Quantum-dots based simultaneous detection of multiple biomarkers of tumor stromal features to predict clinical outcomes in gastric cancer.

Tumor microenvironment has been increasingly recognized as a complex and dynamic cancer society influencing tumor invasion and progression. The prognostic significance of this microenvironment is yet to be fully appreciated. A holistic approach to obtaining integrated information on key components in tumor microenvironment is essential. Here we reported on a quantum dots (QDs)-based simultaneous in-situ detection of infiltrating macrophages, tumor microvessels density (MVD) and neovessels maturity, in gastric cancer tissues, to obtain integrated information on these components, termed as combined tumor stromal features. These stromal features had the comparable prognostic value for overall survival, and even better prognostic value for disease-free survival, compared with traditional tumor cell-based clinico-pathological parameters. Subgroups of gastric cancer patients with favorable and unfavorable combined tumor stromal features were identified, with significantly different clinical outcomes. This study demonstrated the technical advantages of QDs-based simultaneous detection of multiple biomarkers in situ, revealed the important role of tumor stroma in cancer biology, and opened a new field to predict clinical outcome in gastric cancer from the perspectives of tumor microenvironment.