Kakumoto Akinari, Jamiyan Tsengelmaa, Koyanagi Ai, Kuroda Hajime, Yamaguchi Rin, Tsuda Hitoshi, Hirano Akira, Shiozawa Shunichi
Department of Diagnostic Pathology, Tokyo Women's Medical University Adachi Medical Center, 4-33-1 Kohoku, Adachi-ku, Tokyo, 123-8558, Japan.
Department of Pathology and Forensic Medicine, Mongolian National University of Medical Sciences, Ulan Bator, 14210, Mongolia.
Breast Cancer. 2025 Mar;32(2):347-356. doi: 10.1007/s12282-024-01661-8. Epub 2024 Dec 18.
To establish the histological categorization of tumor‑associated stroma (TAS) that reflects the biological behavior of triple-negative breast cancer (TNBC).
One-hundred-and-twenty surgically resected cases of TNBC were examined. We histologically categorized the TAS in the invasive frontal region into two groups: mature stroma (MS) and immature stroma (IS). The designation of IS was applied for tumors in which the largest myxoid stroma filled a high-power magnification field. When there were no myxoid stroma that meet the criteria for IS, TAS was categorized as MS. The tumors with type MS were observed in 103 (85.8%) of patients, whereas 17 (14.2%) of patients had tumors with IS. In total, 72 out of 120 patients with TNBC exhibited high tumor-infiltrating lymphocytes (TILs) representing 60% of the cohort. The incidences of high TILs were 66% (68 out of 103) in the MS group but only 23.5% (4 of 17) in the IS group (p = 0.001). Progression-free survival (PFS) and overall survival (OS) curves were different between IS and MS groups (p < 0.001 each), and Cox multivariate regression analysis revealed that IS was an independent indicator for lower PFS and OS rates (p < 0.001; p = 0.008).
Our findings suggest that TAS characteristics, particularly the distinction between IS and MS, play a significant role in the prognosis of TNBC. The presence of IS, associated with poor prognosis and low TILs, contrasts with the favorable outcomes observed in cases with MS. Understanding these TAS dynamics could aid in identifying patients with varying prognostic outcomes in TNBC, necessitating further research into the mechanisms behind these observations.
建立反映三阴性乳腺癌（TNBC）生物学行为的肿瘤相关间质（TAS）组织学分类。
对120例手术切除的TNBC病例进行检查。我们将浸润前沿区域的TAS组织学分为两组：成熟间质（MS）和未成熟间质（IS）。IS定义为最大黏液样间质充满高倍视野的肿瘤。当不存在符合IS标准的黏液样间质时，TAS分类为MS。103例（85.8%）患者的肿瘤为MS型，而17例（14.2%）患者的肿瘤为IS型。120例TNBC患者中，共有72例表现为高肿瘤浸润淋巴细胞（TILs），占队列的60%。MS组高TILs发生率为66%（103例中的68例），而IS组仅为23.5%（17例中的4例）（p = 0.001）。IS组和MS组的无进展生存期（PFS）和总生存期（OS）曲线不同（每组p < 0.001），Cox多因素回归分析显示，IS是PFS和OS率较低的独立指标（p < 0.001；p = 0.008）。
我们的研究结果表明，TAS特征，特别是IS和MS之间的区别，在TNBC的预后中起重要作用。IS的存在与预后不良和低TILs相关，与MS病例观察到的良好结果形成对比。了解这些TAS动态变化有助于识别TNBC中预后不同的患者，需要进一步研究这些观察结果背后的机制。
