Department of Surgery, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, The Netherlands.
Breast Cancer Res Treat. 2017 Nov;166(2):435-445. doi: 10.1007/s10549-017-4445-8. Epub 2017 Aug 9.
The primary aim of the current study is to validate the prognostic relevance of the relative amount of tumour-associated stroma, the tumour-stroma ratio, in a large cohort of primary operable breast cancer patients.
A retrospective cohort study was performed on women diagnosed and treated for primarily operable invasive breast cancer in the period from 1 January 1990 till 31 December 1999. Tumour-stroma ratio was estimated by microscopic evaluation of haematoxylin and eosin tumour slides. Two independent observers (k = 0.68) performed tumour-stroma ratio evaluation in a significant part of the cohort. The prognostic potential with respect to overall, recurrence-free and distant metastasis-free survival was evaluated.
A total of n = 737 women were evaluated. Median follow-up time was 11.5 years. High stromal content was an independent prognosticator for worse overall (hazard ratio 1.56, p = 0.002, 95% confidence interval 1.18-2.05), distant metastasis-free (hazard ratio 1.52, p = 0.008, 95% confidence interval 1.12-2.06) and recurrence-free survival (hazard ratio 1.35, p = 0.046, 95% confidence interval 1.01-1.81). In subgroups of hormone receptor-positive and lymph node-negative cases, high stromal content was also an independent prognosticator for worse outcome.
Tumour-stroma ratio is an independent risk factor for worse overall, distant metastasis-free and recurrence-free survival in primarily operable breast cancer. However, detailed prospective studies with respect to tumour-stroma ratio are necessary to gain more insight in its prognostic potential in clinical practice.
本研究的主要目的是在一个大型原发性可手术乳腺癌患者队列中验证肿瘤相关基质的相对量（肿瘤-基质比）的预后相关性。
对 1990 年 1 月 1 日至 1999 年 12 月 31 日期间诊断和治疗原发性可手术浸润性乳腺癌的女性进行了回顾性队列研究。通过苏木精和伊红肿瘤切片的显微镜评估来估计肿瘤-基质比。两名独立观察者（k=0.68）在队列的重要部分进行了肿瘤-基质比评估。评估了与总生存、无复发生存和无远处转移生存相关的预后潜力。
共评估了 737 名女性。中位随访时间为 11.5 年。高基质含量是总生存（风险比 1.56，p=0.002，95%置信区间 1.18-2.05）、无远处转移生存（风险比 1.52，p=0.008，95%置信区间 1.12-2.06）和无复发生存（风险比 1.35，p=0.046，95%置信区间 1.01-1.81）的独立预后因素。在激素受体阳性和淋巴结阴性病例亚组中，高基质含量也是总生存、无远处转移生存和无复发生存较差的独立预后因素。
肿瘤-基质比是原发性可手术乳腺癌总生存、无远处转移生存和无复发生存的独立危险因素。然而，需要进行详细的前瞻性研究，以进一步了解其在临床实践中的预后潜力。
