Microsatellite instability and high content of activated cytotoxic lymphocytes identify colon cancer patients with a favorable prognosis

Massimo Guidoboni, Roberta Gafà, Alessandra Viel, Claudio Doglioni, Antonio Russo, Alessandra Santini, Laura Del Tin, Ettore Macrì, Giovanni Lanza, Mauro Boiocchi, Riccardo Dolcetti

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Abstract

Colorectal cancers with high-frequency microsatellite instability show peculiar clinicopathological features and a favorable clinical outcome. We investigated whether the improved prognosis for these cancers is related to the content of activated cytotoxic intraepithelial T lymphocytes. Microsatellite instability and the amount of activated cytotoxic lymphocytes were analyzed according to clinicopathological features, survival, and disease recurrence in 109 right-sided colon carcinomas from 245 consecutive patients with stage II/III colon cancer that underwent radical surgery. High-frequency microsatellite instability was found in 43% of stage II/III proximal colon cancers and was associated with significantly higher numbers of activated cytotoxic lymphocytes. High-frequency microsatellite instability, as well as the content of intratumoral-activated cytotoxic T lymphocytes correlated with improved overall and disease-free survival, particularly in patients with stage in tumors. Multivariate analysis revealed that patients with both features had a risk of death and relapse markedly lower than that associated with microsatellite status or intratumoral cytotoxic lymphocytes separately. The presence of local cytotoxic immune responses is probably the major determinant of the good clinical course of patients with microsatelllte unstable colon cancer. Furthermore, high-frequency microsatellite instability coupled with a high content of intratumoral cytotoxic lymphocytes may identify a subset of colon cancer patients with a favorable clinical outcome, particularly in stage III disease.

Original languageEnglish
Pages (from-to)297-304
Number of pages8
JournalAmerican Journal of Pathology
Volume159
Issue number1
Publication statusPublished - Jul 2001

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ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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