Department of Surgery, Hospital Group Twente, P.O. Box 7600, 7600 SZ Almelo, The Netherlands.
Eur J Surg Oncol. 2012 Apr;38(4):307-13. doi: 10.1016/j.ejso.2012.01.002. Epub 2012 Jan 20.
Triple-negative cancer constitutes one of the most challenging groups of breast cancer given its aggressive clinical behaviour, poor outcome and lack of targeted therapy. Until now, profiling techniques have not been able to distinguish between patients with a good and poor outcome. Recent studies on tumour-stroma, found it to play an important role in tumour growth and progression.
To evaluate the prognostic value of the tumour-stroma ratio (TSR) in triple-negative breast cancer.
One hundred twenty four consecutive triple-negative breast cancer patients treated in our hospital were selected and evaluated. For each patient the Haematoxylin-Eosin (H&E) stained histological sections were evaluated for percentage of stroma. Patients with less than 50% stroma were classified as stroma-low and patients with ≥ 50% stroma were classified as stroma-high.
Of 124 triple-negative breast cancer patients, 40% had a stroma-high and 60% had a stroma-low tumour. TSR was assessed by two investigators (kappa 0.74). The 5-years relapse-free period (RFP) and overall survival (OS) were 85% and 89% in the stroma-low and 45% and 65% in the stroma-high group. In a multivariate cox-regression analysis, stroma amount remained an independent prognostic variable for RFP (HR 2.39; 95% CI 1.07-5.29; p = 0.033) and OS (HR 3.00; 95% CI 1.08-8.32; 0.034).
TSR is a strong independent prognostic variable in triple-negative breast cancer. It is simple to determine, reproducible and can be easily incorporated into routine histological examination. This parameter can help optimize risk stratification and might lead to future targeted therapies.
三阴性乳腺癌因其侵袭性的临床行为、不良预后和缺乏靶向治疗而成为乳腺癌中最具挑战性的一组。到目前为止，分析技术还无法区分预后良好和预后不良的患者。最近关于肿瘤-基质的研究发现，它在肿瘤生长和进展中起着重要作用。
评估三阴性乳腺癌中肿瘤-基质比（TSR）的预后价值。
选择我院连续收治的 124 例三阴性乳腺癌患者进行评估。对每位患者的苏木精-伊红（H&E）染色组织切片进行基质百分比评估。间质百分比<50%的患者分为间质低，间质百分比≥50%的患者分为间质高。
124 例三阴性乳腺癌患者中，40%为间质高，60%为间质低。两名研究人员评估了 TSR（kappa 值为 0.74）。间质低组的 5 年无复发生存期（RFP）和总生存期（OS）分别为 85%和 89%，间质高组分别为 45%和 65%。在多变量 Cox 回归分析中，间质量仍然是 RFP（HR 2.39；95%CI 1.07-5.29；p=0.033）和 OS（HR 3.00；95%CI 1.08-8.32；0.034）的独立预后因素。
TSR 是三阴性乳腺癌的一个强有力的独立预后因素。它的测定简单、可重复，并且可以很容易地纳入常规组织学检查。该参数有助于优化风险分层，并可能导致未来的靶向治疗。
