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SAR Journal of Pathology and Microbiology
Volume-3 | Issue-03
Original Research Article
The Relation between Tumor Infiltrating Lymphocyte and Classical Tumor Staging in Colorectal Carcinoma (Semi-Quantitative Study by Immun histochemistry in a Group of Iraqi Patients)
Dr. Rand M. Anwer, Dr. Alaa Abdulqader Abdulrazaq, Dr. Sajid Saad Mohammed, Dr. Kifah Hamdan Abdul Ghafour, Dr. Nafea Sami Alboaisa
Published : June 30, 2022
DOI : 10.36346/sarjpm.2022.v03i03.002
Abstract
Background: Inflammatory response had a role in cancer progression, presence of noticeable inflammation within the tumor and its margin may play an important prognostic role in colorectal carcinoma. Objective: The goal of the study is to estimate the classical H&E lymphocytes infiltration pattern, CD3, CD8 cells percentage, and their relation with surgical staging TNM. Materials and Methods: Thirty cases of colorectal carcinoma were collected from a privet lab in Baghdad from May 2021 to August 2021. The clinicopathological data were taken from patient’s reports. The pathological samples were taken from tumor invasive margin as paraffin blocks, for each block one H&E slide and two slides for immune staining for CD3, CD8. Results: The tumor size ranged from≤ 3-5cm, twenty-three cases (79%) were moderately differentiated adenocarcinoma, nineteen cases (65%) diagnosed as stage III. Tumor infiltrating lymphocytes (K-M) grade shows grade 1 in seventeen cases (59%), grade 2 in ten cases (34%), and grade 3 in three (7%) cases. Sixteen cases (55%) show high intraepithelial CD3, five cases (17%) show high intraepithelial CD8, four cases (14%) with low lymphocytes/stromal ratio, eighteen cases (61%) show moderate lymphocyte/stromal infiltration, and seven cases (24%) with high lymphocytes/stromal infiltration. there were significant statistical relations between intraepithelial CD3 and stromal CD3/CD8 ratio (p=0.010); intraepithelial CD3 cells and stromal/tumor ratio (p=0.024); intraepithelial CD8 cells and patient age (p=0.019); and between tumor size and stromal /lymphocytes ratio(p=0.025); no significant relation between K-M grade, intraepithelial cells, stromal/tumor ratio and TNM staging nor tumor grade. Conclusions: The relation between classical TNM staging and tumor infiltrating lymphocytes are independent; each one of them measures different aspect of cancer cells behavior, and both of them are important for patient prognosis. There is variation in tumor infiltrating lymphocytes, intraepithelial lymphocyte (CD3, CD8) which clarified by immune histochemical method. Automated calculation method (immunoscore) is superior.

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