Colorectal cancer has a cruel rhythm. A tumour is found, a surgeon removes it, pathology reports are assembled, and then the patient enters a period of watchful uncertainty. In many cases surgery is curative, yet recurrence remains a persistent threat. The World Health Organization estimates that colorectal cancer caused about 1.9 million new cases and more than 900,000 deaths globally in 2022, making it the third most common cancer and second leading cause of cancer-related death worldwide.
AdhesionScore, a Roskilde University spin-out project supported by Spin-outs Denmark, is built around a sharply defined clinical gap: there is no routine predictive test in the immediate postoperative period that can tell clinicians which colorectal cancer patients are at greatest risk of relapse. Spin-outs Denmark describes the project as a “cell assay for predicting the risk of cancer recurrence”, using pre- and postoperative blood samples to assess surgical response and predict recurrence risk within 48 hours.
The scientific idea is both elegant and unsettling. Instead of looking only for fragments of tumour DNA in blood, AdhesionScore asks what the patient’s blood does to cancer cells after surgery. The assay exposes cultured colon cancer cells to serum taken before and after the operation, then measures whether the postoperative serum makes those cells more adhesive. In cancer biology, adhesion is not a trivial property. The ability of cells to attach, detach and colonise new tissue is central to invasion and metastasis.
The project is led by Stine Bull Jessen, a postdoctoral researcher at Roskilde University’s Department of Science and Environment, whose research focuses on molecular and medical biology, cancer cell adhesion and colorectal cancer. Her publication record shows a coherent line of inquiry, moving from a 2022 luciferase-based method for measuring cancer cell adhesion and proliferation, through a 2024 PhD thesis on colorectal cancer surgery and cell adhesion, to a 2025 European Journal of Surgical Oncology paper directly linking surgery-related changes in cancer cell adhesion with recurrence.
The 2025 study is the key evidence base. It included 434 patients undergoing curatively intended colorectal cancer surgery at Copenhagen University Hospital, Herlev, between 15 July 2014 and 31 March 2019. Researchers collected pre- and postoperative serum samples and analysed their effect on cellular adhesion using a high-throughput assay based on CRISPR/Cas9 modified Caco-2 cells and secreted luciferase, explicitly named the AdhesionScore assay.
The results give the project its commercial and clinical force. The study found a significant increase in postoperative adhesion among patients who later experienced recurrence, with p=0.0293. Multiple logistic regression and Cox proportional regression analyses also showed statistically significant associations between increased postoperative adhesion and recurrence, with p=0.0155 and p=0.0126 respectively. Patients with the highest AdhesionScore had the greatest recurrence risk, with a reported hazard ratio of 7 and a 95 percent confidence interval of 1.6 to 37.8.
That last figure is striking, but it needs careful interpretation. A hazard ratio of 7 suggests a strong association, but the wide confidence interval signals uncertainty, and the study is still a step on the road to clinical implementation rather than proof of a finished diagnostic product. The authors conclude that surgery-related differences in adhesion may serve as a novel biological marker of recurrence, not that the assay is already a validated standard-of-care test.
The background science reaches back before the spin-out. In a 2020 BMC Cancer study, researchers including Stine Bull Jessen examined whether perioperative patient serum affected the adhesive properties of cultured colon cancer cells. That smaller study enrolled 30 patients undergoing elective, curatively intended laparoscopic surgery for colon cancer, found that postoperative serum significantly increased adhesion in wild-type LS174T cells compared with preoperative serum, and linked the results to possible pro-metastatic mechanisms in the perioperative phase.
This is important because surgery is not biologically neutral. It removes the primary tumour, but it also produces tissue injury, inflammation, immune modulation and a stress response. The 2020 study notes that manipulation of tumours during surgery can increase circulating tumour cells, while the surgical stress response may reduce anti-tumour defence and increase factors favourable to an oncogenic environment. AdhesionScore’s wager is that a rapid functional assay can read some of that response in an individual patient.
This is also what differentiates AdhesionScore from the better-known field of circulating tumour DNA, or ctDNA. Many blood-based recurrence tools aim to detect molecular residual disease by finding tumour DNA fragments after surgery. Recent reporting and commercial materials describe ctDNA tests as tools that may identify residual disease and recurrence risk, but these approaches are generally based on detecting tumour-derived genetic material rather than measuring how a patient’s postoperative serum changes cancer cell behaviour.
That distinction could be commercially important. A functional assay may capture aspects of the host response that DNA-only tests do not, including inflammatory, immune and soluble-factor changes after surgery. But it also raises operational questions. Cell-based assays are harder to standardise than many molecular tests, because performance can depend on cell line quality, culture conditions, timing, readout stability and laboratory reproducibility. AdhesionScore’s own research acknowledges the need for a high-throughput approach, using modified Caco-2 cells and secreted luciferase to quantify adhesion.
The innovation story is not only scientific. It is institutional. AdhesionScore entered Spin-outs Denmark in 2023. The programme supports entrepreneurial junior researchers who want to transform research results into companies, offering one year of funding of up to DKK 600,000 plus bench fee and overhead, along with mentoring, pitch training and university business-development support.
A further signal came when AdhesionScore was accepted into SPARK Denmark. According to a Spin-outs Denmark LinkedIn post, AdhesionScore was part of Spin-outs Denmark from 2023 to 2024 and became the first Roskilde University case from that collaboration to join the national mentoring programme. The same post identifies Stine Bull Jessen, Jesper Troelsen and Gülizar Aybasti Skjoldager as the team bringing the project forward.
