Tumor-stroma ratio is an independent predictor for survival in early cervical carcinoma
Tumor-stroma ratio is an independent predictor for survival in early cervical carcinoma
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DOI：
10.1016/j.ygyno.2013.11.003
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发表时间：
2014-01-01
影响因子：
4.7
通讯作者：
Wang, Xiao
中科院分区：
文献类型：
--
作者：
Liu, Jing;Liu, Juan;Wang, Xiao
Objective.肿瘤-间质比（TSR）最近已被确定为几种实体瘤的独立预后参数。本研究的目的是评估TSR在早期宫颈癌中的预后作用。本研究纳入了184例早期宫颈癌（FIGO [国际妇产科联合会] IA 2-IIA期）手术患者。从原发性肿瘤最具侵袭性的部分的苏木精-伊红染色的组织切片上估计TSR。基质少于50%的患者被归类为基质贫乏，基质>= 50%的患者被归类为基质丰富。统计分析TSR与生存时间的关系。无瘤生存率和总生存率在间质缺乏组分别为88.44%和92.52%，在间质丰富组分别为62.16%和70.27%。基质缺乏组的无病生存率和总生存率均显著优于基质丰富组（p = 0.001）。多因素分析进一步证实TSR是无病生存期（风险比3.125; p = 0.005）和总生存期（风险比3.464; p = 0.003）的重要预后因素，与肿瘤大小、FIGO分期和淋巴结转移无关。我们的研究表明，TSR是早期宫颈癌的独立预后因素。与间质贫乏的肿瘤相比，间质丰富的肿瘤患者预后更差，复发风险更高。考虑到其简单性和传统的临床病理学的可用性，TSR可能作为一个新的预后早期宫颈癌的组织学特征。(C)2013 Elsevier Inc. All rights reserved.
Objective. Tumor-stroma ratio (TSR) has recently been identified as an independent prognostic parameter for several solid tumors. The aim of the present study was to evaluate the prognostic role of TSR in early cervical cancer.Methods. A cohort of 184 patients who had surgery for early stage cervical cancer (FIGO [International Federation of Gynecology and Obstetrics] stages IA2-IIA) were enrolled in this study. TSR was estimated on hematoxylin-eosin-stained tissue sections from the most invasive part of the primary tumor. Patients with less than 50% stroma were classified as stroma-poor and patients with >= 50% stroma were classified as stroma-rich. The relationship between TSR and survival time was statistically analyzed.Results. The disease-free survival and overall survival rates were 88.44% and 92.52%, respectively, in the stroma-poor group, and 62.16% and 70.27%, respectively, in the stroma-rich group. Both the disease-free and overall survival rates in the stroma-poor group were significantly better than those in the stroma-rich group (p = 0.001). In a multivariate analysis, TSR was further confirmed as a significant prognostic factor for disease-free survival (hazard ratio 3.125; p = 0.005) and overall survival (hazard ratio 3.464; p = 0.003), independent of tumor size, FIGO stage and lymph node metastasis.Conclusion. Our study identified that TSR was an independent prognostic factor of early cervical cancer. Patients with stroma-rich tumors had worse prognosis and higher risk of relapse compared with those with stroma-poor tumors. Considering its simplicity and availability for conventional clinical pathology, TSR may serve as a new prognostic histological characteristic in early cervical cancer. (C) 2013 Elsevier Inc. All rights reserved.