How to Cite
Abstract
Introduction. Correct assessment of stage and prognosis is the basis for successful treatment of any tumor.
Aim. To evaluate the role of immunological parameters of local immunity in colon cancer (CRC) and to develop a complex model for determining the probability of lymphogenic metastasis of the tumor based on the prevalence of the process.
Materials and Methods. The study included 50 patients with CRC, of whom 27 (54 %) had lymph node involvement (N+) and 23 (46 %) had no involvement (N0). Cell suspensions were obtained from tumor tissue, the peritumor zone (1-3 cm from the tumor) and the resection line (~10 cm from the tumor) to identify the major lymphocyte subpopulations and to determine the expression of TLRs (2, 3, 4) on CD45+ lymphocytes and CD45-EpCAM+ epithelial cells. STATISTICA 13.3 was used for statistical analysis of the study results.
Results. N0 patients showed increased numbers of T-lymphocytes, natural killer (NK) cells, in tumor tissue. In the peritumoral zone of N0, a lower content of CD19+ was observed, while in N+, double positive lymphocytes (DP) and NK showed a decrease (p < 0.05). Tumor tissues from the N0 group showed a decrease in the number of tumor cells expressing TLR3, in contrast to the N+ group. In the peritumoral zone of both the groups, there was a multidirectional change in the number of cells expressing TLR2: a decrease in N0 and an increase in N+ (p < 0.05). When analyzing the relative number of lymphocytes in tissue fragments of primary tumors of patients with N0, we observed a decrease in the relative number of cells expressing TLR2 and an increase in the number of cells expressing TLR3 and TLR4. For patients with N+, we noted a 2.5-fold increase in the number of cells expressing TLR4 (p < 0.05). We developed a comprehensive model using the logistic regression method to determine the probability of lymphogenic metastasis of CRC. The mathematical model was used to calculate the N+ probability based on individual patient values. The diagnostic sensitivity was 89.1 % and the specificity was 88.2 %.
Conclusion. The proposed model will make it possible to predict the prevalence of the process at the preoperative stage in CRC patients, and may also become one of the methods for clarifying the diagnosis in process staging.
References
Осомбаев М.Ш., Джекшенов М.Д., Сатыбалдиев О.А., et al. Эпидемиология колоректального рака. Научное обозрение. Медицинские науки. 2021; 1: 37-42.-DOI: https://doi.org/10.17513/srms.1169. [Osombaev M.Sh., Dzhekshenov M.D., Satybaldiev O.A., et al. Epidemiology of colorectal cancer. Scientific Review Medical Sciences. 2021; 1: 37-42.-DOI: https://doi.org/10.17513/srms.1169. (in Rus)].
Старостин Р.А., Гатауллин Б.И., Валитов Б.Р., et al. Колоректальный рак: эпидемиология и факторы риска. Поволжский онкологический вестник. 2021; 12(4): 52-9. [Starostin R.A., Gataullin B.I., Valitov B.R. et al. Colorectal cancer: epidemiology and risk factors. Oncology Bulletin of the Volga Region. 2021; 12(4): 52-9. (In Rus)].
Ansa B.E., Coughlin S.S., Alema-Mensah E., et al. Evaluation of colorectal cancer incidence trends in the United States (2000-2014). J Clin Med. 2018; 7(22): 310-321.-DOI: https://doi.org/10.3390/jcm7020022.
Kobayashi H., West N.P., Takahashi K., et al. Quality of surgery for stage III colon cancer: comparison between England, Germany, and Japan. Ann Surg Oncol. 2014; 21: 398-404.-DOI: https://doi.org/10.1245/s10434-014-3578-9.
Matsuda K., Hotta Т., Takifuji K., et al. Lymph nodes ratio is associated with the survival of colorectal cancer patients with peritoneal carcinomatosis. Am Surg. 2011; 77(5): 602-607.
Ong M., Schofield J. Assessment of lymph node involvement in colorectal cancer. World J Gastrointest Surg. 2016; 8(3): 179-192.-DOI: https://doi.org/10.4240/wjgs.v8.i3.179.
Карачун А.М., Панайотти Л.Л., Петров А.С. Выбор оптимального объема лимфодиссекции в хирургическом лечении рака ободочной кишки: протокол клинического исследования. Тазовая хирургия и онкология. 2017; 2: 11-19.-DOI: https://doi.org/10.17650/2220-3478-2017-7-2-11-19. [Karachun A.M., Panajotti L.L., Petrov A.S. The choice of optimal lymph node dissection extent in surgical treatment for colon cancer: protocol the clinical trial. Pelvic Surgery and Oncology. 2017; 2: 11-19.-DOI: https://doi.org/10.17650/2220-3478-2017-7-2-11-19. (In Rus)].
Schreiber RD. Cancer immunoediting: integrating immunity’s roles in cancer suppression and promotion. Science. 2011; 331:1565-1570.-DOI: https://doi.org/10.1126/science.120348.
