Table 1.
Comparison pre- and post-treatment of the immune repertoire changes seen in the 2 patients.
| Patient | Patient 1 | Patient 2 | |||
|---|---|---|---|---|---|
| Treatment | Baseline Biopsy | Surgical Resection | Baseline Biopsy | Surgical Resection | Surgical Resection |
| Location | Ascending colon | Rectum | |||
| Pathology | Tubular Adenoma | Invasive Adenocarcinoma | Invasive Adenocarcinoma | Adenocarcinoma | Adenocarcinoma |
| Area/ROI name | Total tumor | Total tumor | Total tumor | Tumor area 1 (deep invasive + ulcer) | Tumor area 2 (mucosal) |
| Area (mm2) | 12.06 | 6.01 | 5.321 | 10.57 | 14.9 |
| Analyte | Value | Value | Value | Value | Value |
| CD20+ cell density | 2.2 | 161.4 | 28.2 | 132.5 | 30.2 |
| CD68+ cell density | 100.3 | 99.8 | 125.9 | 387.9 | 288.6 |
| CD163+ cell density | 106.6 | 73.2 | 138.1 | 170.3 | 255.0 |
| CD3+ cell density | 190.7 | 1389.4 | 483.9 | 1267.7 | 543.6 |
| CD4+ cell density | 126.0 | 1356.1 | 402.2 | 1021.8 | 389.3 |
| CD8+ cell density | 89.0 | 252.9 | 94.9 | 378.4 | 134.2 |
| FOXP3+ cell density | 56.1 | 411.0 | 132.5 | 236.5 | 201.3 |
| FOXP3+ fraction | 55% | 36% | 34% | 27% | 49% |
| PD-1+ cell density | 6.2 | 81.5 | 17.9 | 274.4 | 134.2 |
| PD-L1 CPS score | 58% | 70% | <1% | 10% | 30% |
| PD-L1 TPS score | <1% | 0% | 0% | 0% | <1% |
| Immune Proliferation Index | 23% | 58% | 16% | 20% | 35% |
Using PathViewer software, pathologist draws regions of interest (ROI(s)) corresponding to tumor-bearing regions of the image, then counts cells based on visual inspection. The software reports region of interest (ROI) area allowing cell density calculation. As noted, the immune cells are noted to have increased several folds. Furthermore, intra-tumoral heterogeneity and changes can also be appreciated as noted for the 2 Tumor Areas #1 and #2 for Patient 2.