The prognostic significance of tumour-stroma ratio in endometrial carcinoma

BMC Cancer

Research Article

Helene H. Thygesen¹  Michele Cummings²  Matthew Winder²  Richard Hutson²  Nicolas M. Orsi²  Alexander I. Wright²  Hannah Panayiotou² 

[1] Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands;Section of Pathology and Tumour Biology, Leeds Institute of Cancer & Pathology, University of Leeds, St James’s University Hospital, LS9 7TF, Leeds, UK;

关键词: Endometrial cancer;    Tumour-stroma ratio;    Prognosis;    Tumour microenvironment;   

DOI  :  10.1186/s12885-015-1981-7

 received in 2015-07-29, accepted in 2015-12-05,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundHigh tumour stromal content has been found to predict adverse clinical outcome in a range of epithelial tumours. The aim of this study was to assess the prognostic significance of tumour-stroma ratio (TSR) in endometrial adenocarcinomas and investigate its relationship with other clinicopathological parameters.MethodsClinicopathological and 5-year follow-up data were obtained for a retrospective series of endometrial adenocarcinoma patients (n = 400). TSR was measured using a morphometric approach (point counting) on digitised histologic hysterectomy specimens. Inter-observer agreement was determined using Cohen’s Kappa statistic. TSR cut-offs were optimised using log-rank functions and prognostic significance of TSR on overall survival (OS) and disease-free survival (DFS) were determined using Cox Proportional Hazards regression analysis and Kaplan-Meier curves generated. Associations of TSR with other clinicopathological parameters were determined using non-parametric tests followed by Holm-Bonferroni correction for multiple comparisons.ResultsTSR as a continuous variable associated with worse OS (P = 0.034) in univariable Cox-regression analysis. Using the optimal cut-off TSR value of 1.3, TSR-high (i.e. low stroma) was associated with worse OS (HR = 2.51; 95 % CI = 1.22–5.12; P = 0.021) and DFS (HR = 2.19; 95 % CI = 1.15–4.17; P = 0.017) in univariable analysis. However, TSR did not have independent prognostic significance in multivariable analysis, when adjusted for known prognostic variables. A highly significant association was found between TSR and tumour grade (P < 0.001) and lymphovascular space invasion (P < 0.001), both of which had independent prognostic significance in this study population.ConclusionsLow tumour stromal content associates with both poor outcome and with other adverse prognostic indicators in endometrial cancer, although it is not independently prognostic. These findings contrast with studies on many - although not all - cancers and suggest that the biology of tumour-stroma interactions may differ amongst cancer types.

【 授权许可】

CC BY   
© Panayiotou et al. 2015