| Objective:To investigate the desmoplastic pattern at the tumor front in colorectal cancer,and to explore the relationship between the expressions of desmoplastic pattern with clinical pathlogical parameters and determine its prognostic significance;To determine whether the tumor immune infiltrate by morphological expressions,could be a useful prognostic marker in patients with colorectal cancers;To investigate the value of application of D2-40/CD34-CK cocktail antibodies and determine its prognostic significance in colorectal cancer with insufficient lymph node harvest.【Methods】 1.The first part: To investigate the desmoplastic pattern at the extramural desmoplastic was histologically classified as mature,intermediate,or immature,based on the presence of keloid-like collagen and myxoid stroma in colorectal cancer that diagnosed the pathological stages at p T3-p T4,and to explore the relationship between desmoplastic pattern and clinical pathlogical parameters as well as the expressions of SLUG protein;and to determine its prognostic significance.2.The second part: To determine whether the tumor immune infiltrate by morphological expressions,as recently evaluated with the immunoscore methodology,could be a useful prognostic marker in patients with colorectal cancers.3.The third part:To investigate the value of application of D2-40/CD34-CK cocktail antibodies by double immunohistochemical staining for assessment of lymphovascular invasion(LVI)and determine its prognostic significance in colorectal cancer with insufficient lymph node harvest..【Results】 1.From 212 cases of colorectal cancers observed,there were defined as mature,intermediate or immature.In statistical analysis,the desmoplastic pattern at the extramural desmoplastic was significantly associated with T stages,N stages,distant metastases and tumor budding(P < 0.05);and was negatively correlated the expression of SLUG protein;and Univariate analyses supports was significantly associated with PFS amd OS(P < 0.05).2.The densities of CD3 and CD8 lymphocytes and the associated Immunoscore weresignificantly associated with histological types,tumor differentiation,Dukes staging,depth of invasion,N stages,clinical stages,tumor budding,mismatch repair status,and the expression of PD-L1,Fox P3 protein(P < 0.05).In addition,immunoscore was significantly correlated with differences in disease-free and overall survival(all P < 0.05).Univariate analyses supports Immunoscore and the expression of Fox P3 protein were significantly associated with PFS amd OS(P < 0.05);Cox multivariate analysis supports the advantage of the Immunoscore compared with the T staging or clinical stages in predicting overall survival(P < 0.001).3.The presence of LVI detected by double staining of cocktail antibodies was better than H&E staining.There is statistically significant differences between these two groups(P < 0.001);The presence of LVI proved by double staining significantly associated with Dukes staging,depth of invasion,clinical stages,lymph node metastasis and tumor budding(P < 0.05);The presence of LVI,the location of LVI,the extent of LVI and the number of tumor cells in thrombus >5.5 for cases with LVI ≤2 clusters,were significantly associated with OS(P < 0.05).【Conclusions】 1.The desmoplastic pattern at the extramural desmoplastic was a poor prognostic factor of colorectal cancers,which could be used as a supplementary prognosis parameters for TNM stage in the routine pathology report.2.The densities of CD3 and CD8 lymphocytes and the associated immunoscore were correlated with the mismatch repair status.Meanwhile,immunoscore was significantly associated with PFS and OS,and it may be an independent risk factors for patient outcomes.3.Evaluation of LVI by using D2-40/CD34-CK cocktail antibodies double staining is superior to that of routine H&E section assessment.LVI is an independent prognostic factor for CRC patients with insufficient lymph node harvest;therefore,the assessment of LVI should be a supplementary examination for these patients. |
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