title: Number of Intratumoral T Lymphocytes Is Associated With Lymph Node Size, Lymph Node Harvest, and Outcome in Node-Negative Colon Cancer.
abstract: OBJECTIVE
  We postulated that lymph node (LN) harvest and LN size are influenced by immunologic effects.
  
  
  METHODS
  To investigate this hypothesis, we performed a retrospective analysis of 170 node-negative colon cancer cases to evaluate the density of intratumoral T lymphocytes (ITLs). CD3- and CD8-positive T cells were counted using a digital system.
  
  
  RESULTS
  The ITL density was significantly increased in cases with sufficient LN harvest and high numbers of LNs larger than 5 mm (LN5). High ITL numbers were associated with improved cancer-specific survival. The analysis of the immune score revealed a significantly different cancer-specific outcome (P = .024), with no cancer-related death in the group with the highest score. The immune score and tumor budding were independently prognostic.
  
  
  CONCLUSIONS
  ITL density is independently prognostic and associated with LN harvest and LN size. The immune response is very likely the true explanation for the known prognostic effect of the LN harvest in colon cancer.
authors.affiliation: From the Institute of Pathology bruno.maerkl@klinikum-augsburg.de.
authors.forename: Bruno
authors.initials: B
authors.lastname: Märkl
authors.affiliation: From the Institute of Pathology.
authors.forename: Johanna
authors.initials: J
authors.lastname: Wieberneit
authors.affiliation: From the Institute of Pathology.
authors.forename: Hallie
authors.initials: H
authors.lastname: Kretsinger
authors.affiliation: From the Institute of Pathology.
authors.forename: Patrick
authors.initials: P
authors.lastname: Mayr
authors.affiliation: Department of Visceral and Transplantation Surgery.
authors.forename: Matthias
authors.initials: M
authors.lastname: Anthuber
authors.affiliation: From the Institute of Pathology.
authors.forename: Hans M
authors.initials: HM
authors.lastname: Arnholdt
authors.affiliation: Clinical and Population Based Cancer Registry Augsburg, Klinikum Augsburg, Augsburg, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schenkirsch
mesh_terms: D000368:Aged; D019540:Area Under Curve; D003110:Colonic Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000473:pathology*
keywords: Colon cancer; Intratumoral T lymphocytes; Lymph node harvest; Lymph node size