Background and Objectives: Iron is an essential micronutrient for many biological functions and has been found to be intimately linked to cancer biology. Although the effects of increased dietary iron consumption in the development of CRC have been previously investigated in several cohort studies, the available evidence on the involvement of iron deficiency in this process is relatively scarce. Previously published papers did not analyze specific outcomes, such as the presence of biologically aggressive histopathological characteristics, that are associated with the subtypes of iron deficiency. The purpose of this study was to investigate the connection between the development of colorectal cancer and the presence of functional iron deficiency (FID), which is defined as insufficient biological availability of iron in the presence of adequate storage reserves, or absolute iron deficiency (AID), which is defined as severely depleted iron storage levels. Materials and Methods: Our paper represents a single center registry-based cohort study. Iron levels were routinely evaluated upon diagnosis of CRC and the collected data were coupled with patient- and tumor-specific data (2018–2022). Spearman’s correlation coefficient and the chi-squared test were used to analyze the association. Results: Out of 129 patients, 75 (58.13%) were anemic. AID was identified in 26.35% of cases and FID was encountered in 51.16% of cases. A statistically significant association between FID and lymphatic invasion was encountered. An analysis of the correlation demonstrated a significant association between anemia and right-sided tumor location. Conclusions: Functional iron deficiency seems to be independently associated with lymphatic invasion. Although a statistically significant correlation with the T or N stage was not demonstrated, the analysis suggested a potential positive relationship between the presence of FID and more aggressive tumor characteristics.

Inflammatory acute phase proteins have been reported to play a crucial role in cancer progression. Various hematologic and inflammatory markers and scores, such as the lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation score (SIS), prognostic nutritional index (PNI), Glasgow prognostic score, and, more recently, the Naples prognostic score, have been reported as significant prognostic markers. The aim of this prospective study was to evaluate the prognostic significance of the C reactive protein-to-albumin ratio (CAR) in patients with colon cancer. Materials and Methods: We conducted a prospective observational study on a series of patients who underwent curative surgery for colon cancer. The C reactive protein-to-albumin ratio was determined preoperatively, and we evaluated the correlations between the CAR and various clinical and pathological parameters, as well as the correlation with Overall and Relapse-free survival. Furthermore, we compared the accuracy of the CAR with that of the Naples score. Results: One hundred and ten patients were included in the study. We set 0.4927 as the cut-off value for the CAR according to a receiver operating characteristic curve analysis. Based on the cut-off value, patients were divided into a low CAR group and a high CAR group. The preoperative CAR exhibited statistically significant correlation with tumor volume, T and N stage, number of positive lymph nodes, and grade of tumor differentiation. We also demonstrated a positive correlation between high CAR values and a higher Naples score (p = 0.0005), even when a subgroup analysis was performed for each group individually. Conclusions: The preoperative CAR is a useful prognostic marker in patients with colon cancer. These results may help to design strategies to personalize targeted management approaches among colon cancer patients.

Background: Accumulating evidence regarding the association between tumor-infiltrating lymphocyte (TIL) subtypes and prognosis in colorectal cancer has emerged recently in the literature. Whether the prognostic impact of TIL subsets is different according to tumor location remains unknown, despite genetic, epigenetic and molecular differences between the proximal and distal colon. Our study aimed to investigate the value of CD3⁺ lymphocytes, reflecting overall T-cell infiltration, CD8⁺ cells identifying cytotoxic effector T-cells and CD73⁺ cells acting as a modulator of immunosuppression, stratified by primary tumor location. Methods: The density of CD73⁺, CD3⁺ and CD8⁺ tumor-infiltrating B- and T-cells was determined in colon cancer patients using whole-section tissue sampling, heat-induced epitope retrieval, primary antibodies and DAB visualization. QuPath Cell counter function quantified nucleated cells and immune-positive percentages; ImageJ assessed staining intensity via color deconvolution and optical density. An Immunoreactive Score combined intensity and positivity for immune profiling. The Receiver Operating Characteristic (ROC) curve analysis was used to determine the optimal cut-off values for CD3⁺, CD8⁺ and CD73⁺ lymphocytes. Statistical analysis was performed in order to identify potential associations between TILs expression and pathological characteristics, according to the location of the primary tumor. Survival analysis was carried out using the Kaplan–Meier method. Results: A total of 100 patients were included in the study. CD3⁺ T-cells were the most abundantly expressed and were more predominantly encountered in the right colon. Total CD3⁺ numbers were correlated with T stage and the presence of perineural invasion in left-sided tumors, as well as with tumor grading in the right colon. Correlation analysis based on CD3⁺ threshold values according to tumor location demonstrated a statistically significant association between a higher N stage and low CD3⁺ cell values (p value = 0.0306), and higher perineural invasion and low CD3⁺ TILs values in the left colon (p value = 0.0123). In addition, low CD8⁺ values were associated with a higher T stage in the left colon (p value = 0.0382). Survival analysis did not demonstrate statistically significant differences between the investigated groups. Conclusions: TIL subtypes in colon cancer patients demonstrate significant variability according to the location of the primary tumor and are associated with different clinical and pathological characteristics. This exploratory study requires larger validation before TIL densities can guide therapy.

Background/Objectives: Indocyanine green (ICG)-guided near-infrared (NIR) fluorescence imaging represents a potentially advantageous approach for the identification of lymphatic drainage pathways. This study was undertaken to evaluate the efficacy of ICG-guided NIR fluorescence in mapping lymphatic drainage and facilitating sentinel lymph node biopsy (SLNB) in patients diagnosed with colon cancer. Methods: A prospective cohort of 30 consecutive patients with colon cancer undergoing surgical resection at our institution was enrolled in this study. Peritumoral injection of ICG was performed to facilitate intraoperative identification of sentinel lymph nodes (SLNs). Identified SLNs were marked and excised ex vivo following specimen retrieval. All the retrieved specimens were submitted for histopathological analysis using hematoxylin and eosin (H&E) staining. SLNs that were negative for metastatic disease upon H&E staining underwent further examination via immunohistochemistry (IHC). Results: Successful identification of SLNs was achieved in 83.33% of cases. The false positive rate was 6.6%, and the false negative rate was 8%, respectively. Atypical lymphatic drainage patterns were observed in 6.6% of the patients. Notably, the patients exhibiting atypical lymphatic drainage subsequently developed metastases during the follow-up period. Immunohistochemical analysis failed to detect micrometastases in SLNs that were initially deemed negative based on H&E staining. Conclusions: NIR–ICG fluorescence is a safe, reliable, and technically feasible method for performing SLNB in patients with colon cancer. Furthermore, this technique offers the potential for intraoperative identification of atypical lymphatic drainage pathways, which may have significant implications for determining the optimal extent of standard lymphadenectomy.

Background/Objectives: Accurate intraoperative tumour localisation remains challenging in minimally invasive colorectal surgery, where conventional tattooing methods suffer from marker migration, tissue diffusion, and potential allergic reactions. Radio frequency identification (RFID) technology offers a promising alternative through implantable passive transponders detectable via electromagnetic coupling, eliminating ionising radiation exposure. Methods: This preclinical feasibility study evaluated three RFID frequency bands for surgical tumour marking: 134 kHz (low frequency, LF), 13.56 MHz (high frequency, HF), and 868 MHz (ultra-high frequency, UHF). Finite element electromagnetic simulations characterised antenna field distributions, while experimental validation employed glass-encapsulated transponders in air and tissue-simulating saline (0.9% NaCl, σ ≈ 1.5 S/m). Detection ranges were measured across 28 angular configurations with expanded measurement uncertainty (k = 2) ranging from ±0.9 to ±3.2 mm. Results: Maximum detection distances in air were 25.0 ± 0.9 mm (LF), 23.0 ± 1.1 mm (HF), and 68.0 ± 2.3 mm (UHF). In saline, ranges decreased to 22.5 ± 1.0 mm, 20.7 ± 1.2 mm, and 18.0 ± 1.4 mm, respectively, demonstrating tissue attenuation of 10% at LF/HF vs. 74% at UHF. Angular characterisation revealed 64–70% range reduction at orthogonal orientation for LF/HF systems. Computational–experimental correlation yielded r² = 0.975 across 154 paired observations. Conclusions: The 13.56 MHz HF band emerges as the optimal candidate for clinical translation, offering adequate tissue penetration (20.7 mm), superior antenna miniaturisation potential (5 mm diameter), established biocompatibility pathways, and mature near-field communication ecosystem support. Future development should address angular sensitivity through multi-axis antenna configurations and validation in anatomically realistic tissue phantoms. This study establishes the electromagnetic evidence base for clinical system development; translation to clinical practice requires sequential preclinical and clinical evaluation.