CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题：The prognostic value of tumor-stroma ratio and a newly developed computer-aided quantitative analysis of routine H&E slides in high-grade serous ovarian cancer.
The prognostic value of tumor-stroma ratio and a newly developed computer-aided quantitative analysis of routine H&E slides in high-grade serous ovarian cancer.
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TSR 是 HGSOC 生存评估的独立预后因素。
纳入340例晚期患者，接受初次肿瘤细胞减灭术（PDS），或接受新辅助化疗（NACT）后行间隔性肿瘤细胞减灭术（IDS）。病理医师人工评分并使用OTSR定量评估最具侵袭性（MI）区域和全肿瘤（WT）区域的TSR。按间质比例将患者分为间质丰富（≥50%）和间质少（<50%）两组。采用免疫组织化学染色评估TIL。
PDS患者中，间质丰富肿瘤更常见乳头状生长模式（60%比34%）；NACT患者中，间质丰富肿瘤肿瘤退缩分级较低（TRG 4/5：21%比57%），胸膜转移率较高（25%比16%）。与间质少患者相比，间质丰富患者总生存期和无进展生存期均显著较短（31比45个月，P<0.0001；15比17个月，P=0.0008）。结合间质比例和TIL后，可分为三个生存结局不同的组：良好组（间质少、TIL高）、中等组（间质丰富且TIL高，或间质少且TIL低）和较差组（间质丰富、TIL低）。在多变量分析中，这些分组基于CD8和CD103均保持显著性（风险比[HR]=1.42，95%置信区间[CI]=1.02–1.99；HR=1.49，95% CI=1.01–2.18；以及HR=1.48，95% CI=1.05–2.08；HR=2.24，95% CI=1.55–3.23）。OTSR可重现上述结果，且与专家病理医师评分高度一致（相关系数=0.83）。
TSR是HGSOC生存评估的独立预后因素。间质丰富肿瘤预后较差；接受NACT时，发生胸膜转移的可能性也更高。OTSR可高效、低成本地确定TSR，重复性高且观察者间差异较小。
340 patients with advanced-stage who underwent primary debulking surgery (PDS) or neo-adjuvant chemotherapy (NACT) with interval debulking (IDS). TSR was assessed in both the most invasive (MI) and whole tumor (WT) regions through manual scoring by pathologists and quantification using OTSR. Patients were categorized as stroma-rich ( 50% stroma) or stroma-poor (< 50%). TILs were evaluated via immunohistochemical staining.
In PDS, stroma-rich tumors were significantly associated with a more frequent papillary growth pattern (60% vs 34%), while In NACT stroma-rich tumors had a lower Tumor Regression Grading (TRG 4&5, 21% vs 57%) and increased pleural metastasis (25% vs 16%). Stroma-rich patients had significantly shorter overall and progression-free survival compared to stroma-poor (31 versus 45 months; P < 0.0001, and 15 versus 17 months; P = 0.0008, respectively). Combining stromal percentage and TILs led to three distinct survival groups with good (stroma-poor, high TIL), medium (stroma-rich, high TIL, or; stroma-poor, Low TIL), and poor(stroma-rich, low TIL) survival. These survival groups remained significant in CD8 and CD103 in multivariable analysis (Hazard ratio (HR) = 1.42, 95% Confidence-interval (CI) = 1.02-1.99; HR = 1.49, 95% CI = 1.01-2.18, and HR = 1.48, 95% CI = 1.05-2.08; HR = 2.24, 95% CI = 1.55-3.23, respectively). OTSR was able to recapitulate these results and demonstrated high concordance with expert pathologists (correlation = 0.83).
TSR is an independent prognostic factor for survival assessment in HGSOC. Stroma-rich tumors have a worse prognosis and, in the case of NACT, a higher likelihood of pleural metastasis. OTSR provides a cost and time-efficient way of determining TSR with high reproducibility and reduced inter-observer variability.
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