The value of the tumour-stroma ratio for predicting neoadjuvant chemoradiotherapy response in locally advanced rectal cancer: a case control study

BMC Cancer

Shenyan Zhang¹  Yaxi Zhu¹  Zaiyi Liu²  Changhong Liang²  Chen Liu³  Yanqi Huang³  Jinrong Qu⁴  Zhenhui Li⁵  Yanting Liang⁶  Huan Lin⁷  Ke Zhao⁷  Suyun Li⁷ 

[1] Department of Pathology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China;Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, China;Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, China;The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China;Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China;Department of Radiology, Yunnan Cancer Center, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, 650118, Kunming, China;Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China;School of Medicine, South China University of Technology, Guangzhou, China;Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, China;

关键词: Whole-slide images;    Tumour-stroma ratio;    Locally advanced rectal cancer;    Neoadjuvant chemoradiotherapy response;    Tumour regression grade;   

DOI  :  10.1186/s12885-021-08516-x

来源: Springer

【 摘 要 】

BackgroundThe tumour-stroma ratio (TSR) is recognized as a practical prognostic factor in colorectal cancer. However, TSR assessment generally utilizes surgical specimens. This study aims to investigate whether the TSR evaluated from preoperative biopsy specimens by a semi-automatic quantification method can predict the response after neoadjuvant chemoradiotherapy (nCRT) of patients with locally advanced rectal cancer (LARC).MethodsA total of 248 consecutive patients diagnosed with LARC and treated with nCRT followed by resection were included. Haematoxylin and eosin (HE)-stained sections of biopsy specimens were collected, and the TSR was evaluated by a semi-automatic quantification method and was divided into three categories, using the cut-offs determined in the whole cohort to balance the proportion of patients in each category. The response to nCRT was evaluated on the primary tumour resection specimen by an expert pathologist using the four-tier tumour regression grade (TRG) system.ResultsThe TSR can discriminate patients that are major-responders (TRG 0–1) from patients that are non-responders (TRG 2–3). Patients were divided into stroma-low (33.5%), stroma-intermediate (33.9%), and stroma-high (32.7%) groups using 56.3 and 72.8% as the cutoffs. In the stroma-low group, 58 (69.9%) patients were major-responders, and only 39 (48.1%) patients were considered major-responders in the stroma-high group (P = 0.018). Multivariate analysis showed that the TSR was the only pre-treatment predictor of response to nCRT (adjusted odds ratio 0.40, 95% confidence interval 0.21–0.76, P = 0.002).ConclusionAn elevated TSR in preoperative biopsy specimens is an independent predictor of nCRT response in LARC. This semi-automatic quantified TSR could be easily translated into routine pathologic assessment due to its reproducibility and reliability.

【 授权许可】

CC BY