Abstract
Colorectal cancer (CRC) is highly prevalent worldwide. The relationship between the infiltration of immunocytes in CRC and clinical outcome has been investigated in recent years. The present study aims to construct a new prognostic signature using an immunocyte panel. Our novel prognostic immunoscore included 13 types of immunocytes, which were identified by least absolute shrinkage and selection operator (LASSO)-Cox regression. The time-dependent receiver operating characteristic (ROC) curve and Kaplan–Meier survival estimates were applied to evaluate the prognostic ability. Compared with the signature based on a single immune marker (i.e., CD8 mRNA expression and CD8+ expressing T cells), the novel prognostic immunoscore possessed better specificity and sensitivity of prognosis (area under the curves (AUCs) are 0.852, 0.856, and 0.774 for 1-, 2-, and 3-year survival times, respectively). Significant differences were identified between the high and low immunoscore groups in overall survival and disease-free survival in training and validation cohorts. Combining the immunoscore with clinical information may provide a more accurate prognosis for CRC. The immunoscore can identify patients with poor outcomes in the high Tumor Mutational Burden (TMB) group, who may benefit the most from immunotherapy. The immunoscore was also closely related to two immune checkpoints (i.e., PD-L1 and PD-1, r = 0.3087 and r = 0.3341, respectively). Collectively, our study demonstrates that the novel prognostic immunoscore reported here may be useful in distinguishing different prognoses and may improve the clinical management of patients with CRC.
Highlights
Colorectal cancer (CRC) is highly prevalent worldwide, and is the third most common type of cancer in the world, after lung and breast cancer [1]
We developed and validated a novel immunoscore for 13 immunocyte subtypes to improve the prediction of CRC patient survival
If the immunoscore was used in clinical practice, clinicians could adjust the treatment plan according to the results to generate an individualized and comprehensive protocol for each CRC patient
Summary
Colorectal cancer (CRC) is highly prevalent worldwide, and is the third most common type of cancer in the world, after lung and breast cancer [1]. A growing body of evidence has shown that a relationship exists between a CRC patient’s immune microenvironment and his/her prognosis [2]. Immune profiling studies have reached the forefront of cancer research [3]. Various immunocyte subtypes constitute the complex immune response to CRC [4]. The different stages and pathological types of cancer associating with the prognosis of CRC tend to activate different immunocytes’ subtypes [5]. They may be significant for clinical research [6,7]. There are few studies investigating the prognostic ability of the immunocyte fraction [8]
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