Value Analysis of Tumor Stroma Ratio in Prognostic Evaluation of Oral Squamous Cell Carcinoma Patients

doi:10.13701/j.cnki.kqyxyj.2024.03.010

Abstract

Abstract: Objective: To evaluate the prognostic significance of tumor stromal ratio (TSR) in oral squamous cell carcinoma (OSCC) patients. Methods: Clinical and pathological data were gathered from OSCC patients who had radical resection at the First Affiliated Hospital of Bengbu Medical College between January 2015 and December 2017. Based on the percentage limit of 50%, TSR is split into two groups: high-TSR (≥50%) and low-TSR (＜50%). The connection between tumor-stromal ratio and the overall and disease-free survival of patients with OSCC was examined. Results: Within 98 patients who had complete postoperative follow-up and clinical data, 42 patients had a high tumor-stromal ratio and 56 patients had a low TSR. The 5-year overall survival rate of OSCC patients in the high TSR group was 31.0% (13/42), and 5-year disease-free survival rate was 26.2% (11/42). On the other hand, the 5-year overall survival rate of OSCC patients in the low TSR group was 73.2% (41/56), and 5-year disease-free survival rate was 67.9% (38/56). Tumor clinical stage and TSR were substantially correlated with patients' 5-year overall survival and 5-year disease-free survival (P＜0.001). Tumor site was not associated with patients' 5-year overall survival (χ²=1.327, P=0.932) and 5-year disease-free survival (χ²=3.113, P=0.683). Age, T staging, lymph node metastases, TSR, and OSCC disease-free survival rates were substantially connected with overall survival rates for patients with OSCC, according to single factor COX regression analysis results. Tumor T stage, lymph node metastasis, and tumor-stromal ratio were identified as independent risk variables for overall survival and disease-free survival in OSCC patients by multivariate COX analysis (P<0.05). Conclusion: Following surgery, TSR can be utilized as a prognostic indicator for OSCC patients and as a guide for the choice of adjuvant treatment options for OSCC patients.

Key words: tumor-stroma ratio, oral squamous cell carcinoma, prognosis, survival rate

FANG Minjian, LIU Liang, QIU Ruolan, CAO Wei, GE Suyun, CHAI Damin. Value Analysis of Tumor Stroma Ratio in Prognostic Evaluation of Oral Squamous Cell Carcinoma Patients[J]. Journal of Oral Science Research, 2024, 40(3): 242-247.

