Tumor microenvironmental factors have prognostic significances in advanced gastric cancer

Abstract

Ahn B, Chae Y-S, Kim CH, Lee Y, Lee JH, Kim JY. Tumor microenvironmental factors have prognostic significances in advanced gastric cancer. APMIS 2018; 126: 814-821.Tumor microenvironment is important in the progression and survival of cancer cells. We evaluated the prognostic significance of tumor stroma percentage (TSP), Klintrup-M€ akinen (KM) grade, which reflects the density of inflammatory cells of the tumor, and Glasgow microenvironment score (GMS), a combination of TSP and KM grade, in advanced gastric cancers. A total of 196 pT3 and pT4 gastric cancers were histologically evaluated using TSP, KM grade, and GMS. These were correlated with other clinicopathologic factors including patients' survival. High TSP (78 cases), low KM grade (124 cases), and higher GMS (score 0, 72 cases; 1, 53 cases; and 2, 71 cases) were correlated with poor differentiation, diffuse type, presence of lymphovascular invasion, perineural invasion, and lymph node metastasis. High TSP was significantly correlated with low KM grade (p < 0.001). High TSP (HR, 3.079, 95% CI, 1.612-5.883, p = 0.001), low KM grade (3.201, 1.774-5.776, p < 0.001), and higher GMS (12.274,, p < 0.001) were independent poor prognostic factors. TSP, KM grade, and GMS are significantly associated with clinicopathologic behavior and patients' survival. Assessing these factors is a feasible and cost-effective way to identify tumor microenvironment with different biological features and prognosis of gastric cancer patients.

Prognostic effects of histology‐based tumour microenvironment scores in resected distal bile duct cancer

“…29 Thus, in this study, we found that a TSP of 70% was the best cut-off value to predict the prognosis of patients with DBDC, a value which was higher than those used for colorectal and gastric cancers as reported in previous studies. 9,10 Our findings suggest that the TSP cut-off value could be optimised in relation to the primary tumour.…”

“…The TSP, KM grade and GMS are determined based on the results of histological examination and can be successfully applied to predict the prognosis of patients with hollow viscus cancers, including colorectal and gastric cancer. 9,10,17,18 According to the primary site, tumours have a unique TME. Pancreatic cancer, bile duct cancer and breast cancer are the most representative examples of tumours showing desmoplastic tumour stroma.…”

“…28 In our study, the cut-off value for a high TSP was different from that in previous studies. 9,10 Depending on its origin, the tumour usually shows a diverse TME, including varying proportions of desmoplastic stroma and immune cells. 29 Thus, in this study, we found that a TSP of 70% was the best cut-off value to predict the prognosis of patients with DBDC, a value which was higher than those used for colorectal and gastric cancers as reported in previous studies.…”

“…8,9 Among the components of TME, stromal fibrosis and immune cells can be easily identified on routine histological examination, using haematoxylin and eosin (H&E)-stained tissue and a microscope. 9,10 Based on these findings and from a histopathological viewpoint, the tumour stroma percentage (TSP) for stromal fibrosis and the Klintrup-M€ akinen (KM) grade for immune cells were developed. 11,12 Furthermore, the Glasgow microenvironment score (GMS) was devised by combining the TSP and KM grade.…”

“…9 These parameters have been used to successfully stratify patients with colorectal cancer and gastric cancer according to survival. 9,10 The aim of this study was to evaluate the clinicopathological correlations and prognostic value of the histology based TME scores, including the TSP, KM grade and GMS, in resected DBDC.…”