Evidence map›Paper›PMID 42312545›Full record

ArticleThe Journal of pathology2026

Tumor Invasive Border Index (TIBI) in colorectal cancer: linking infiltrative morphology to molecular insights.

Akseli Kehusmaa, Jouni Härkönen, Huayi Li, Päivi Sirniö, Ville K Äijälä, Henna Karjalainen, Meeri Kastinen, Vilja V Tapiainen, Tuomo Mantere, Vesa-Matti Pohjanen and 20 more

Abstract read
In one paragraph

Article in The Journal of pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Akseli Kehusmaa *Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.ORCID https://orcid.org/0009-0004-9415-7283
Jouni Härkönen *Department of Pathology, Hospital Nova of Central Finland, Well Being Services County of Central Finland, Jyväskylä, Finland.
Huayi Li *Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland.
Päivi SirniöTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Ville K ÄijäläTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.ORCID https://orcid.org/0009-0005-7664-8027
Henna KarjalainenTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Meeri KastinenTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Vilja V TapiainenTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Tuomo MantereTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Vesa-Matti PohjanenTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Hanna ElomaaResearch Program in Systems Oncology, University of Helsinki, Helsinki, Finland.
Onni SirkiäDepartment of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland.
Nicolas PasquierTurku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland.
Maarit AhtiainenCentral Finland Biobank, Well Being Services County of Central Finland, Jyväskylä, Finland.
Olli HelminenTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Erkki-Ville WirtaDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
Taneli T MattilaTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Outi LindgrenTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Janette SavelaTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Jukka RintalaTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Sanna MeriläinenTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Juha SaarnioTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Tero RautioTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Toni T SeppäläFaculty of Medicine and Health Technology, Tampere University and Tays Cancer Centre, Tampere University Hospital, Tampere, Finland.ORCID https://orcid.org/0000-0002-4940-3498
Jan BöhmDepartment of Pathology, Hospital Nova of Central Finland, Well Being Services County of Central Finland, Jyväskylä, Finland.
Jukka-Pekka MecklinDepartment of Education and Research, Wellbeing Services County of Central Finland, Jyväskylä, Finland.
Markus J MäkinenTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Anne TuomistoTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Johanna IvaskaTurku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland.
Juha P VäyrynenTranslational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.ORCID https://orcid.org/0000-0002-8683-2996

Funding

Cancer Foundation of Northern FinlandFinnish State Research FundingKaarina and Erkki Piippola FoundationOrionin TutkimussäätiöOulun Yliopiston Tukisäätiö 20250059Sigrid Juséliuksen Säätiö 230229Sigrid Juséliuksen Säätiö 240241Sigrid Juséliuksen Säätiö 250264Suomen Lääketieteen Säätiö 6021Suomen Lääketieteen Säätiö 8018Syöpäsäätiö 59-5619Syöpäsäätiö 69-7354
6 · The paper itself

Abstract

Tumor border configuration influences colorectal cancer (CRC) prognosis, yet its molecular determinants remain unclear and existing assessment criteria have faced challenges with reproducibility. We introduce the Tumor Invasive Border Index (TIBI), a novel and reproducible method that quantifies the proportion of tumor stroma and adipose tissue within a hotspot at the deepest point of invasion. TIBI was evaluated in two CRC cohorts (n = 1,100 and n = 776) and analyzed in relation to tumor and patient features. Molecular correlates of an infiltrative growth pattern were explored in The Cancer Genome Atlas (TCGA) CRC cohorts (n = 350), with key features validated independently. High TIBI, indicating an infiltrative border, was associated with advanced disease, tumor budding, lymphovascular invasion, and an immune microenvironment characterized by lower M1-like macrophage and granulocyte densities. High TIBI independently predicted higher CRC-specific mortality, with multivariable hazard ratios of 1.52 (95% CI 1.07-2.17) in cohort 1 and 2.45 (95% CI 1.37-4.37) in cohort 2. Molecular analysis revealed associations with mismatch repair proficiency, TP53 and KRAS mutations, MYC signaling downregulation, and epithelial-mesenchymal transition upregulation. L1CAM and DSG3 were among the genes showing high expression in infiltrative tumors. As experimental validation, we identified a CRC cell line with high expression of L1CAM and DSG3 and demonstrated that silencing them reduced invasion in vitro. A TIBI-associated gene signature also predicted infiltrative growth and adverse outcome in the TCGA gastric cancer cohort. These findings highlight molecular characteristics of tumor border configuration and establish TIBI as a clinically relevant tumor biomarker. © 2026 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Indexed as

Biomarkers, TumorColorectal NeoplasmsAdipose TissueAgedEpithelial-Mesenchymal TransitionFemaleHumansMaleMiddle AgedMutationNeoplasm InvasivenessPredictive Value of TestsPrognosisTumor MicroenvironmentBiomarkers, Tumorcolorectal cancerepithelial‐mesenchymal transitiontumor biomarkerstumor border configurationtumor invasion

Identifiers

PMID42312545
PMCPMC13431732

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.