Yuan Changwei, Du Yicong, Li Haodong, Xu Chunru, Zhu Weijie, Zhang Zhongyuan, Zhao Wei, Li Xuesong
Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Transl Androl Urol. 2024 May 31;13(5):679-687. doi: 10.21037/tau-23-666. Epub 2024 May 24.
Clear cell renal cell carcinoma (ccRCC) is one of the most common urological tumors, and its incidence is increasing year by year. Tumor stroma ratio (TSR) can reflect the amount of stromal component around tumor cells, and can independently predict the prognosis of tumor. This study aims to evaluate the prognostic value of TSR in ccRCC patients.
From January 2010 to December 2015, clinical and histopathological data of patients with ccRCC patients who underwent surgical operation were collected. Using TSR (50%) as the cut-off value, the patients were divided into low-TSR group (<50%) and high-TSR group (≥50%). The clinicopathological characteristics and survival status of patients were compared between the two groups. Univariate and multivariate analyses were used to identify the prognostic factors for overall survival (OS), cancer-specific survival (CSS), metastasis-free survival (MFS).
The mean age of 569 patients was 56.84±12.76 years old. There were 401 males and 168 females. According to the TSR, patients were divided into low-TSR group (n=333, 58.5%) and high-TSR group (n=236, 41.5%). The median follow-up time was 67.0 months (interquartile range, 33.0-72.0 months). The 5-year OS, CSS and MFS were 91.2%, 94.6% and 91.0%, respectively. The 5-year OS, CSS and MFS were 84.2%,89.7% and 82.7% in the high-TSR group and 96.1%, 98.0% and 96.0% in the low-TSR group (P<0.05). Multivariate analysis showed that age >60 years [hazard ratio (HR) =2.455, 95% confidence interval (CI): 1.292-4.668, P=0.006), tumor grade (HR =6.580, 95% CI: 3.276-13.216, P<0.001) and TSR (HR =2.611, 95% CI: 1.265-5.387, P=0.009) were independent prognostic factors for OS. Multivariate analysis showed that tumor stage (HR =3.213, 95% CI: 1.437-7.184, P=0.004), tumor grade (HR =6.102, 95% CI: 2.664-13.976, P<0.001) and TSR (HR =2.653, 95% CI: 1.063-6.621, P=0.03) were independent prognostic factors for CSS. Multivariate analysis showed that tumor stage (HR =4.805, 95% CI: 2.677-8.624, P<0.001), tumor grade (HR =6.423, 95% CI: 3.432-12.020, P<0.001), hemorrhage (HR =0.514, 95% CI: 0.265-0.996, P=0.049) and TSR (HR =2.370, 95% CI: 1.264-4.443, P=0.007) were independent prognostic factors for MFS.
TSR is a new independent prognostic risk factor for ccRCC patients. The assessment of TSR is simple and cost-effective, and it is a useful supplement added to the pathological evaluation system.
透明细胞肾细胞癌（ccRCC）是最常见的泌尿系统肿瘤之一，其发病率逐年上升。肿瘤间质比（TSR）可反映肿瘤细胞周围间质成分的数量，并能独立预测肿瘤预后。本研究旨在评估TSR在ccRCC患者中的预后价值。
收集2010年1月至2015年12月接受手术治疗的ccRCC患者的临床和组织病理学数据。以TSR（50%）为临界值，将患者分为低TSR组（<50%）和高TSR组（≥50%）。比较两组患者的临床病理特征和生存状况。采用单因素和多因素分析确定总生存（OS）、癌症特异性生存（CSS）、无转移生存（MFS）的预后因素。
569例患者的平均年龄为56.84±12.76岁。男性401例，女性168例。根据TSR，患者分为低TSR组（n = 333，58.5%）和高TSR组（n = 236，41.5%）。中位随访时间为67.0个月（四分位间距，33.0 - 72.0个月）。5年OS、CSS和MFS分别为91.2%、94.6%和91.0%。高TSR组的5年OS、CSS和MFS分别为84.2%、89.7%和82.7%，低TSR组分别为96.1%、98.0%和96.0%（P < 0.05）。多因素分析显示，年龄>60岁[风险比（HR）= 2.455，95%置信区间（CI）：1.292 - 4.668，P = 0.006]、肿瘤分级（HR = 6.580，95% CI：3.276 - 13.216，P < 0.001）和TSR（HR = 2.611，95% CI：1.265 - 5.387，P = 0.009）是OS的独立预后因素。多因素分析显示，肿瘤分期（HR = 3.213，95% CI：1.437 - 7.184，P =
