Shang An, Yu Pengcheng, Li Liping, He Ge, Xu Junyi
Department of General Surgery, The Fourth Hospital of Guangxi Medical University, Liuzhou, Guangxi 545007, P.R. China.
Department of Pneumology, The Fourth Hospital of Guangxi Medical University, Liuzhou, Guangxi 545007, P.R. China.
Oncol Lett. 2025 Feb 19;29(4):190. doi: 10.3892/ol.2025.14936. eCollection 2025 Apr.
The tumor-stroma ratio (TSR) has been regarded as an important factor associated with tumor metastasis, based on the 'seed and soil' theory, which may have guiding significance for the selection of chemotherapy regimens. Therefore, a high TSR may be a new risk factor for tumor recurrence in patients with stage II colorectal cancer (CRC). The present study aimed to evaluate the prognostic value of TSR in CRC, especially for the computer-calculated TSR. A comprehensive literature retrieval was performed using the PubMed, Web of Science, Embase and Cochrane Library databases to identify relevant studies published up to December 13, 2023. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to estimate the prognostic value of the TSR in CRC. A total of 21 studies published between 2007 and 2023 were included in the present meta-analysis. The combined analysis demonstrated that a high TSR was significantly associated with worse overall survival (OS; HR=1.84; 95% CI, 1.44-2.34; P<0.001), disease-free survival (DFS; HR=1.85; 95% CI, 1.27-2.68; P<0.001), cancer-specific survival (CSS; H=1.97; 95% CI, 1.46-2.65; P<0.001) and recurrence free survival (RFS; HR=1.55; 95% CI, 1.25-1.92; P<0.001) in patients with CRC. Moreover, an elevated computer-calculated TSR was also associated with poor OS (HR=1.89; 95% CI, 1.48-2.40; P<0.001) and DFS (HR=1.85; 95% CI, 1.27-2.68; P<0.001). However, a high TSR was not associated with poor OS in patients with stage I CRC (HR=1.01; 95% CI, 0.48-2.14; P=0.97). In conclusion, the results of the present meta-analysis indicate that a high TSR is associated with poor OS, DFS, CSS and RFS in patients with CRC, especially for those with stage II-III. In addition, TSR calculated by computer using whole-slide images may also be an effective prognostic marker for OS and DFS in patients with CRC.
基于“种子与土壤”理论，肿瘤间质比（TSR）被视为与肿瘤转移相关的重要因素，这可能对化疗方案的选择具有指导意义。因此，高TSR可能是II期结直肠癌（CRC）患者肿瘤复发的新危险因素。本研究旨在评估TSR在CRC中的预后价值，尤其是计算机计算的TSR。使用PubMed、Web of Science、Embase和Cochrane图书馆数据库进行全面的文献检索，以识别截至2023年12月13日发表的相关研究。计算合并风险比（HRs）及其95%置信区间（CIs），以评估TSR在CRC中的预后价值。本荟萃分析共纳入了2007年至2023年间发表的21项研究。综合分析表明，高TSR与CRC患者较差的总生存期（OS；HR=1.84；95%CI，1.44-2.34；P<0.001）、无病生存期（DFS；HR=1.85；95%CI，1.27-2.68；P<0.001）、癌症特异性生存期（CSS；HR=1.97；95%CI，1.46-2.65；P<0.001）和无复发生存期（RFS；HR=1.55；95%CI，1.25-1.92；P<0.001）显著相关。此外，计算机计算的TSR升高也与较差的OS（HR=1.89；95%CI，1.48-2.40；P<0.001）和DFS（HR=1.85；95%CI，1.27-2.68；P<0.001）相关。然而，高TSR与I期CRC患者较差的OS无关（HR=1.01；95%CI，0.48-2.14；P=0.97）。总之，本荟萃分析结果表明，高TSR与CRC患者较差的OS、DFS、CSS和RFS相关，尤其是II-III期患者。此外，使用全切片图像通过计算机计算的TSR也可能是CRC患者OS和DFS的有效预后标志物。
