Pujani Mukta, Singh Kanika, Agarwal Charu, Chauhan Varsha, Prasad Sneha, Singh Mitasha, Wadhwa Ruchira, Yadav Alka
Department of Pathology, ESIC Medical College & Hospital, Faridabad, Haryana India.
Department of Community Medicine, ESIC Medical College & Hospital, Faridabad, Haryana India.
Indian J Surg Oncol. 2025 Apr;16(2):691-697. doi: 10.1007/s13193-024-02127-1. Epub 2024 Nov 8.
Histomorphological features like tumor-infiltrating lymphocytes (TIL), tumor budding (TB), tumor stroma ratio (TSR), and tumor border configuration (TBC) may provide important prognostic information for more accurate stratification and personalized therapeutic approach in colorectal cancer (CRC). The objective of the current study was to investigate the prognostic impact of novel histopathological features (TIL, TB, TBC, TSR) and a new combined risk score (CRS) in primary CRC. This cross-sectional observational study was conducted on hematoxylin and eosin (H&E)-stained slides of 65 primary CRC cases. Stromal TIL was categorized into 3 groups: low (0 to 10%), intermediate (15 to 50%), and high (55 to 100%). Tumor budding was counted in 10 HPFs and graded as follows: 0-4 buds-low TB, 5-9 buds-intermediate TB, and 10 or more buds-high TB. TBC was labeled as either pushing or infiltrative. TSR was scored into two groups as high TSR (low stroma as ≤ 50%) and low TSR (high stroma > 50%). A novel CRS was constructed based on TBC, TB, and TSR: Infiltrating TBC, TB score > 5 (median), and low TSR were categorized as risk items. Final categories were as follows: low-risk tumors with ≤ 1 risk item and high-risk tumors with > 1 risk items. TIL showed a significant correlation with histological tumor type; TB was significantly associated with tumor location, grade, T stage, and perineural invasion, while TBC significantly correlated with tumor location only. TSR showed significant association with tumor location and perineural invasion, while the combined risk score significantly correlated with tumor location and grade. Tumor border configuration, tumor budding, tumor stroma ratio, and the newly formed combined risk score are simple, cost-effective, potential markers in colorectal cancer patients, suggesting that their incorporation in the routine histopathological evaluation could be useful in determining the prognosis of colorectal cancer cases.
肿瘤浸润淋巴细胞（TIL）、肿瘤芽生（TB）、肿瘤间质比（TSR）和肿瘤边界形态（TBC）等组织形态学特征可为结直肠癌（CRC）更准确的分层和个性化治疗方法提供重要的预后信息。本研究的目的是调查新的组织病理学特征（TIL、TB、TBC、TSR）和新的综合风险评分（CRS）对原发性CRC的预后影响。这项横断面观察性研究对65例原发性CRC病例的苏木精和伊红（H&E）染色切片进行。基质TIL分为3组：低（0至10%）、中（15至50%）和高（55至100%）。在10个高倍视野（HPF）中计数肿瘤芽生，并分级如下：0 - 4个芽为低TB，5 - 9个芽为中TB，10个或更多芽为高TB。TBC标记为推挤型或浸润型。TSR分为两组，高TSR（低基质≤50%）和低TSR（高基质>50%）。基于TBC、TB和TSR构建了一个新的CRS：浸润性TBC、TB评分>5（中位数）和低TSR被归类为风险项目。最终分类如下：风险项目≤1的低风险肿瘤和风险项目>1的高风险肿瘤。TIL与组织学肿瘤类型显著相关；TB与肿瘤位置、分级、T分期和神经周围浸润显著相关，而TBC仅与肿瘤位置显著相关。TSR与肿瘤位置和神经周围浸润显著相关，而综合风险评分与肿瘤位置和分级显著相关。肿瘤边界形态、肿瘤芽生、肿瘤间质比和新形成的综合风险评分是结直肠癌患者简单、经济有效的潜在标志物，表明将它们纳入常规组织病理学评估可能有助于确定结直肠癌病例的预后。
