Park et al reported a histopathologic score based on an invasive tumor's microenvironment. This was initially described for primary colorectal cancer but has been used at other sites. The authors are from the University of Glasgow and University of Cardiff.
Patient selection: invasive carcinoma
Parameters:
(1) inflammatory infiltration at the invasive margin based on Klintrup-Makinen grade
(2) tumor stroma percentage at the invasive margin
Inflammatory infiltrate:
(1) low grade: no or patchy increase in inflammatory cells
(2) high grade if prominent inflammatory reaction with some evidence of destruction of cancer cell islands
Tumor stroma percentage (at 100 magnification with tumor present at all 4 sides of field)
(1) low if percent stroma in field <= 50%
(2) high if percent stroma in field > 50%
Inflammatory Status
Tumor Stroma Percentage
Score
high grade
low or high
0
low
low
1
low
high
2
Interpretation:
• A score of 2 is associated with worse survival (HR 2.4 and 5-year survival 51% in colorectal cancer).
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