Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
Br J Cancer. 2020 Jul;123(1):38-45. doi: 10.1038/s41416-020-0847-1. Epub 2020 May 4.
Tumour budding and low tumour-stroma ratio (TSR) are associated with poor prognosis in some cancers, but their value in Western hepatocellular carcinoma is unclear. The prognostic value of tumour budding and TSR in hepatocellular carcinoma was examined.
Some 259 hepatocellular carcinoma patients treated in Oulu University Hospital 1983-2018 were included in this retrospective cohort study. Tumour budding and TSR were analysed from the haematoxylin- and eosin-stained original diagnostic slides, by dividing patients into bud-negative (0 bud) or bud-positive (≥1 bud) groups, and into high TSR (<50%) and low TSR (≥50%) groups. Surgically treated patients (n = 47) and other treatments (n = 212) were analysed separately. Primary outcomes were overall, and disease-specific 5-year mortality was adjusted for confounding factors.
Surgically treated patients with positive tumour budding had increased 5-year overall (adjusted HR 3.87, 95% CI 1.10-13.61) and disease-specific (adjusted HR 6.17, 95% CI 1.19-31.90) mortality compared with bud-negative patients. In surgically treated patients, TSR had no effect on 5-year overall (adjusted HR 2.03, 95% CI 0.57-7.21) or disease-specific (adjusted HR 3.23, 95% CI 0.78-13.37) mortality. No difference in survival related to tumour budding and TSR in non-surgically treated patients was observed.
Tumour budding is a prognostic factor in surgically treated hepatocellular carcinoma.
肿瘤芽殖和低肿瘤间质比（TSR）与某些癌症的预后不良有关，但它们在西方肝细胞癌中的价值尚不清楚。本研究旨在探讨肿瘤芽殖和 TSR 在肝细胞癌中的预后价值。
本回顾性队列研究纳入了 1983 年至 2018 年在奥卢大学医院治疗的 259 例肝细胞癌患者。通过对苏木精和伊红染色的原始诊断切片进行分析，将患者分为芽殖阴性（0 芽）或芽殖阳性（≥1 芽）组，以及 TSR 高（<50%）和 TSR 低（≥50%）组。分别分析了接受手术治疗的患者（n=47）和接受其他治疗的患者（n=212）。主要结局是总生存率和疾病特异性 5 年死亡率，并对混杂因素进行了调整。
与芽殖阴性患者相比，接受手术治疗且肿瘤芽殖阳性的患者 5 年总生存率（调整后的 HR 3.87，95%CI 1.10-13.61）和疾病特异性生存率（调整后的 HR 6.17，95%CI 1.19-31.90）均增加。在接受手术治疗的患者中，TSR 对 5 年总生存率（调整后的 HR 2.03，95%CI 0.57-7.21）或疾病特异性生存率（调整后的 HR 3.23，95%CI 0.78-13.37）均无影响。在未接受手术治疗的患者中，肿瘤芽殖和 TSR 与生存率之间无差异。
肿瘤芽殖是手术治疗肝细胞癌的预后因素。
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