Background: The different expression of tumor-stroma ratio (TSR) have been proved to be a new and reliable independent prognostic factor in some solid tumors.The aim of the study is to test the different expression of TSR and its prognostic significance in non-small cell lung cancer (NSCLC).
Methods: A total of 73 patients who underwent surgery resection for NSCLC were included in this study. TSR was assessed visually on the hematoxylin-stained tissue sections of surgical specimens. Patients with more than 50% intratumor stroma were quantified as the stroma-rich group and those with less than 50% as the stroma-poor group.
Results: In 73 cases of tissue samples, 46 cases were included in the stroma-poor group, while 27 cases in stroma-rich group. The different expression of TSR in NSCLC tissue was not correlated with gender, age and pathological type, lymph node metastasis, tumor size, pTNM staging, and so on. Kaplan-Meier survival analysis showed that the different expression of TSR was significantly correlated with survival days (P=0.014). Cox regression analysis showed that not only different expression of TSR is a independent prognostic factor for NSCLC (HR=1.832, 95%CI: 1.017-3.299), but also pTNM staging (HR=1.953, 95%CI: 1.284-2.970).
Conclusions: The different expression of TSR might be an independent prognostic factor in NSCLC.
背景与目的 已有研究表明，作为一种病理形态定量方法，肿瘤间质比（tumor-stroma ratio, TSR）在一些实体瘤中已经被证实是一种新的、可靠的预后因子。本研究旨在探讨TSR在I期-III期术后非小细胞肺癌（non-small cell lung cancer, NSCLC）的预后价值。 方法 对73例I期-III期NSCLC外科手术切除标本的蜡块进行切片，运用苏木素染色法染色。在低倍镜镜下选取肿瘤组织内间质浸润最明显的区域，高倍镜下计数该区域单视野内肿瘤细胞及肿瘤内间质分别占该视野的百分比（即TSR），根据TSR将病例分为两组：肿瘤组织内肿瘤细胞面积<50%视野定义为间质丰富组（stroma-rich group），而肿瘤细胞面积≥50%视野定义为间质稀少组（stroma-poor group）。随访两组患者的总生存期（overall survival, OS）。采用SPSS 16.0软件进行统计处理实验数据，采用卡方检验分析间质稀少组及间质丰富组与不同临床特征之间的关系，用Kaplan-Meier生存分析和Cox回归分析等统计方法分析两组间预后的差异。结果 在73例组织标本中，间质丰富组有27例，间质稀少组有46例，所占比例分别为37%、63%。卡方检验分析此两组之间在性别、年龄吸、烟史、肿瘤大小、病理分型及pTNM分期等病理特征间无统计差异；Kaplan-Meier生存分析显示，TSR与NSCLC患者的OS明显相关（Log-rank test, P=0.014），间质丰富组的患者OS明显低于间质稀少组的患者。多因素Cox、回归分析显示TSR和pTNM是影响NSCLC独立的预后因素（HR=1.832, 95%CI: 1.017-3.299; HR=1.953, 95%CI: 1.284-2.970）。结论 TSR是NSCLC独立的预后因素。