Jiang Wei, Yang Kun, Xiao Chanchan, Ji Hongli, Yan Botao, Zhao Shuhan, Zhang Biao, Cheng Jiaxin, Xu Shuoyu, Wang Guangxing, Lin Zexi, Lu Jianping, Chen Gang, Zhuo Shuangmu, Yan Jun
Department of General Surgery, Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, P. R. China.
School of Science, Jimei University, 361021, Xiamen, P. R. China.
NPJ Precis Oncol. 2025 Aug 2;9(1):270. doi: 10.1038/s41698-025-01069-3.
The current tumor‒node‒metastasis (TNM) staging system cannot provide sufficient information for prognosis and chemotherapy benefits in patients with colorectal cancer (CRC). The tumor microenvironment plays a critical role in disease progression and therapeutic response. Here, we developed and validated a multimodal tumor microenvironment signature of CRC (MTMS) using 1314 CRC patients to enhance prognosis and chemotherapy benefit predictions. We found that the MTMS is an independent predictor of prognosis. Furthermore, incorporating the MTMS and clinicopathological characteristics into the integrated nomograms significantly outperformed traditional models and the TNM staging system. Shapley values identified the MTMS as the most important predictor. Moreover, chemotherapy had no impact on prognosis in nomogram-predicted low-risk score patients but was associated with improved prognosis in medium and high-risk score patients. In summary, the MTMS is a valuable prognostic predictor in CRC patients and the integrated nomogram may help identify those who could benefit from chemotherapy.
目前的肿瘤-淋巴结-转移（TNM）分期系统无法为结直肠癌（CRC）患者的预后和化疗获益提供足够信息。肿瘤微环境在疾病进展和治疗反应中起关键作用。在此，我们利用1314例CRC患者开发并验证了一种结直肠癌多模态肿瘤微环境特征（MTMS），以增强预后和化疗获益预测。我们发现MTMS是预后的独立预测因子。此外，将MTMS和临床病理特征纳入综合列线图显著优于传统模型和TNM分期系统。Shapley值确定MTMS为最重要的预测因子。此外，化疗对列线图预测的低风险评分患者的预后没有影响，但与中高风险评分患者的预后改善相关。总之，MTMS是CRC患者有价值的预后预测因子，综合列线图可能有助于识别那些能从化疗中获益的患者。
