Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, via Lorenz Böhler, 5, 39100 Bolzano-Bozen, Italy.
Department of Otolaryngology, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, 39100 Bolzano-Bozen, Italy.
Cells. 2024 Oct 26;13(21):1772. doi: 10.3390/cells13211772.
The management of head and neck squamous cell carcinoma (HNSCC) relies heavily on TNM staging and WHO histologic grading; however, in recent years, the analysis of prognostic markers expressed in the tumor stroma has gained attention. The tumor-stroma ratio (TSR) quantifies the proportion of tumor tissue relative to the surrounding stromal tissue; it is assessed with the percentage of stromal tissue within the tumor area, with a cutoff point of 50% being widely used to discriminate high-stroma cancer. In this systematic review and meta-analysis, we investigated the potential prognostic role of the TSR in HNSCC. After a literature screening, 24 studies dealing with the TSR and survival outcomes were included. The TSR showed a significant association with overall survival (OS) in both unadjusted and adjusted measures (RR 2.04, CI 1.57-2.65, < 0.01; HR 2.36 CI 1.89-2.94, < 0.00001), with an even stronger prognostic potential in oral cavity/oral tongue cancers (RR 2.44 CI 1.84-3.22, < 0.00001). The TSR also showed prognostic value when dealing with cancer-specific survival and was associated with a reduction in disease-free survival (DFS). In particular, the TSR also retained its prognostic role in terms of DFS when specifically considering early-stage cancers in both unadjusted and adjusted analyses (RR 1.81 CI 1.57-2.10, < 0.00001; HR 2.09 CI 1.58-2.76, < 0.00001). Therefore, we conclude that the TSR is a reliable prognostic marker that is easy to assess in routine histological slides and can be effectively implemented in the routine evaluation of HNSCC.
头颈部鳞状细胞癌（HNSCC）的管理主要依赖于 TNM 分期和世卫组织组织学分级；然而，近年来，肿瘤基质中表达的预后标志物分析引起了关注。肿瘤基质比（TSR）量化了肿瘤组织相对于周围基质组织的比例；它通过肿瘤区域内基质组织的百分比进行评估，广泛使用 50%的截止点来区分高基质癌症。在这项系统评价和荟萃分析中，我们研究了 TSR 在 HNSCC 中的潜在预后作用。经过文献筛选，纳入了 24 项涉及 TSR 和生存结果的研究。TSR 在未调整和调整后的测量中与总生存期（OS）显著相关（RR 2.04，CI 1.57-2.65，<0.01；HR 2.36，CI 1.89-2.94，<0.00001），在口腔/舌癌中具有更强的预后潜力（RR 2.44，CI 1.84-3.22，<0.00001）。当涉及癌症特异性生存率时，TSR 也具有预后价值，并且与无病生存率（DFS）降低相关。特别是，当在未调整和调整分析中都专门考虑早期癌症时，TSR 仍然保留了其在 DFS 方面的预后作用（RR 1.81，CI 1.57-2.10，<0.00001；HR 2.09，CI 1.58-2.76，<0.00001）。因此，我们得出结论，TSR 是一种可靠的预后标志物，在常规组织学切片中易于评估，并可有效地用于 HNSCC 的常规评估。
