The tumor-stroma ratio is an independent predictor of survival in patients with 2018 FIGO stage IIIC squamous cell carcinoma of the cervix following primary radical surgery
The tumor-stroma ratio is an independent predictor of survival in patients with 2018 FIGO stage IIIC squamous cell carcinoma of the cervix following primary radical surgery
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DOI：
10.1016/j.ygyno.2019.12.022
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发表时间：
2020-03-01
影响因子：
4.7
通讯作者：
Xiang, Yang
中科院分区：
文献类型：
--
作者：
Zong, Liju;Zhang, Qianqian;Xiang, Yang
Objective.确定肿瘤-间质比（TSR）的价值，同时确定2018年国际妇产科联合会（FIGO）IIIC期宫颈鳞状细胞癌患者在原发性根治术后的预后因素。本回顾性研究纳入了2005年1月至2016年12月期间接受根治性手术的384例淋巴结阳性宫颈鳞状细胞癌（2018 FIGO IIIC期）患者。在苏木精和伊红染色的肿瘤载玻片上评估TSR 5，并将其分类为间质低（= 50%间质）。67例患者被归类为高基质;他们的无病生存期（DFS）和总生存期（OS）比低基质的患者短。在多变量分析中，肿瘤大小>= 4cm、转移淋巴结>= 3个和间质高状态是较短DFS和OS的独立预测因素。这些因素被纳入预后评分系统，其中患者被分为低风险（评分0）、中等风险（评分1）和高风险（评分2-3）组。评分系统能很好地区分DFS和OS（C-index = 0.65，95%可信区间，0.59-0.72; C-index = 0.65，95%可信区间，0.59-0.72）。TSR是一个独立的预后因素，我们的预后评分系统结合了该参数，对2018年FIGO IIIC期宫颈癌患者根治术后的复发和生存具有良好的区分能力。TSR是一个潜在的新的临床病理学变量，用于预测这些患者的预后，这取决于我们的研究结果的验证。(C)2019由Elsevier Inc.出版
Objective. To determine the value of the tumor-stroma ratio (TSR) while identifying prognostic factors in patients with 2018 International Federation of Gynecology and Obstetrics (FIGO) stage IIIC squamous cell carcinoma of the cervix following primary radical surgery.Methods. Three hundred eighty-four patients with node-positive squamous cell carcinoma of the cervix (2018 FIGO stage IIIC) who underwent radical surgery between January 2005 and December 2016 were included in this retrospective study. The TSR5 were assessed on hematoxylin and eosin-stained tumor slides and classified as stroma-low (= 50% stroma).Results. Sixty-seven patients were categorized as stroma-high; they had shorter disease-free survival (DFS) and overall survival (OS) periods than did their stroma-low counterparts. On multivariate analysis, a tumor size >= 4cm, >= 3 metastatic lymph nodes, and stroma-high status were independent predictors of shorter DFS and OS. These factors were incorporated into a prognostic scoring system in which patients were categorized into low-(score 0), intermediate-(score 1), and high-risk (scores 2-3) groups. The scoring system differentiated DFS and OS well (C-index = 0.65, 95% confidence interval, 0.59-0.72; and C-index = 0.65, 95% confidence interval, 0.59-0.72, respectively).Conclusions. The TSR is an independent prognostic factor, and our prognostic scoring system that incorporates this parameter exhibits good discriminative ability for both recurrence and survival in patients with 2018 FIGO stage IIIC cervical cancer after radical surgery. The TSR is a potentially novel clinicopathological variable for predicting the prognoses of these patients contingent on the validation of our findings. (C) 2019 Published by Elsevier Inc.