Multidisciplinary Approach for Prognostic Prediction

*Multidisciplinary Approach for Colorectal Cancer*

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**64**

**67**

of CRC.

mutations [3].

**Chapter 5**

**Abstract**

CD8+ T cell

**1. Colorectal cancer facts**

*and Sandra F. Martins*

Immunoscore and microbiome in colorectal cancer.

**Keywords:** colorectal cancer, Immunoscore, microbiome, diet, CD3+ T cell,

Colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the fourth leading cause of cancer death in the world, accounting for about 1.4 million new cases and almost 700,000 deaths in 2012 [1]. In Portugal, the incidence of CRC is 42.80 new cases for 100,000 habitants with a mortality rate of 26.6 [2]. The distribution of CRC burden varies widely around the world, with more than twothirds of all cases and about 60% of all deaths occurring in developed countries. The global burden of CRC is expected to increase by 60% to more than 2.2 million new cases and 1.1 million cancer deaths by 2030 [1]. The lifetime risk of developing colorectal cancer is about 6%, which increased fourfold if there is a family history

The multistep models of CRC tumorigenesis postulate an adenoma-carcinoma sequence as the main pathway to develop a cancer. It tells us that CRC arises from a benign precursor polyp that became dysplastic and invasive due to accumulative

Immunoscore and Microbiome in

Colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the fourth leading cause of cancer death in the world, accounting for about 1.4 million new cases and almost 700,000 deaths in 2012. The clinical outcome and the tumor progression are now considered the result of a balance between the invasiveness of the tumor and the immune response of the patient against the tumor. The immune system has the ability to control and shape cancer through a mechanism called immunoediting, which include elimination, equilibrium, and escape. The consensus Immunoscore is a scoring system that outlines the density of CD3+ and CD8+ T-cell effectors existent in the tumor and its invasive margin. The pre-existing intra-tumoral immunity could be enhanced and activated by immunotherapy. Immunoscore could be a good prognostic marker, by identifying patients at high risk of tumor recurrence and stratifying patients who could benefit from adjuvant therapies. Human surfaces and cavities are populated by numerous microbial communities, and they play an indispensable role in human health, as they interact with the immune system. The authors made a literature revision concerning the role of

Colorectal Cancer: What's New?

*Filipa Macedo, Nuno Bonito, Adhemar Longatto-Filho* 
