Musella Gennaro, Coppini Martina, França Vieira E Silva Fábio, Campisi Giuseppina, Pérez-Sayáns Mario, Caponio Vito Carlo Alberto, Lorenzo-Pouso Alejandro I
Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
Department of Precision Medicine in Medical, Surgical and Critical Care, University of Palermo, Palermo, Italy.
Oral Dis. 2025 Mar 24. doi: 10.1111/odi.15319.
Tumor-stroma ratio (TSR) has been recognized as a significant prognostic factor in various cancers. This systematic review evaluates the role of TSR in head and neck squamous cell carcinoma (HNSCC) and its association with patient outcomes such as overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), and lymph node metastasis (LNM).
A comprehensive search was conducted across Scopus, Embase, PubMed, and Web of Science. Nineteen studies were included. Data extraction and quality assessment were performed progressively, with meta-analyses. All studies assessed TSR using hematoxylin and eosin staining of tissue samples. The meta-analyses focused on the impact of TSR on OS, DFS, DSS, and LNM, providing pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding confidence intervals (CIs).
Meta-analysis revealed a significant association between TSR and OS (HR 1.99, 95% CI 1.71-2.32, p < 0.001), DFS (HR 2.07, 95% CI 1.80-2.39, p < 0.001), DSS (HR 2.33, 95% CI 1.95-2.78, p < 0.001), and LNM (OR 1.76, 95% CI 1.15-2.70, p = 0.01). Minimal to low heterogeneity was detected among studies, and no publication bias was observed.
TSR can effectively identify high-risk patients, being a reliable prognostic marker that could be readily integrated into routine pathology practice for HNSCC.
肿瘤间质比（TSR）已被认为是多种癌症的重要预后因素。本系统评价评估了TSR在头颈部鳞状细胞癌（HNSCC）中的作用及其与患者总生存期（OS）、无病生存期（DFS）、疾病特异性生存期（DSS）和淋巴结转移（LNM）等预后的相关性。
全面检索了Scopus、Embase、PubMed和Web of Science数据库。纳入了19项研究。逐步进行数据提取和质量评估，并进行荟萃分析。所有研究均使用苏木精-伊红染色的组织样本评估TSR。荟萃分析聚焦于TSR对OS、DFS、DSS和LNM的影响，提供合并风险比（HRs）和优势比（ORs）以及相应的置信区间（CIs）。
荟萃分析显示TSR与OS（HR 1.99，95%CI 1.71-2.32，p<0.001）、DFS（HR 2.07，95%CI 1.80-2.39，p<0.001）、DSS（HR 2.33，95%CI 1.95-2.78，p<0.001）和LNM（OR 1.76，95%CI 1.15-2.70，p=0.01）之间存在显著相关性。各研究间检测到的异质性最小至低，未观察到发表偏倚。
TSR可有效识别高危患者，是一种可靠的预后标志物，可轻易整合到头颈部鳞状细胞癌的常规病理实践中。
