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Shuai Wang, Qian Si, Yan Wu, Yawei Sun, Weixian Zhang, Xiaofeng Huang, Tao Zeng, Sheng Chen, Xihu Yang, Yanhong Ni, Qingang Hu
Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
Cancer Med. 2023 Jun;12(11):12161-12172. doi: 10.1002/cam4.5909. Epub 2023 May 15.
Different regions of oral squamous cell carcinoma (OSCC) have particular histopathological characteristics, and the individual histological characteristics of the tumors are poorly understood. Therefore, calculating the proportion of tumor cells in different regions that allow assessment of the prognostic outcomes for OSCC patients would be of great clinical significance.
We established an open-source software-based analytic pipeline that defines the inner tumor and invasive tumor front (ITF) in pancytokeratin-stained whole slide images (WSIs) and quantifies the tumor-stroma ratio (TSR) within the two regions. We applied this method to 114 patients with OSCC and predicted patient prognosis by the TSR. The proportion of tumor area in the inner tumor was generally higher than that in the ITF (p < 0.0001). TSR was an independent prognostic factor for overall survival (OS) (p = 0.016), disease-free survival (DFS) (p = 0.026), and relapse-free survival (RFS) (p = 0.037) in inner tumor, and TSR was an independent prognostic factor for OS (p = 0.00052), DFS (p = 0.035), and metastasis-free survival (MFS) (p = 0.038) in the ITF. Tumor-low status was associated with poorer prognosis. There was a significant correlation between the TSR and perineural invasion (PNI) in the inner tumor (p = 0.009).
The histopathological characteristics of different regions of OSCC may be used to develop the potential prognostic markers. The TSR of the inner tumor is more targeted in predicting prognosis and accurately assesses the risk of PNI+.
口腔鳞状细胞癌（OSCC）的不同区域具有特定的组织病理学特征，肿瘤的个体组织学特征尚未完全清楚。因此，计算不同区域肿瘤细胞的比例，以评估 OSCC 患者的预后结果将具有重要的临床意义。
我们建立了一个基于开源软件的分析管道，该管道可在全组织细胞角蛋白染色的幻灯片图像（WSI）中定义肿瘤内部和侵袭性肿瘤前缘（ITF），并量化这两个区域内的肿瘤-基质比（TSR）。我们将该方法应用于 114 例 OSCC 患者，并通过 TSR 预测患者的预后。肿瘤区域在内肿瘤中的比例通常高于 ITF（p<0.0001）。TSR 是内肿瘤总生存期（OS）（p=0.016）、无病生存期（DFS）（p=0.026）和无复发生存期（RFS）（p=0.037）的独立预后因素，TSR 是 OS（p=0.00052）、DFS（p=0.035）和无转移生存期（MFS）（p=0.038）的独立预后因素在 ITF 中。肿瘤低状态与较差的预后相关。内肿瘤中 TSR 与神经周围侵犯（PNI）之间存在显著相关性（p=0.009）。
OSCC 不同区域的组织病理学特征可用于开发潜在的预后标志物。内肿瘤的 TSR 更适合预测预后，并且可以准确评估 PNI+的风险。
