Standardized Assessment of the Tumor-Stroma Ratio in Colorectal Cancer: Interobserver Validation and Reproducibility of a Potential Prognostic Factor
The tumor stroma plays a relevant role in the initiation and evolution of solid tumors. Tumor-stroma ratio (TSR) is a histological feature that expresses the proportion of the stromal component that surrounds cancer cells. In different studies, the TSR represents a potential prognostic factor: a ric...
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| Format: | Article |
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SAGE Publishing
2021-02-01
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| Series: | Clinical Pathology |
| Online Access: | https://doi.org/10.1177/2632010X21989686 |
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| author | Ricella M Souza da Silva Eduardo M Queiroga Alexandre R Paz Fabiana F P Neves Karin S Cunha Eliane P Dias |
| author_facet | Ricella M Souza da Silva Eduardo M Queiroga Alexandre R Paz Fabiana F P Neves Karin S Cunha Eliane P Dias |
| author_sort | Ricella M Souza da Silva |
| collection | DOAJ |
| description | The tumor stroma plays a relevant role in the initiation and evolution of solid tumors. Tumor-stroma ratio (TSR) is a histological feature that expresses the proportion of the stromal component that surrounds cancer cells. In different studies, the TSR represents a potential prognostic factor: a rich stroma in tumor tissue can promote invasion and aggressiveness. The aim of this study was to evaluate the reproducibility and determine the interobserver agreement in the TSR score. The stromal estimate was evaluated in patients diagnosed with colorectal adenocarcinoma (CRA), who underwent surgical resection. We also evaluated age, gender, and other anatomopathological features. Tumor-stroma ratio was calculated based on the slide used in routine diagnostic pathology to determine the T-status. Stromal percentages were separated into 2 categories: ⩽50%—low stroma and >50%—high stroma. The interobserver agreement in the TSR scoring was evaluated among 4 pathologists at different stages of professional experience, using 2 different ways to learn the scoring system. In total, 98 patients were included in this study; 54.1% were male, with a mean age of 61.9 years. Localized disease was diagnosed in 60.2% of patients. Stromal-poor CRA was predominant. The concordance between the TSR percentages of the 4 pathologists was substantial (Kappa > 0.6). There was greater agreement among pathologists for stromal-poor tumors. Substantial agreement and high reproducibility were observed in the determination of TSR score. The TSR score is feasible, suggesting that the presented methodology can be used to facilitate the determination of the stromal proportion of potential prognostic factor. |
| first_indexed | 2024-12-14T19:51:55Z |
| format | Article |
| id | doaj.art-5e7a95e19eea4352bb9d53ca72f084a5 |
| institution | Directory Open Access Journal |
| issn | 2632-010X |
| language | English |
| last_indexed | 2024-12-14T19:51:55Z |
| publishDate | 2021-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Pathology |
| spelling | doaj.art-5e7a95e19eea4352bb9d53ca72f084a52022-12-21T22:49:23ZengSAGE PublishingClinical Pathology2632-010X2021-02-011410.1177/2632010X21989686Standardized Assessment of the Tumor-Stroma Ratio in Colorectal Cancer: Interobserver Validation and Reproducibility of a Potential Prognostic FactorRicella M Souza da Silva0Eduardo M Queiroga1Alexandre R Paz2Fabiana F P Neves3Karin S Cunha4Eliane P Dias5Pathological Anatomy Service, Lauro Wanderley University Hospital of Federal University of Paraíba, João Pessoa, Paraíba, BrazilLaboratory of Pathological Anatomy, Alcides Carneiro University Hospital of the Federal University of Campina Grande, Campina Grande, Paraíba, BrazilPathological Anatomy Service, Lauro Wanderley University Hospital of Federal University of Paraíba, João Pessoa, Paraíba, BrazilAnatomopathological Diagnosis Center, Pathology Laboratory, João Pessoa, Paraíba, BrazilPostgraduation Program in Pathology, School of Medicine, Fluminense Federal University, Niterói, Rio de Janeiro,BrazilPostgraduation Program in Pathology, School of Medicine, Fluminense Federal University, Niterói, Rio de Janeiro,BrazilThe tumor stroma plays a relevant role in the initiation and evolution of solid tumors. Tumor-stroma ratio (TSR) is a histological feature that expresses the proportion of the stromal component that surrounds cancer cells. In different studies, the TSR represents a potential prognostic factor: a rich stroma in tumor tissue can promote invasion and aggressiveness. The aim of this study was to evaluate the reproducibility and determine the interobserver agreement in the TSR score. The stromal estimate was evaluated in patients diagnosed with colorectal adenocarcinoma (CRA), who underwent surgical resection. We also evaluated age, gender, and other anatomopathological features. Tumor-stroma ratio was calculated based on the slide used in routine diagnostic pathology to determine the T-status. Stromal percentages were separated into 2 categories: ⩽50%—low stroma and >50%—high stroma. The interobserver agreement in the TSR scoring was evaluated among 4 pathologists at different stages of professional experience, using 2 different ways to learn the scoring system. In total, 98 patients were included in this study; 54.1% were male, with a mean age of 61.9 years. Localized disease was diagnosed in 60.2% of patients. Stromal-poor CRA was predominant. The concordance between the TSR percentages of the 4 pathologists was substantial (Kappa > 0.6). There was greater agreement among pathologists for stromal-poor tumors. Substantial agreement and high reproducibility were observed in the determination of TSR score. The TSR score is feasible, suggesting that the presented methodology can be used to facilitate the determination of the stromal proportion of potential prognostic factor.https://doi.org/10.1177/2632010X21989686 |
| spellingShingle | Ricella M Souza da Silva Eduardo M Queiroga Alexandre R Paz Fabiana F P Neves Karin S Cunha Eliane P Dias Standardized Assessment of the Tumor-Stroma Ratio in Colorectal Cancer: Interobserver Validation and Reproducibility of a Potential Prognostic Factor Clinical Pathology |
| title | Standardized Assessment of the Tumor-Stroma Ratio in Colorectal Cancer: Interobserver Validation and Reproducibility of a Potential Prognostic Factor |
| title_full | Standardized Assessment of the Tumor-Stroma Ratio in Colorectal Cancer: Interobserver Validation and Reproducibility of a Potential Prognostic Factor |
| title_fullStr | Standardized Assessment of the Tumor-Stroma Ratio in Colorectal Cancer: Interobserver Validation and Reproducibility of a Potential Prognostic Factor |
| title_full_unstemmed | Standardized Assessment of the Tumor-Stroma Ratio in Colorectal Cancer: Interobserver Validation and Reproducibility of a Potential Prognostic Factor |
| title_short | Standardized Assessment of the Tumor-Stroma Ratio in Colorectal Cancer: Interobserver Validation and Reproducibility of a Potential Prognostic Factor |
| title_sort | standardized assessment of the tumor stroma ratio in colorectal cancer interobserver validation and reproducibility of a potential prognostic factor |
| url | https://doi.org/10.1177/2632010X21989686 |
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