Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil.
Histopathology. 2020 May;76(6):906-918. doi: 10.1111/his.14070. Epub 2020 May 3.
Previous studies have demonstrated that the tumour-stroma ratio (TSR) and tumour budding are of prognostic value for oral squamous cell carcinomas (OSCCs). The aim of this study was to evaluate the prognostic significance of those histological parameters, individually and in combination, for OSCC.
The TSR and tumour budding (the presence of five or more buds at the invasive front) were estimated in 254 patients with OSCC. The clinicopathological association was investigated with a chi-square test, and the prognostic significance (cancer-specific survival and disease-free survival) was verified with Kaplan-Meier analysis and the Cox proportional hazard model. The TSR (≥50%, stroma-rich) was significantly and independently associated with both shortened cancer-specific survival and poor disease-free survival, whereas tumour budding was significantly associated with reduced cancer-specific survival. The TSR/tumour budding model was independently associated with a high risk of cancer mortality and recurrence (disease-free survival). In patients with early-stage tumours (clinical stage I and II, n = 103), the TSR, tumour budding and the TSR/tumour budding model were significantly associated with both cancer-related death and recurrence, whereas, in advanced-stage tumours (clinical stage III and IV, n = 144), only the TSR and the TSR/tumour budding model were significantly associated with cancer-specific survival.
The TSR, tumour budding and their combination provide significant information on OSCC outcome, suggesting that their incorporation in the routine evaluation of histopathological specimens might be useful in prognostication for OSCC patients.
先前的研究已经证明肿瘤间质比（TSR）和肿瘤芽殖对于口腔鳞状细胞癌（OSCC）具有预后价值。本研究旨在评估这些组织学参数单独和联合对 OSCC 的预后意义。
在 254 例 OSCC 患者中评估了 TSR 和肿瘤芽殖（侵袭前沿存在 5 个或更多芽殖）。采用卡方检验研究临床病理相关性，并采用 Kaplan-Meier 分析和 Cox 比例风险模型验证预后意义（癌症特异性生存和无病生存）。TSR（≥50%，富含间质）与癌症特异性生存和无病生存缩短显著相关，而肿瘤芽殖与癌症特异性生存降低显著相关。TSR/肿瘤芽殖模型与癌症死亡率和复发风险增加（无病生存）独立相关。在早期肿瘤患者（临床分期 I 和 II，n=103）中，TSR、肿瘤芽殖和 TSR/肿瘤芽殖模型与癌症相关死亡和复发均显著相关，而在晚期肿瘤患者（临床分期 III 和 IV，n=144）中，仅 TSR 和 TSR/肿瘤芽殖模型与癌症特异性生存显著相关。
TSR、肿瘤芽殖及其联合提供了有关 OSCC 结局的重要信息，提示其纳入组织病理学标本的常规评估可能有助于预测 OSCC 患者的预后。
