Department of Pathology, University of Helsinki, Helsinki, Finland.
Department of Pathology, University of Turku, Turku, Finland.
Histopathology. 2018 Jun;72(7):1128-1135. doi: 10.1111/his.13481. Epub 2018 Mar 23.
Oral tongue squamous cell carcinoma (OTSCC) has a relatively poor outcome, and there is a need to identify better prognostic factors. Recently, tumour-stroma ratio (TSR) has been associated with prognosis in several cancers. The aim of this multi-institutional study was to evaluate the prognostic value of TSR from original haematoxylin and eosin (HE)-stained tumour-resection slides in a series of early-stage (cT1-2N0) OTSCC patients.
A TSR cutoff value of 50% was used to divide the patients into stroma-rich (≥50%) and stroma-poor (<50%) groups. The relationships between TSR and clinicopathological characteristics of 311 early-stage OTSCC cases were analysed. The prognostic value of TSR in OTSCC was calculated separately and in combination with a previously published cancer cell budding and depth of invasion (BD) prognostic model. A total of 89 cases (28.6%) belonged to the stroma-rich group. In a multivariate analysis, the stroma-rich group had worse disease-free survival, with a hazard ratio (HR) of 1.81 [95% confidence interval (CI) 1.17-2.79, P = 0.008], and higher cancer-related mortality (HR 1.71, 95% CI 1.02-2.86, P = 0.03). The combination of the highest-risk parameter scores of TSR and the BD model showed significant correlations with recurrence rate (HR 3.42, 95% CI 1.71-6.82, P = 0.004) and cancer-related mortality (HR 11.63, 95% CI 3.83-35.31, P < 0.001).
We conclude that TSR is a simple histopathological feature that is useful for prognostication of early-stage OTSCC, and suggest that TSR analyses in association with BD score could be included in routine clinical pathology reports for HE-stained slides.
口腔舌鳞状细胞癌（OTSCC）的预后较差，因此需要确定更好的预后因素。最近，肿瘤-基质比（TSR）与几种癌症的预后相关。本多机构研究的目的是评估一系列早期（cT1-2N0）OTSCC 患者中来自原始苏木精和伊红（HE）染色肿瘤切除切片的 TSR 的预后价值。
使用 TSR 截断值 50%将患者分为基质丰富（≥50%）和基质贫乏（<50%）组。分析了 311 例早期 OTSCC 病例的 TSR 与临床病理特征之间的关系。单独计算 TSR 在 OTSCC 中的预后价值，并与之前发表的癌症细胞芽殖和浸润深度（BD）预后模型相结合。共有 89 例（28.6%）属于基质丰富组。在多变量分析中，基质丰富组的无病生存率较差，风险比（HR）为 1.81（95%置信区间[CI] 1.17-2.79，P=0.008），癌症相关死亡率更高（HR 1.71，95% CI 1.02-2.86，P=0.03）。TSR 和 BD 模型的最高风险参数评分的组合与复发率显著相关（HR 3.42，95%CI 1.71-6.82，P=0.004）和癌症相关死亡率（HR 11.63，95% CI 3.83-35.31，P<0.001）。
我们得出结论，TSR 是一种简单的组织病理学特征，可用于预测早期 OTSCC 的预后，并建议将 TSR 分析与 BD 评分结合起来纳入常规临床病理报告的 HE 染色切片。
