Novel adenoma-immune phenotypes are associated with risk of metachronous polyps and colorectal cancer in a bowel screening cohort

Adenoma immune profiles, especially CD3+ T cell density, predict future colorectal neoplasia with an odds ratio of 1.44 in a bowel screening cohort.

• Why it matters: Current guidelines misclassify about 40% of patients' risk for metachronous lesions after polypectomy, highlighting the need for better predictive biomarkers to improve surveillance strategies.
• What they did: The study analyzed immune cell densities in adenomas from 2642 patients using immunohistochemistry, multiplex immunofluorescence, and transcriptomics, identifying immune clusters linked to future lesion risk.
• The result: High T cell density and specific immune cell cluster profiles were significantly associated with increased future lesion risk, suggesting immune contexture as a potential biomarker for personalized surveillance.