Integrating Tumor Stroma Biomarkers With Clinical Indicators for Colon Cancer Survival Stratification

Frontiers in Medicine

article

Yong Chen¹  Wenlong Wang¹  Bo Jiang¹  Lei Yao¹  Fada Xia¹  Xinying Li¹ 

[1] Department of General Surgery, Xiangya Hospital, Central South University

关键词: colon cancer;    microenvironment;    tumor stroma;    immune cells;    prognosis stratification;   

DOI  :  10.3389/fmed.2020.584747

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

The tumor stroma plays an important role in tumor progression and chemotherapeutic resistance; however, its role in colon cancer (CC) survival prognosis remains to be investigated. Here, we identified tumor stroma biomarkers and evaluated their role in CC prognosis stratification. Four independent datasets containing a total of 1,313 patients were included in this study and were divided into training and testing sets. Stromal scores calculated using the estimation of stromal and immune cells in malignant tumors using expression data (ESTIMATE) algorithm were used to assess the tumor stroma level. Kaplan-Meier curves and the log-rank test were used to identify relationships between stromal score and prognosis. Tumor stroma biomarkers were identified by cross-validation of multiple datasets and bioinformatics methods. Cox proportional hazards regression models were constructed using four prognosis factors (age, tumor stage, the ESTIMATE stromal score, and the biomarker stromal score) in different combinations for prognosis prediction and compared. Patients with high stromal scores had a lower overall survival rate ( p = 0.00016), higher risk of recurrence ( p < 0.0001), and higher probability of chemotherapeutic resistance ( p < 0.0001) than those with low scores. We identified 16 tumor stroma biomarkers and generated a new prognosis indicator termed the biomarker stromal score (ranging from 0 to 16) based on their expression levels. Its addition to an age/tumor stage-based model significantly improved prognosis prediction accuracy. In conclusion, the tumor stromal score is significantly negatively associated with CC survival prognosis, and the new tumor stroma indicator can improve CC prognosis stratification.

【 授权许可】

CC BY