Imunohistoquímica Geral

Towards the introduction of the ‘Immunoscore’ in the classification of malignant tumours

Escrito por Carla Brito Lopes

The American Joint Committee on Cancer/Union Internationale Contre le Cancer (AJCC/UICC) TNM staging system provides the most reliable guidelines for the routine prognostication and treatment of colorectal carcinoma. This traditional tumour staging summarizes data on tumour burden (T), the presence of cancer cells in draining and regional lymph nodes (N) and evidence for distant metastases (M).

However, it is now recognized that the clinical outcome can vary significantly among patients within the same stage. The current classification provides limited prognostic information and does not predict response to therapy. Multiple ways to classify cancer and to distinguish different subtypes of colorectal cancer have been proposed, including morphology, cell origin, molecular pathways, mutation status and gene expression-based stratification. These parameters rely on tumour-cell characteristics.

Extensive literature has investigated the host immune response against cancer and demonstrated the prognostic impact of the in situ immune cell infiltrate in tumours. A methodology named ‘Immunoscore’ has been defined to quantify the in situ immune infiltrate. In colorectal cancer, the Immunoscore may add to the significance of the current AJCC/UICC TNM classification, since it has been demonstrated to be a prognostic factor superior to the AJCC/UICC TNM classification.

An international consortium has been initiated to validate and promote the Immunoscore in routine clinical settings. The results of this international consortium may result in the implementation of the Immunoscore as a new component for the classification of cancer, designated TNM-I (TNM-Immune). © 2013 The Authors. Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.


[Galon, J., Mlecnik, B., Bindea, G., Angell, H. K., Berger, A., Lagorce, C., Lugli, A., Zlobec, I., Hartmann, A., Bifulco, C., Nagtegaal, I. D., Palmqvist, R., Masucci, G. V., Botti, G., Tatangelo, F., Delrio, P., Maio, M., Laghi, L., Grizzi, F., Asslaber, M., D’Arrigo, C., Vidal-Vanaclocha, F., Zavadova, E., Chouchane, L., Ohashi, P. S., Hafezi-Bakhtiari, S., Wouters, B. G., Roehrl, M., Nguyen, L., Kawakami, Y., Hazama, S., Okuno, K., Ogino, S., Gibbs, P., Waring, P., Sato, N., Torigoe, T., Itoh, K., Patel, P. S., Shukla, S. N., Wang, Y., Kopetz, S., Sinicrope, F. A., Scripcariu, V., Ascierto, P. A., Marincola, F. M., Fox, B. A. and Pagès, F. (2014), Towards the introduction of the ‘Immunoscore’ in the classification of malignant tumours. J. Pathol., 232: 199–209. doi: 10.1002/path.4287]. Reprinted with permission of Journal of Pathology published by John Wiley & Sons Ltd

Sobre o autor

Carla Brito Lopes

Carla nasceu em Viana do Castelo em 1977. Licenciada em Anatomia Patológica, Citológica e Tanatológica pela Escola Superior de Tecnologia da Saúde em Lisboa. Concluiu a certificação em Laboratory Management pela ASCP (American Association of Clinical Pathology) em Setembro de 2016. Mestre em Genética Molecular e Biomedicina pela Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa. Trabalhou no Centro Hospitalar Lisboa Central entre 1998 e 2015, exercendo histopatologia e imunohistoquímica, sendo co-responsável pelo sector. Trabalha no Dr. Joaquim Chaves, Laboratório de Anatomia Patológica desde 2004 onde exerce funções de Coordenação Técnica e da Qualidade.