β2-microglobulin expression is associated with aggressive histology, activated tumor immune milieu, and outcome in colon carcinoma (2024)

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Soo Hyun Lee, MD

Department of Pathology,

Boston Medical Center

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Boston, MA

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US

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Amaya Pankaj, MD

Departments of Pathology, Massachusetts General Hospital

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Boston, MA

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Steffen Rickelt, PhD

Department of Medicine,Massachusetts Institute of Technology

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Cambridge, MA

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David Ting, MD

Department of Medicine,Massachusetts General Hospital Cancer Center

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Boston, MA

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Departments of Medicine,

Harvard Medical School

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Boston

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Cristina Ferrone, MD

Departments of Surgery, Massachusetts General Hospital

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Boston, MA

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Deepa T Patil, MD

Departments of Medicine,

Harvard Medical School

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Boston

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Department of Pathology, Brigham and Women’s Hospital

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Boston, MA

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Omer Yilmaz, MD

Departments of Pathology, Massachusetts General Hospital

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Boston, MA

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Departments of Medicine,

Harvard Medical School

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Boston

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David Berger, MD

Division of General Surgery, Massachusetts General Hospital

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Boston, MA

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Vikram Deshpande, MD

Departments of Medicine,

Harvard Medical School

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Boston

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Department of Pathology, Beth Israel Deaconess Medical Center

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Boston, MA

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Osman Yilmaz, MD

Department of Pathology, Beth Israel Deaconess Medical Center

,

Boston, MA

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Departments of Pathology, Harvard Medical School

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Boston

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Corresponding author: Osman Yilmaz; osmanhy@gmail.com

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American Journal of Clinical Pathology, aqae066, https://doi.org/10.1093/ajcp/aqae066

Published:

13 June 2024

Article history

Received:

26 February 2024

Accepted:

06 May 2024

Published:

13 June 2024

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    Soo Hyun Lee, Amaya Pankaj, Steffen Rickelt, David Ting, Cristina Ferrone, Deepa T Patil, Omer Yilmaz, David Berger, Vikram Deshpande, Osman Yilmaz, β2-microglobulin expression is associated with aggressive histology, activated tumor immune milieu, and outcome in colon carcinoma, American Journal of Clinical Pathology, 2024;, aqae066, https://doi.org/10.1093/ajcp/aqae066

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Abstract

Objectives

We sought to assess the expression of human leukocyte antigen (HLA) proteins and β2-microglobulin (B2M) in tumor cells and the relationship with immune microenvironment and outcome in colorectal cancer (CRC).

Methods

A total of 953 CRC cases were evaluated by immunohistochemistry for HLA class I, HLA class II, and B2M. The expression level of these biomarkers was correlated with clinicopathologic information, BRAF V600E and mismatch repair (MMR) proteins, and the quantitated expression levels of immune cells (CD8 and CD163) and immune regulatory proteins (FoxP3, programmed cell death 1 ligand 1 [PD-L1], and LAG3).

Results

We found that B2M-low tumors were statistically correlated with aggressive histologic features, including higher stage, higher grade, extramural venous invasion, perineural invasion, and distant metastasis. Expression of B2M was positively correlated (R2=0.3) and significantly associated with MMR-deficient tumors (P<.001); B2M-low tumors were also associated with an “immune cold”’ microenvironment, including a reduced number of immune cells (CD8 and CD163), reduced expression of immune regulatory proteins by immune cells (PD-L1, FoxP3, and LAG3), and reduced tumor cell expression of PD-L1. These B2M-low tumors correlated with lower disease-specific survival (P=.018), a finding that maintained significance only for the proficient MMR cohort (P=.037).

Conclusions

Our findings suggest that B2M expression may support predictive models for both outcome and checkpoint inhibitor therapy treatment response for colorectal adenocarcinoma.

© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)

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