Histopathological tumour microenvironment score independently predicts outcome in primary operable colorectal cancer
Issued Date
2024-05-01
Resource Type
eISSN
20564538
Scopus ID
2-s2.0-85191059177
Journal Title
Journal of Pathology: Clinical Research
Volume
10
Issue
3
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Pathology: Clinical Research Vol.10 No.3 (2024)
Suggested Citation
Hatthakarnkul P., Pennel K., Alexander P., van Wyk H., Roseweir A., Inthagard J., Hay J., Andersen D., Maka N., Park J., Roxburgh C., Thuwajit C., McMillan D., Edwards J. Histopathological tumour microenvironment score independently predicts outcome in primary operable colorectal cancer. Journal of Pathology: Clinical Research Vol.10 No.3 (2024). doi:10.1002/2056-4538.12374 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98164
Title
Histopathological tumour microenvironment score independently predicts outcome in primary operable colorectal cancer
Corresponding Author(s)
Other Contributor(s)
Abstract
Colorectal cancer (CRC) is a heterogenous malignancy and research is focused on identifying novel ways to subtype patients. In this study, a novel classification system, tumour microenvironment score (TMS), was devised based on Klintrup–Mäkinen grade (KMG), tumour stroma percentage (TSP), and tumour budding. TMS was performed using a haematoxylin and eosin (H&E)-stained section from retrospective CRC discovery and validation cohorts (n = 1,030, n = 787). TMS0 patients had high KMG, TMS1 were low for KMG, TSP, and budding, TMS2 were high for budding, or TSP and TMS3 were high for TSP and budding. Scores were assessed for association with survival and clinicopathological characteristics. Mutational landscaping and Templated Oligo-Sequencing (TempO-Seq) profiling were performed to establish differences in the underlying biology of TMS. TMS was independently prognostic in both cohorts (p < 0.001, p < 0.001), with TMS3 predictive of the shortest survival times. TMS3 was associated with adverse clinical features including sidedness, local and distant recurrence, higher T stage, higher N stage, and presence of margin involvement. Gene set enrichment analysis of TempO-Seq data showed higher expression of genes associated with hallmarks of cancer pathways including epithelial to mesenchymal transition (p < 0.001), IL2 STAT5 signalling (p = 0.007), and angiogenesis (p = 0.017) in TMS3. Additionally, enrichment of immunosuppressive immune signatures was associated with TMS3 classification. In conclusion, TMS represents a novel and clinically relevant method for subtyping CRC patients from a single H&E-stained tumour section.