title: Immunoprofiling for prognostic assessment of colon cancer: a novel complement to ultrastaging.
abstract: BACKGROUND
  Although AJCC/TNM staging remains the gold standard for prognostic assessment of colon cancer, stage-specific outcomes vary. We therefore prospectively evaluated the prognostic role of immunoprofiling.
  
  
  METHODS
  Our cohort included 35 patients from an ongoing prospective trial of ultrastaging for colon cancer. Specimens were analyzed for T cell markers (CD3, CD4, CD8, and FoxP3). The number of tumor-infiltrating lymphocytes was analyzed at the tumor's margin and center and correlated with AJCC/TNM stage, clinicopathologic variables, and disease-free survival.
  
  
  RESULTS
  There was a significant inverse association between number of CD3(+) cells in the tumor center and tumor stage (P = 0.05). The tumor center/margin ratio of CD3(+) cells also showed an inverse but non-significant relationship with nodal involvement (P = 0.07). Body mass index was inversely associated with numbers of CD3(+)(P = 0.04) and CD8(+)(P = 0.02) cells. Longer disease-free survival was correlated with higher CD8+ counts (P = 0.07), lower CD4(+)/CD8(+) ratios (P = 0.008), and higher CD8(+)/FoxP3(+) ratios (P = 0.02).
  
  
  CONCLUSIONS
  This is the first prospective validation of immunoprofiling in patients whose colon cancer is staged with strict surgical and pathology quality measures. The apparent correlation between immunophenotypic response and clinical outcome warrants evaluation in a larger prospective trial.
authors: Department of Surgical Oncology, The John Wayne Cancer Institute at Providence Saint John's Health Center, 2200 Santa Monica Blvd., Santa Monica, CA, 90404, USA.
authors: Simon
authors: S
authors: Lavotshkin
authors: John R
authors: JR
authors: Jalas
authors: Hitoe
authors: H
authors: Torisu-Itakura
authors: Junko
authors: J
authors: Ozao-Choy
authors: Ji Hey
authors: JH
authors: Lee
authors: Myung Shin
authors: MS
authors: Sim
authors: Alexander
authors: A
authors: Stojadinovic
authors: Zev
authors: Z
authors: Wainberg
authors: Carlo B
authors: CB
authors: Bifulco
authors: Bernard A
authors: BA
authors: Fox
authors: Anton J
authors: AJ
authors: Bilchik
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000276:immunology* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies