Type 2 diabetes (T2D) is linked with increased colorectal cancer (CRC) risk and poorer survival, modulated by tumor immune cell infiltration.
The Immune Cell Score (ICS), reflecting CD3+ and CD8+ T-cell densities, stratifies CRC tumors into low, intermediate, and high immune infiltration phenotypes influencing diabetes-associated risk.
T2D particularly elevates CRC risk and worsens CRC-specific and disease-free survival in tumors with low immune infiltration (ICSLow), but not in high immunity subtypes (ICSHi).
Overall survival in T2D patients is inferior regardless of tumor immune status, underscoring systemic diabetes effects beyond tumor-specific immunity.