References

[1] 李江,张春叶.口腔癌及口咽癌病理诊断规范[J].中国口腔颌面外科杂志,2020,18(4):289-296.
[2] Beltramini GA, Belloni LM, Fusco N, et al. Comparing prognostic utility between the 8th edition of TNM staging system and the lymph node ratio for oral squamous cell carcinoma [J]. Head Neck, 2021, 43(10):2876-2882.
[3] Mesker WE, Junggeburt JM, Szuhai K, et al. The carcinoma-stromal ratio of colon carcinoma is an independent factor for survival compared to lymph node status and tumor stage [J]. Cell Oncol, 2007, 29(5):387-398.
[4] Souza da Silva RM, Queiroga EM, Paz AR, et al. Standardized assessment of the tumor-stroma ratio in colorectal cancer: Interobserver validation and reproducibility of a potential prognostic factor [J]. Clin Pathol, 2021, 14:2632010X21989686.
[5] Pang X, Tang YL, Liang XH. Transforming growth factor-β signaling in head and neck squamous cell carcinoma: Insights into cellular responses [J]. Oncol Lett, 2018, 16(4):4799-4806.
[6] Kubota K, Moriyama M, Furukawa S, et al. CD163⁺CD204⁺ tumor-associated macrophages contribute to T cell regulation via interleukin-10 and PD-L1 production in oral squamous cell carcinoma [J]. Sci Rep, 2017, 7(1):1755.
[7] Wang J, Yang L, Mao X, et al. Streptococcus salivarius-mediated CD8⁺ T cell stimulation required antigen presentation by macrophages in oral squamous cell carcinoma [J]. Exp Cell Res, 2018, 366(2):121-126.
[8] Lee HY, Hong IS. Double-edged sword of mesenchymal stem cells: Cancer-promoting versus therapeutic potential [J]. Cancer Sci, 2017, 108(10):1939-1946.
[9] Rhee KJ, Lee JI, Eom YW. Mesenchymal stem cell-mediated effects of tumor support or suppression [J]. Int J Mol Sci, 2015, 16(12):30015-30033.
[10] Zakhartseva LM, Yanovytska MA. Prognostic value of tumor stroma ratio in triple negative breast cancer[J]. Wiad Lek, 2021, 74(3 cz 2):565-571.
[11] 路娜,古吉敏,闵志波.肿瘤间质比在三阴性乳腺癌患者预后评估中的价值[J].新乡医学院学报,2017,34(12):1089-1092.
[12] Xu Q, Chen YY, Luo YH, et al. Proposal of an automated tumor-stromal ratio assessment algorithm and a nomogram for prognosis in early-stage invasive breast cancer [J]. Cancer Med, 2023, 12(1):131-145.
[13] Xi KX, Wen YS, Zhu CM, et al. Tumor-stroma ratio (TSR) in non-small cell lung cancer (NSCLC) patients after lung resection is a prognostic factor for survival [J]. J Thorac Dis, 2017, 9(10):4017-4026.
[14] Wang D, Luo J, Tao Y. Tumor-stroma ratio predicts prognosis and PD-L1 expression in hepatocellular carcinoma [J]. BMC Cancer, 2023, 23(1):434.
[15] 李腾飞,杨彦,黄陈.肿瘤间质比在Ⅱ、Ⅲ期结直肠癌患者预后评估中的价值[J].中华结直肠疾病电子杂志,2021,10(2):158-163.
[16] Almangush A, Heikkinen I, Bakhti N, et al. Prognostic impact of tumour-stroma ratio in early-stage oral tongue cancers [J]. Histopathology, 2018, 72(7):1128-1135.
[17] Almangush A, Alabi RO, Troiano G, et al. Clinical significance of tumor-stroma ratio in head and neck cancer: a systematic review and meta-analysis [J]. BMC Cancer, 2021, 21(1):480.
[18] Dourado MR, Miwa KYM, Hamada GB, et al. Prognostication for oral squamous cell carcinoma patients based on the tumour-stroma ratio and tumour budding [J]. Histopathology, 2020, 76(6):906-918.
[19] Huang S, Cai H, Song F, et al. Tumor-stroma ratio is a crucial histological predictor of occult cervical lymph node metastasis and survival in early-stage (cT1/2N0) oral squamous cell carcinoma [J]. Int J Oral Maxillofac Surg, 2022, 51(4):450-458.
[20] Wang S, Si Q, Wu Y, et al. Multiperspective quantitative tumor-stroma ratio reveals histological areas associated with poor outcomes in oral squamous cell carcinoma [J]. Cancer Med, 2023, 12(11):12161-12172.
[21] 林诗晗,邹璐宁,林雪梅,等.基于TCGA/GEO 数据库对lncRNA在口腔鳞状细胞癌中甲基化水平及预后相关性的分析[J].实用口腔医学杂志,2022,38(3):368-372.
[22] Gieniec KA, Butler LM, Worthley DL, et al. Cancer-associated fibroblasts-heroes or villains? [J]. Br J Cancer, 2019, 121(4):293-302.
[23] 周瑜,翁海燕,司呈云,等.第8版TNM分期修订版对早期口腔黏膜鳞癌患者预后及危险分层作用的临床研究[J].中国口腔颌面外科杂志,2022,20(6):571-576.
[24] Tam S, Amit M, Zafereo M, et al. Depth of invasion as a predictor of nodal disease and survival in patients with oral tongue squamous cell carcinoma [J]. Head Neck, 2019, 41(1):177-184.
[25] Shinn JR, Wood CB, Colazo JM, et al. Cumulative incidence of neck recurrence with increasing depth of invasion [J]. Oral Oncol, 2018, 87:36-42.
[26] Morand GB, Ikenberg K, Vital DG, et al. Preoperative assessment of CD44-mediated depth of invasion as predictor of occult metastases in early oral squamous cell carcinoma [J]. Head Neck, 2019, 41(4):950-958.