Plant patterns in colorectal liver metastases, biomarkers in the blood for metastatic cancer and the tumor microenvironment in metastatic colorectal cancer.
Colorectal cancer remains one of the world's most common cancers. Every year, more than 6,000 patients become ill in Sweden. About a third of the patients gets the cancer spread to the liver, so-called daughter swellings/liver metastases.
For those patients where the disease is limited, it can be surgically removed and the five-year survival rate in Sweden for those patients undergoing liver surgical treatment, today exceeds 55 percent.
The importance of plant pattern in colorectal liver metastases
Liver metastases from colorectal cancer can grow in different ways in the liver and can be studied in a microscope when the tissue has been surgically removed. A large proportion of patients have a growth style that correlates to a greater risk of relapse into their disease (replacement). This growing pattern is characterized by a lack of the immune system noticing the cancer and the tumor cells can here use the liver's own blood vessels instead of forming their own (angiogenesis). The other common growing pattern is called "desmoplastic" and correlates to a good prognosis after surgery and a low risk of relapse. Here, the body's immune system seems to react to the tumor cells and a capsule of connective tissue forms between the normal liver and the metastasis.
We do not yet know exactly what mechanisms underlie these two modes of growth and we do not yet have a way to classify the mode of growth before surgery.
Current research projects focus on finding a non-invasive way to classify the type of metastasis a patient has before surgery. In the project, we use magnetic resonance imaging and tracer layer X-ray. We are also working but to analyze blood samples to see if we can find one or a combination of markers in the blood that can predict what metastasis type a patient has. Furthermore, we are also working to map differences between gene expressions from tissue from the different metastasis types with in-situ RNA sequencing.
Biomarkers in the blood for metastatic cancer
We are also working to discover new tumor markers that can be measured in the blood of patients with colorectal cancer, breast cancer and pancreatic cancer, among others.
Among other things, we have found that a connective tissue protein (type IV collagen) is a promising marker in the blood for metastatic colorectal and breast cancer and that it can be used in combination with other markers to better detect the disease.
The composition of the tumor microenvironment in metastatic colorectal cancer
The tumor microenvironment is the environment that surrounds and strains the cancer cells in a tumor. Over the years, it has become clearer that the environment in cancer plays a major role in supporting and driving the cancer cells' ability to survive and spread in the body.
In this project, we characterize the tumor microenvironment with a focus on the stroma of tissue from patients with colorectal cancer that has spread to different parts of the body (intestine, liver, lung, peritoneum, skeleton) and compare it with tumors from the intestine that never spread. In this way, we hope to find differences why some patients' tumor spreads but in others does not.
Head of research
Hanna NyströmPhysician, associate professor, senior consultant (attending) physician, other position