Le Minh-Khang, Odate Toru, Kawai Masataka, Oishi Naoki, Kondo Tetsuo
Department of Pathology, University of Yamanashi, Yamanashi, 409-3898, Japan.
Breast Cancer Res Treat. 2023 Jan;197(1):113-121. doi: 10.1007/s10549-022-06768-0. Epub 2022 Nov 6.
Tumor-stroma ratio (TSR) of invasive breast carcinoma has gained attention in recent years due to its prognostic significance. Previous studies showed TSR is a potential biomarker for indicating the tumor response to neoadjuvant chemotherapy. However, it is not clear how well TSR evaluation in biopsy specimens might reflect the TSR in resection specimens. We conducted a study to investigate whether biopsy evaluation of TSR can be an alternative method.
We collected cases with invasive breast carcinoma of no special type (IBC-NST) from University of Yamanashi hospital between 2011 and 2017 whose biopsy and resection specimens both had a pathologically diagnosis of IBC-NST (n = 146). We conceptualized a method for evaluating TSR in biopsy specimens within a preliminary cohort (n = 50). Within the studied cohort (n = 96), biopsy-based TSR (b-TSR) and resection-based TSR (r-TSR) were scored by two pathologists. We then evaluated our method's validity and performance by measuring interobserver variability between the two pathologists, Spearman's correlation between b-TSR and r-TSR, and the receiver operating characteristics (ROC) analysis for defining stroma-rich and stroma-poor tumors.
Intra-class coefficient between the two pathologists was 0.59. The correlation coefficients between b-TSR and r-TSR in the two pathologists were 0.45 and 0.37. The ROC areas under the curve were 0.7 and 0.67. By considering an r-TSR of < 50% as stroma-rich, the sensitivity and specificity of detecting stroma-rich tumors were 64.1% and 66.7%, respectively, when b-TSR was < 40%.
Our current b-TSR evaluation method can provide information about r-TSR and facilitate pre-treatment therapy follow-up.
浸润性乳腺癌的肿瘤间质比（TSR）近年来因其预后意义而受到关注。先前的研究表明TSR是指示肿瘤对新辅助化疗反应的潜在生物标志物。然而，尚不清楚活检标本中的TSR评估在多大程度上能反映切除标本中的TSR。我们开展了一项研究以调查TSR的活检评估是否可作为一种替代方法。
我们收集了2011年至2017年间来自山梨大学医院的非特殊类型浸润性乳腺癌（IBC-NST）病例，其活检和切除标本均经病理诊断为IBC-NST（n = 146）。我们在一个初步队列（n = 50）中构思了一种评估活检标本中TSR的方法。在研究队列（n = 96）中，两名病理学家对基于活检的TSR（b-TSR）和基于切除的TSR（r-TSR）进行评分。然后，我们通过测量两名病理学家之间的观察者间变异性、b-TSR与r-TSR之间的Spearman相关性以及用于定义富含间质和间质贫乏肿瘤的受试者工作特征（ROC）分析来评估我们方法的有效性和性能。
两名病理学家之间的组内相关系数为0.59。两名病理学家的b-TSR与r-TSR之间的相关系数分别为0.45和0.37。曲线下的ROC面积分别为0.7和0.67。将r-TSR < 50%视为富含间质时，当b-TSR < 40%时，检测富含间质肿瘤的敏感性和特异性分别为64.1%和66.7%。
我们目前的b-TSR评估方法可以提供有关r-TSR的信息，并有助于治疗前的随访。
