Mass General Brigham researchers conducted a prospective cohort study of blood vessels in colorectal tumours, linking higher blood vessel density to lower colorectal cancer-specific mortality

Tumours require a blood supply to grow and survive. The blood vessels that nourish tumours can have different characteristics across cancer types and could have a connection to patient survival and outcomes.

Researchers from Mass General Brigham Cancer Institute, the Broad Institute of MIT and Harvard, and Harvard T.H.Chan School of Public Health conducted a prospective cohort study using advanced imaging techniques to microscopically characterise colorectal tumour vessels.

The study found that patients with tumours showing higher overall blood vessel density had better survival, and a higher proportion of microvessels was associated with better outcomes.

The results are published in JAMA Network Open. “Numerous blood vessels extend deep into tumours, yet their role in tumour biology is still relatively understudied,” explained corresponding author Shuji Ogino, MD, the chief of the Programme in Molecular Pathological Epidemiology in the Department of Pathology at Mass General Brigham.

“We are finding that some tumour vessel subtypes may represent potential therapeutic targets. For example, immunotherapy combined with vessel-targeting therapy may prove even more effective in treating colorectal cancer than immunotherapy alone.”

The study used the prospective cohort incident-tumour biobank method (PCIBM) to analyse tumour samples from 837 colorectal cancer patients in the Nurses' Health Study, a study that has run for 50 years, and the Health Professionals Follow-Up Study.

The research team developed a custom in-situ multispectral immunofluorescence assay to visualise and quantify multiple biomarkers within a single tissue section or cell sample.

They used this technique to classify more than 61,000 tumour blood vessels by molecular and structural features.

By incorporating AI-based machine learning, the researchers analysed tumour vessel data faster and more efficiently than traditional methods.

Additional findings indicate that higher proportions of certain kinds of vessels were associated with worse patient outcomes.

Vessel subtypes associated with angiogenesis (new blood vessel growth) were linked to a poorer prognosis.

Also, smaller, rounder vessels were correlated with better outcomes, while larger, more abnormal vessels were linked to worse outcomes.

A group led by Ogino recently found that certain vessel features characterise colorectal cancer diagnosed in patients under age 50 (so-called early-onset colorectal cancer).

Future research will explore whether various vessel features are linked to known or novel risk factors using the PCIBM approach.

The authors note that additional studies are needed to validate the findings and better understand how tumour vessel characteristics may influence colorectal cancer outcomes.

“Our study demonstrated that vascular features could serve as prognostic biomarkers, biological or clinical signs that signal the likely path of a disease,” Ogino said.

“It indicates what might have happened in the past or what may happen in the future, no matter what treatment is used, which may be useful for risk stratification and precision medicine.”

Article: Tumor Vascular Features and Colorectal Cancer–Specific Mortality

Source: Mass General Brigham