Our group studies colorektal cancer and biomarkers for prognosis.
A few years ago, I changed my research focus from studies of the immunopathology of the intestine, which included studies on inflammatory bowel disease, celiac disease and the human gut microbiota, and colorectal cancer (CRC), to only include CRC. This cancer form is the third most common cancer in the Western world and only 50% of the patients are cured by current treatment modalities. The cause of CRC is unknown and only about 10% of the cases can be explained by genetic factors indicating that environmental factors, including the composition of the intestinal microbiota, play a key role. Surgery is the primary treatment and saves many lives. However, a very significant fraction of treated patients succumbs from the disease during 5-10 years after surgery. The main pathway for cancer death is that tumor cells leave the intestine via lymphatic vessels and end up in the regional lymph nodes, where further selection of particularly aggressive clones develop with ability to leave this site and eventually end up in peripheral organs, mainly the liver, causing metastases that eventually kill the patient. Detection and characterization of tumor cells in the lymph nodes of CRC patients is of particular importance for successful treatment.
Although the standard method for detection of tumor cells in lymph nodes is the single most important method for determining patient survival it is a weak method missing about 30% of patients that were considered tumor-free but who later died from CRC. My research group have developed a lymph node test for CRC based on selected biomarkers. It is a mRNA test that is superior to the standard method because it can analyze the entire lymph node volume and determines whether the tumor cells are aggressive or relatively harmless. This quantitative RT-PCR test, named ColoNode, is now produced as "reseach use only" product by a company HILOPROBE, which I have developed together with four other founders, Sten Hammarström, Lina Olsson, Gudrun Lindmark and Anne Israelsson. The company is in the process of CE- labelling ColoNode for use in the clinic. It is my belief that the new method will be of great use for the clinicians in choosing appropriate treatment for these cancer patients sawing lives.
At the research end of this project we are investigating whether a complementary test for lymph nodes which focuses on the immune response to the tumor in the node could further improve tumor detection and characterization. Moreover, certain intestinal bacterial species have been described as risk factors for CRC. We will investigate whether a particular microbial flora can be detected in lymph nodes from CRC patients.