Tumour stroma ratio is a potential predictor for 5-year disease-free survival in breast cancer
Abstract Background The tumour–stroma ratio (TSR) is identified as a promising prognostic parameter for breast cancer, but the cutoff TSR value is mostly assessed by visual assessment, which lacks objective measurement. The aims of this study were to optimize the cutoff TSR value, and evaluate its p...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-022-10183-5 |
| _version_ | 1828096225278164992 |
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| author | Dandan Yan Xianli Ju Bin Luo Feng Guan Huihua He Honglin Yan Jingping Yuan |
| author_facet | Dandan Yan Xianli Ju Bin Luo Feng Guan Huihua He Honglin Yan Jingping Yuan |
| author_sort | Dandan Yan |
| collection | DOAJ |
| description | Abstract Background The tumour–stroma ratio (TSR) is identified as a promising prognostic parameter for breast cancer, but the cutoff TSR value is mostly assessed by visual assessment, which lacks objective measurement. The aims of this study were to optimize the cutoff TSR value, and evaluate its prognosis value in patients with breast cancer both as continuous and categorical variables. Methods Major clinicopathological and follow-up data were collected for a series of patients with breast cancer. Tissue microarray images stained with cytokeratin immunohistochemistry were evaluated by automated quantitative image analysis algorithms to assess TSR. The potential cutoff point for TSR was optimized using maximally selected rank statistics. The association between TSR and 5-year disease-free survival (5-DFS) was assessed by Cox regression analysis. Kaplan–Meier analysis and log-rank test were used to assess the significance in survival analysis. Results The optimal cut-off TSR value was 33.5%. Using this cut-off point, categorical variable analysis found that low TSR (i.e., high stroma, TSR ≤ 33.5%) predicts poor outcomes for 5-DFS (hazard ratio [HR] = 2.82, 95% confidence interval [CI] = 1.81–4.40, P = 0.000). When TSR was considered as a continuous parameter, results showed that increased stroma content was associated with worse 5-DFS (HR = 1.71, 95% CI = 1.34–2.18, P = 0.000). Similar results were also obtained in three molecular subtypes in continuous and categorical variable analyses. Moreover, in the Kaplan–Meier analysis, log-rank test showed that low TSR displayed a worse 5-DFS than high TSR (P = 0.000). Similar results were also obtained in patients with triple-negative breast cancer, human epidermal growth factor receptor 2 (HER2)-positive breast cancer, and luminal–HER2-negative breast cancer. Conclusion TSR is an independent predictor for 5-DFS in breast cancer with worse survival outcomes in low TSR. The prognostic value of TSR was also observed in other three molecular subtypes. |
| first_indexed | 2024-04-11T07:25:56Z |
| format | Article |
| id | doaj.art-f07b6b2887324345ae3440f8c2781c96 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-11T07:25:56Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-f07b6b2887324345ae3440f8c2781c962022-12-22T04:37:04ZengBMCBMC Cancer1471-24072022-10-0122111110.1186/s12885-022-10183-5Tumour stroma ratio is a potential predictor for 5-year disease-free survival in breast cancerDandan Yan0Xianli Ju1Bin Luo2Feng Guan3Huihua He4Honglin Yan5Jingping Yuan6Department of Pathology, Renmin Hospital of Wuhan UniversityDepartment of Pathology, Renmin Hospital of Wuhan UniversityDepartment of Pathology, Renmin Hospital of Wuhan UniversityDepartment of Pathology, Renmin Hospital of Wuhan UniversityDepartment of Pathology, Renmin Hospital of Wuhan UniversityDepartment of Pathology, Renmin Hospital of Wuhan UniversityDepartment of Pathology, Renmin Hospital of Wuhan UniversityAbstract Background The tumour–stroma ratio (TSR) is identified as a promising prognostic parameter for breast cancer, but the cutoff TSR value is mostly assessed by visual assessment, which lacks objective measurement. The aims of this study were to optimize the cutoff TSR value, and evaluate its prognosis value in patients with breast cancer both as continuous and categorical variables. Methods Major clinicopathological and follow-up data were collected for a series of patients with breast cancer. Tissue microarray images stained with cytokeratin immunohistochemistry were evaluated by automated quantitative image analysis algorithms to assess TSR. The potential cutoff point for TSR was optimized using maximally selected rank statistics. The association between TSR and 5-year disease-free survival (5-DFS) was assessed by Cox regression analysis. Kaplan–Meier analysis and log-rank test were used to assess the significance in survival analysis. Results The optimal cut-off TSR value was 33.5%. Using this cut-off point, categorical variable analysis found that low TSR (i.e., high stroma, TSR ≤ 33.5%) predicts poor outcomes for 5-DFS (hazard ratio [HR] = 2.82, 95% confidence interval [CI] = 1.81–4.40, P = 0.000). When TSR was considered as a continuous parameter, results showed that increased stroma content was associated with worse 5-DFS (HR = 1.71, 95% CI = 1.34–2.18, P = 0.000). Similar results were also obtained in three molecular subtypes in continuous and categorical variable analyses. Moreover, in the Kaplan–Meier analysis, log-rank test showed that low TSR displayed a worse 5-DFS than high TSR (P = 0.000). Similar results were also obtained in patients with triple-negative breast cancer, human epidermal growth factor receptor 2 (HER2)-positive breast cancer, and luminal–HER2-negative breast cancer. Conclusion TSR is an independent predictor for 5-DFS in breast cancer with worse survival outcomes in low TSR. The prognostic value of TSR was also observed in other three molecular subtypes.https://doi.org/10.1186/s12885-022-10183-5Breast cancerTumor-stroma ratioDigital image-quantified analysisPrognosis prediction |
| spellingShingle | Dandan Yan Xianli Ju Bin Luo Feng Guan Huihua He Honglin Yan Jingping Yuan Tumour stroma ratio is a potential predictor for 5-year disease-free survival in breast cancer BMC Cancer Breast cancer Tumor-stroma ratio Digital image-quantified analysis Prognosis prediction |
| title | Tumour stroma ratio is a potential predictor for 5-year disease-free survival in breast cancer |
| title_full | Tumour stroma ratio is a potential predictor for 5-year disease-free survival in breast cancer |
| title_fullStr | Tumour stroma ratio is a potential predictor for 5-year disease-free survival in breast cancer |
| title_full_unstemmed | Tumour stroma ratio is a potential predictor for 5-year disease-free survival in breast cancer |
| title_short | Tumour stroma ratio is a potential predictor for 5-year disease-free survival in breast cancer |
| title_sort | tumour stroma ratio is a potential predictor for 5 year disease free survival in breast cancer |
| topic | Breast cancer Tumor-stroma ratio Digital image-quantified analysis Prognosis prediction |
| url | https://doi.org/10.1186/s12885-022-10183-5 |
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