SPARK Denmark’s own project page lists Jesper Troelsen as applicant and describes AdhesionScore as an established functional cell-based in vitro assay using pre- and postoperative blood samples to measure how those samples affect cell adhesion. It states that the aim is to provide cancer surgeons and oncologists with a score that can support follow-up treatment planning and earlier intervention, and notes that the team was accepted into cohort 5.
The clinical promise is easy to understand. If a recurrence-risk signal can be generated within 48 hours of surgery, it could influence surveillance intensity, discussions about adjuvant therapy and the speed with which oncologists intervene. Spin-outs Denmark frames the intended use in precisely those terms: rapid individualised assessment of recurrence risk after surgery, guiding improved clinical decision-making.
Yet the harder question is whether that promise can survive validation. The 2025 study was retrospective in the sense that it analysed patient samples collected between 2014 and 2019, and its clinical utility will need confirmation in prospective cohorts, ideally across hospitals, surgical techniques, tumour stages and perioperative treatment pathways. Clinical adoption will also require evidence that the test improves decisions, not merely that it predicts risk.
There are also regulatory and reimbursement hurdles. AdhesionScore is effectively an in vitro diagnostic concept, and its own LinkedIn profile describes the company as working in in vitro prognostics, personalised medicine, oncology, in vitro diagnostics and cancer prognostics. Such products must demonstrate analytical validity, clinical validity and clinical utility before they can become routine hospital tools.
For Denmark’s innovation ecosystem, AdhesionScore is a useful counterpoint to the more familiar hardware and quantum spin-out narrative. It is a life-science project emerging from Roskilde University, connected to Zealand University Hospital’s Center for Surgical Science Research Unit, and built from a collaboration between molecular biology and surgical oncology. The company profile says AdhesionScore is a cancer prognostics spin-out from Roskilde University in collaboration with the Center for Surgical Science Research Unit at Zealand University Hospital.
Its strength is that it starts with a clinical bottleneck rather than a technology looking for a use case. Colorectal cancer follow-up is already a defined pathway, recurrence is a known and measurable outcome, and clinicians already stratify patients by risk. The gap is timing and precision: who is in danger immediately after surgery, before conventional follow-up has time to reveal relapse?
The risk is that recurrence is biologically heterogeneous. A single functional readout may not capture all mechanisms of relapse. Some recurrences may be driven by residual tumour burden best detected by ctDNA, others by host microenvironment, immune response, inflammatory state or tumour biology. AdhesionScore may become most valuable not as a replacement for molecular residual disease testing, but as a complementary signal in a richer postoperative risk model.
That is where the project becomes most interesting for policy and innovation readers. The future of cancer prognostics may not be one definitive test, but carefully validated layers of information: pathology, imaging, molecular residual disease, immune markers and functional assays. AdhesionScore’s contribution is to insert the surgical event itself into the prediction model, treating surgery not only as treatment but as a biological perturbation that can be measured.
The most responsible reading of AdhesionScore is therefore neither hype nor dismissal. It is an early but unusually concrete example of translational oncology: a laboratory assay derived from a clinically plausible mechanism, supported by peer-reviewed evidence, aimed at a defined decision point, and now entering the mentoring and spin-out machinery needed to test whether it can become a product.
For patients, the question after surgery is always personal: has the cancer gone, and what happens next? AdhesionScore does not yet answer that question in routine care. But it asks it in a new way. Not simply, what did the tumour look like? Not only, is tumour DNA still circulating? But what has surgery changed in the patient’s blood, and does that change make cancer cells more likely to attach?
If future studies confirm its early signal, AdhesionScore could give surgeons and oncologists something they rarely have: a rapid biological reading of recurrence risk in the days immediately after the operation. In a disease where waiting can be psychologically brutal and clinically consequential, that would be more than a clever assay. It would be a new clock in postoperative cancer care.
References
- Davidsen, J., Jessen, S. B., Watt, S. K., Larsen, S., Dahlgaard, K., Kirkegaard, T., Gögenur, I., & Troelsen, J. T. (2020). CDX2 expression and perioperative patient serum affects the adhesion properties of cultured colon cancer cells. BMC Cancer, 20, 426. https://doi.org/10.1186/s12885-020-06941-y [ncbi.nlm.nih.gov]
- Jessen, S. B. (2024). Colorectal cancer surgery impact on cancer cell adhesion: Introducing functional cell assays for investigating clinical implications. Roskilde University. [forskning.ruc.dk]
- Jessen, S. B., Vogelsang, R. P., Dolin, T. G., Jørgensen, J., Olsson, J. B., Kirkegaard, T., Gögenur, I., & Troelsen, J. T. (2025). Surgery-related change in cancer cell adhesion associates with recurrence in patients undergoing colorectal cancer surgery. European Journal of Surgical Oncology, 51(8), Article 110055. https://doi.org/10.1016/j.ejso.2025.110055 [ejso.com], [forskning.ruc.dk]
- Roskilde University. (n.d.). Stine Bull Jessen. Roskilde University Research Portal. [forskning.ruc.dk]
- SPARK Denmark. (n.d.). Jesper Troelsen: AdhesionScore. University of Copenhagen. [sparkdenmark.ku.dk]
- Spin-outs Denmark. (n.d.). AdhesionScore. https://spinouts.dk/project/adhesionscore/ [spinouts.dk]
- Spin-outs Denmark. (n.d.). Programme. https://spinouts.dk/program/ [spinouts.dk]
- World Health Organization. (2026, February 13). Colorectal cancer. https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer [who.int]
