Hospital General Universitario Santa Lucía, Cartagena, Spain.
Group of Molecular Pathology and Pharmacogenetics, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Universitario Santa Lucía, Cartagena, Spain.
Sci Rep. 2025 Jul 1;15(1):21626. doi: 10.1038/s41598-025-04962-w.
This study examined the prognostic significance of immunoscore within consensus molecular subtypes (CMS), tumour budding (TB), and macrophage infiltration in colorectal cancer (CRC). A retrospective series was analysed using immunohistochemical staining, immunoscore evaluation, and CMS classification, according to established methods. Among the 255 patients with CRC, 34.9% had stage III disease. The CMS classification showed a predominance of CMS2/3 (69.4%), with relapse occurring across all the subtypes. Low immunoscore was frequent in conventional and serrated adenocarcinomas, as well as in CMS2/3, whereas MSI-H correlated with intermediate-high immunoscore. TB was prevalent in relapsed patients, particularly in CMS2/3 and CMS4, and was linked to serrated histology. TB of ≥ 20 foci was correlated with hepatic metastases. CD163+ macrophage infiltration was common in CMS1 and CMS2/3, and was associated with high immune scores. TB influenced overall and relapse-free survival, whereas CMS affected the overall survival. Immunoscore were not associated with survival. The associations identified between CMS subtypes and clinical as well as pathological characteristics enhance the understanding of CMS behaviour in clinical practice.
本研究探讨了免疫评分在结直肠癌（CRC）共识分子亚型（CMS）、肿瘤芽生（TB）和巨噬细胞浸润中的预后意义。根据既定方法，采用免疫组织化学染色、免疫评分评估和CMS分类对一项回顾性系列研究进行分析。在255例CRC患者中，34.9%患有III期疾病。CMS分类显示以CMS2/3为主（69.4%），所有亚型均有复发情况。在传统型和锯齿状腺癌以及CMS2/3中，低免疫评分较为常见，而微卫星高度不稳定（MSI-H）与中高免疫评分相关。TB在复发患者中普遍存在，尤其是在CMS2/3和CMS4中，且与锯齿状组织学相关。≥20个病灶的TB与肝转移相关。CD163+巨噬细胞浸润在CMS1和CMS2/3中常见，并与高免疫评分相关。TB影响总生存期和无复发生存期，而CMS影响总生存期。免疫评分与生存期无关。在CMS亚型与临床及病理特征之间确定的关联增强了对CMS在临床实践中行为的理解。
