结直肠癌（CRC）是全球第二大癌症死亡原因，但疾病进程因肿瘤特征和免疫因素而异。我们的目标是研究肿瘤坏死与肿瘤特征、免疫细胞浸润、血清细胞因子浓度以及CRC预后的关联。我们对三个独立的CRC队列，包括1413名患者进行了分析。考察了肿瘤坏死面积百分比与临床病理参数、肿瘤浸润免疫细胞、系统和肠系膜静脉血浆细胞因子浓度以及生存之间的关联。随着肿瘤坏死百分比的升高，CRC特异性生存期缩短，与肿瘤级别、T、N或M类别、错配修复状态、BRAF状态和其他可能的混杂因素无关。在最大的队列中（N = 1100），高肿瘤坏死百分比（≥40% vs. <3%）的风险比（HR）为3.22（95% CI 1.68-6.17，Ptrend <0.0001）。肿瘤坏死百分比与体外CXCL8浓度呈正相关，CXCL8是一种促炎性趋化因子，与肠系膜CXCL10浓度和侵袭性肿瘤边缘的肥大细胞密度呈负相关。我们的结果支持肿瘤坏死作为结直肠癌预后因素的价值。CXCL8可能在肿瘤坏死的全身影响中发挥作用。©2023. 作者（们）

Colorectal cancer (CRC) causes the second most cancer deaths worldwide, but the disease course varies according to tumour characteristics and immunological factors. Our objective was to examine the associations of tumour necrosis with tumour characteristics, immune cell infiltrates, serum cytokine concentrations, as well as prognosis in CRC.Three independent CRC cohorts, including 1413 patients, were analysed. Associations of the areal percentage of tumour necrosis with clinicopathologic parameters, tumour infiltrating immune cells, cytokine concentrations in systemic and mesenteric vein blood, and survival were examined.Higher tumour necrosis percentage associated with shorter colorectal cancer-specific survival independent of tumour grade, T, N or M-class, mismatch repair status, BRAF status, and other possible confounding factors. In the largest cohort (N = 1100), the HR for high tumour necrosis percentage (≥40% vs. <3%) was 3.22 (95% CI 1.68-6.17, Ptrend < 0.0001). Tumour necrosis percentage positively correlated with peripheral serum levels of CXCL8, a proinflammatory chemokine, and negatively correlated with mesenteric serum levels of CXCL10 and mast cell densities in the invasive margin of the tumour.Our results support the value of tumour necrosis as a prognostic factor in colorectal cancer. CXCL8 may have a role in the systemic effects of tumour necrosis.© 2023. The Author(s).