Никипелова Е.А., Кит О.И., Шапошников А.В., et al. Колоканцерогенез: онкоиммунология локальных изменений. Злокачественные опухоли. 2016; 4(Спецвыпуск 1): 81-86.-DOI: https://doi.org/10.18027/2224-5057-2016-4s1-81-86. [Nikipelova E.A., Kit O.I., Shaposhnikov AV., et al. Colocancerogenesis: oncoimmunology of local changes. Malignant Tumors. 2016; 4(Spec Issuse 1): 81-86. DOI: https://doi.org/10.18027/2224-5057-2016-4s1-81-86. (In Rus)].
Pages F., Galon J., Fridman W.H. The essential role of the in situ immune reaction in human colorectal cancer. J Leukoc Biol. 2008; 84(4): 981-987.-DOI: https://doi.org/10.1189/jlb.1107773.
Grizzi F., Bianchi P., Malesci A., et al. Prognostic value of innate and adaptive immunity in colorectal cancer. World J Gastroenterol. 2013; 19(2): 174-184.-DOI: https://doi.org/10.3748/wjg.v19.i2.174.
Jiménez-Dalmaroni M.J., Gerswhin M.E., Adamopoulos I.E. The critical role of toll-like receptors--From microbial recognition to autoimmunity: A comprehensive review. Autoimmun Rev. 2016; 15(1): 1-8.-DOI: https://doi.org/10.1016/j.autrev.2015.08.009.
Gay N.J., Symmons M.F., Gangloff M., Bryant C.E. Assembly and localization of Toll-like receptor signalling complexes. Nat Rev Immunol. 2014; 14(8): 546-58.-DOI: https://doi.org/10.1038/nri3713.
Li T.T., Ogino S., Qian Z.R. Toll-like receptor signaling in colorectal cancer: carcinogenesis to cancer therapy. World Journal of Gastroenterology. 2014; 20(47): 17699-17708.-DOI: https://doi.org/10.3748/wjg.v20.i47.17699.
Свитич О.А., Филина А.Б., Давыдова Н.В., et al. Роль факторов врожденного иммунитета в процессе опухолеобразования. Медицинская иммунология. 2018; 20(2): 151-162.-DOI: https://doi.org/10.15789/1563-0625-2018-2-151-162. [Svitich O.A., Filina A.B., Davydova N.V., et al. The Role of Innate Immunity Factors in Tumorigenesis Process. Medical Immunology. 2018; 20(2): 151-162.-DOI: https://doi.org/10.15789/1563-0625-2018-2-151-162. (In Rus)].
Brunner R., Jensen-Jarolim E., Pali-Schöll I. The ABC of clinical and experimental adjuvants--a brief overview. Immunol Lett. 2010; 128(1): 29-35.-DOI: https://doi.org/10.1016/j.imlet.2009.10.005.
Cammarota R., Bertolini V., Pennesi G., et al. The tumor microenvironment of colorectal cancer: stromal TLR-4 expression as a potential prognostic marker. J Transl Med. 2010; 8: 112.-DOI: https://doi.org/10.1186/1479-5876-8-112.
Slattery M.L., Herrick J.S., Bondurant K.L., Wolff R.K. Toll-like receptor genes and their association with colon and rectal cancer development and prognosis. Int J Cancer. 2012; 130(12): 2974-80.-DOI: https://doi.org/10.1002/ijc.26314.
Кит О.И., Демидова А.А., Дженкова Е.А., et al. Способ прогнозирования лимфогенного метастазирования рака ободочной кишки. Патент на изобретение РФ № 2800534; опубл. 24.07.2023, Бюл. № 21: 11 с. [Kit O.I., Demidova A.A., Dzhenkova E.A., et al. Method for prediction of lymphatic metastasis in colon cancer. Russian Invention Patent No. 2800534; Publ. 24.07.2023, Bul. No. 21: 11 p. (In Rus)].
Ed. by Kleihues P., Sobin L.H. Pathology and genetics of tumours of the digestive system. World Health Organization Classification of Tumours. IARCPress. International Agency for Research on Cancer (IARC). Lyon, France. 2000: 110.
Вторушин С.В., Рачковский К.В., Заявьялова М.В., et al. Способ прогнозирования лимфогенного метастазирования при аденокарциноме толстого кишечника. Патент на изобретение РФ № 2688678; опубл. 22.05.2019, Бюл. № 15: 14 с. [Vtorushin S.V., Rachkovskij K.V., Zayavyalova M.V., et al. Method for prediction of lymphatic metastasis in colon adenocarcinoma. Russian Invention Patent No. 2688678; pub. 22.05.2019, Bul. No. 15: 14 p. (in Rus)].
Златник Е.Ю., Новикова И.А., Бондаренко Е.С., et al. Характеристика системного и локального иммунитета и стволовых опухолевых клеток у больных колоректальным раком с различной распространенностью, динамикой и прогнозом. Медицинская иммунология. 2022; 24 (1): 121-134.-DOI: https://doi.org/10.15789/1563-0625-COL-2352. [Zlatnik E.Yu., Novikova I.A., Bondarenko E.S., et al. Characteristics of local and system immunity, and features of cancer stem cells in patients with different stage, dynamics and prognosis of colorectal carcinoma. Medical Immunology (Russia). 2022; 24(1): 121-134.DOI: https://doi.org/10.15789/1563-0625-COL-2352. (In Rus)].
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