Association of the tumor microenvironment collagen score and immunoscore with colon cancer lymph node metastasis

Abstract Background In clinical practice, lymph node status has an important impact on colon cancer (CC) management and treatment. The role of the tumor microenvironment collagen score and immunoscore in colon cancer lymph node metastasis remains unknown. Methods A total of 249 CC patients who under...

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Main Authors: Chenyan Long, Jiaxin Cheng, Mingyuan Feng, Botao Yan, Yiran Li, Wei Jiang, Dexin Chen, Jun Yan
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-13842-5
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author Chenyan Long
Jiaxin Cheng
Mingyuan Feng
Botao Yan
Yiran Li
Wei Jiang
Dexin Chen
Jun Yan
author_facet Chenyan Long
Jiaxin Cheng
Mingyuan Feng
Botao Yan
Yiran Li
Wei Jiang
Dexin Chen
Jun Yan
author_sort Chenyan Long
collection DOAJ
description Abstract Background In clinical practice, lymph node status has an important impact on colon cancer (CC) management and treatment. The role of the tumor microenvironment collagen score and immunoscore in colon cancer lymph node metastasis remains unknown. Methods A total of 249 CC patients who underwent laparoscopic-assisted D3 lymphadenectomy from June 2016 to May 2019 were included. The patients’ clinicopathological data were collected retrospectively. A total of 142 collagen features were extracted by multiphoton imaging and collagen quantification. A collagen score was constructed using a LASSO logistic regression model. Antibodies against CD3 and CD8 were used for immunostaining. The immunoscore was constructed based on the mean densities of CD3 + and CD8 + T cells both in the tumor center and invasion margin on imaging. Results The lymph node metastasis rate among colon cancer patients was 42.2% (105/249). The multivariate analysis indicated that lymphatic invasion (OR: 3.892, 95% CI: 1.784–8.491, p = 0.001), vascular invasion (OR, 3.234, 95% CI: 1.544–6.776); p = 0.002), mucus adenocarcinoma and signet-ring cell carcinoma (OR: 2.990, 95% CI: 1.413–6.328, p = 0.004), the collagen score (OR: 6.304, 95% CI: 2.145–18.527, p = 0.001) and the immunoscore [intermediate group (OR, 2.473; 95% CI, 1.192–5.130; p = 0.015); low group (OR, 5.877; 95% CI, 2.423–14.257; p < 0.01)] were independent risk factors for colon cancer lymph node metastasis. The newly developed model comprising these five independent predictors showed good discrimination with an AUROC of 0.809 (95% CI: 0.755–0.862). The new model performed significantly better than the traditional clinicopathological model [AUROC: 0.715 (95% CI: 0.649–0.780), p < 0.001]. Conclusions The tumor microenvironment collagen score and immunoscore are associated with colon cancer lymph node metastasis.
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spelling doaj-art-7b6a426f90b741a6894a3fc85f4707fe2025-08-20T03:41:40ZengBMCBMC Cancer1471-24072025-03-0125111310.1186/s12885-025-13842-5Association of the tumor microenvironment collagen score and immunoscore with colon cancer lymph node metastasisChenyan Long0Jiaxin Cheng1Mingyuan Feng2Botao Yan3Yiran Li4Wei Jiang5Dexin Chen6Jun Yan7Department of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalAbstract Background In clinical practice, lymph node status has an important impact on colon cancer (CC) management and treatment. The role of the tumor microenvironment collagen score and immunoscore in colon cancer lymph node metastasis remains unknown. Methods A total of 249 CC patients who underwent laparoscopic-assisted D3 lymphadenectomy from June 2016 to May 2019 were included. The patients’ clinicopathological data were collected retrospectively. A total of 142 collagen features were extracted by multiphoton imaging and collagen quantification. A collagen score was constructed using a LASSO logistic regression model. Antibodies against CD3 and CD8 were used for immunostaining. The immunoscore was constructed based on the mean densities of CD3 + and CD8 + T cells both in the tumor center and invasion margin on imaging. Results The lymph node metastasis rate among colon cancer patients was 42.2% (105/249). The multivariate analysis indicated that lymphatic invasion (OR: 3.892, 95% CI: 1.784–8.491, p = 0.001), vascular invasion (OR, 3.234, 95% CI: 1.544–6.776); p = 0.002), mucus adenocarcinoma and signet-ring cell carcinoma (OR: 2.990, 95% CI: 1.413–6.328, p = 0.004), the collagen score (OR: 6.304, 95% CI: 2.145–18.527, p = 0.001) and the immunoscore [intermediate group (OR, 2.473; 95% CI, 1.192–5.130; p = 0.015); low group (OR, 5.877; 95% CI, 2.423–14.257; p < 0.01)] were independent risk factors for colon cancer lymph node metastasis. The newly developed model comprising these five independent predictors showed good discrimination with an AUROC of 0.809 (95% CI: 0.755–0.862). The new model performed significantly better than the traditional clinicopathological model [AUROC: 0.715 (95% CI: 0.649–0.780), p < 0.001]. Conclusions The tumor microenvironment collagen score and immunoscore are associated with colon cancer lymph node metastasis.https://doi.org/10.1186/s12885-025-13842-5Colon cancerCollagen scoreImmunoscoreLymph node metastasis
spellingShingle Chenyan Long
Jiaxin Cheng
Mingyuan Feng
Botao Yan
Yiran Li
Wei Jiang
Dexin Chen
Jun Yan
Association of the tumor microenvironment collagen score and immunoscore with colon cancer lymph node metastasis
BMC Cancer
Colon cancer
Collagen score
Immunoscore
Lymph node metastasis
title Association of the tumor microenvironment collagen score and immunoscore with colon cancer lymph node metastasis
title_full Association of the tumor microenvironment collagen score and immunoscore with colon cancer lymph node metastasis
title_fullStr Association of the tumor microenvironment collagen score and immunoscore with colon cancer lymph node metastasis
title_full_unstemmed Association of the tumor microenvironment collagen score and immunoscore with colon cancer lymph node metastasis
title_short Association of the tumor microenvironment collagen score and immunoscore with colon cancer lymph node metastasis
title_sort association of the tumor microenvironment collagen score and immunoscore with colon cancer lymph node metastasis
topic Colon cancer
Collagen score
Immunoscore
Lymph node metastasis
url https://doi.org/10.1186/s12885-025-13842-5
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