Comparative Analysis of Tumor‐Immune Microenvironment Diversity Among Biopsy, Resection, and Metastatic Colorectal Cancer Specimens

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BACKGROUND: Colorectal cancer (CRC) tumor immune microenvironment (TIME) components such as programmed death-ligand 1 (PD-L1) and CD4+T/CD8+T cells play an important role in immunotherapy, which is closely related to the treatment and prognosis of patients. Due to the fact that CRC is relatively insidious and most of it has advanced and metastasis when discovered, it is important to use biopsy specimens to accurately assess the TIME before treatment. However, there are no studies investigating the association of TIME in biopsy and excision specimens and in metastatic colorectal lesions. METHODS: This study compares PD-L1 expression and CD4+T and CD8+T cell infiltration as representative indicators of CRC TIME among endoscopic biopsy specimens (n = 20), surgical resection specimens (n = 20), metastasis specimens (n = 29), microsatellite instability (MSI) specimens (n = 15), and microsatellite stable (MSS) specimens (n = 78). RESULTS: (1) There was a positive correlation of PD-L1 in tumor cells (TCs) from biopsy and resection (p < 0.05) but not in interstitial cells (ICs) (p > 0.05). CD4+T and CD8+T cells were positively correlated in biopsy and resection specimens (p < 0.05). (2) There are no significant differences in PD-L1-positive cells and CD4+T/CD8+T cell infiltrations between primary lesions of nonmetastatic patients and primary lesions of metastatic patients. (3) Compared with MSS CRC, MSI CRC had higher PD-L1 expression, CD4+T/CD8+T cells, and Ki67-positive rates (p < 0.05). CONCLUSION: CD4+T/CD8+T cell infiltration and PD-L1 expression in resected specimens can be used to predict the progression and growth environment of patients' tumors to a certain extent, which is convenient for clinicians to predict treatment and medication in advance. Metastatic CRC has significant differences in tumor infiltration and MSI from nonmetastatic CRC.

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