An easy and practical prognostic parameter: tumor–stroma ratio in Luminal, Her2, and triple-negative breast cancers

Öztürk, Çiğdem; Okçu, Oğuzhan; Şen, Bayram; Bedir, Recep

doi:10.1590/1806-9282.20210979

Cited by 5 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(Table 2) Vol. 18 No.3 Summer, 2023 IRANIAN JOURNAL OF PATHOLOGY Lymph node metastasis was seen in 21 cases (70%). The lymphovascular invasion was identified in 16 cases (53.33%).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Utility of Indigenously Developed Square Grid Method for Evaluation of Tumor-Stroma Ratio and Stromal Tumor-Infiltrating Lymphocytes in Invasive Breast Carcinoma: A Pilot Study

B N,

A S,

C A

et al. 2023

Iran J Pathol

View full text Add to dashboard Cite

Background & Objective: Invasive breast carcinoma (IBC) is the most commonly diagnosed cancer among women in India. The conventional visual method of evaluation of Tumor-Stroma Ratio (TSR) and Stromal Tumor-Infiltrating Lymphocytes (sTIL) appears to be subjective. The present study aims to evaluate the utility of the indigenously designed square grid method for the evaluation of tumor-stroma ratio and stromal tumor-infiltrating lymphocytes in invasive breast carcinoma by assessing the inter-observer variability. Methods: This was a retrospective study conducted at a rural tertiary care referral institute from July 2018 to June 2020. In each case, microphotographs were taken from 10 representative fields in H&E-stained sections for evaluating TSR in low-power and sTIL in high-power. Both the parameters were evaluated employing an indigenously designed square grid applied onto microphotographs in the power-point slides by making use of principles of the Pythagorean theorem. Both parameters were separately evaluated by two pathologists. Cohen kappa statistics was the statistical tool used to analyze inter-observer variability. Results: Thirty cases were analyzed. Invasive breast carcinoma of no special type (IBC-NST) was the most common histopathological type (26 cases (86.67%)). For TRS evaluation, a Kappa value of 0.78 suggested substantial agreement with an agreement of 91.67%. For sTIL evaluation, a Kappa value of 0.51 suggested moderate agreement with an agreement of 88.33%. The P-values were statistically highly significant ( P <0.001). Conclusion: Square grid method is a novel technique for evaluating TSR and sTIL in invasive breast carcinoma. It can be considered an example of the application of Pythagoras’ theorem in Pathology.

show abstract

“…(Table 2) Vol. 18 No.3 Summer, 2023 IRANIAN JOURNAL OF PATHOLOGY Lymph node metastasis was seen in 21 cases (70%). The lymphovascular invasion was identified in 16 cases (53.33%).…”

Section: Resultsmentioning

confidence: 99%

“…Baudhayana, an Indian mathematician discussed the theorem around Vol. 18 No. 3 Summer, 2023 IRANIAN JOURNAL OF PATHOLOGY 800 BC in his book Baudhayana-Sulba-Sutra (6).…”

Section: Introductionmentioning

confidence: 99%

Utility of Indigenously Developed Square Grid Method for Evaluation of Tumor-Stroma Ratio and Stromal Tumor-Infiltrating Lymphocytes in Invasive Breast Carcinoma: A Pilot Study

B N,

A S,

C A

et al. 2023

Iran J Pathol

View full text Add to dashboard Cite

show abstract

“…All data were extracted from 51 eligible studies [ 2 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. Extracted data included the author’s information, study location, number of patients analyzed, and high TSR evaluation criteria.…”

Section: Methodsmentioning

confidence: 99%

“…However, the impact of the proportion of stroma is not clear in terms of whether it accelerates or suppresses tumor progression. Recently, the prognostic implications of TSR have been exhibited for various malignant tumors [ 2 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. In colorectal cancers, low stroma was associated with less frequent vascular and perineural invasion and distant metastasis [ 45 ].…”

Section: Introductionmentioning

confidence: 99%

“…TSR is divided into high TSR (stroma-low) and low TSR (stroma-high) by evaluation criteria. In previous studies, the evaluation criteria of TSR affected high TSR rates [ 2 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. If the evaluation criteria are different, the prognostic implications of TSR can differ.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Significance of Tumor–Stroma Ratio (TSR) in Predicting Outcomes of Malignant Tumors

et al. 2023

View full text Add to dashboard Cite

Background and Objectives: The present study aimed to elucidate the distribution and the prognostic implications of tumor–stroma ratio (TSR) in various malignant tumors through a meta-analysis. Materials and Methods: This meta-analysis included 51 eligible studies with information for overall survival (OS) or disease-free survival (DFS), according to TSR. In addition, subgroup analysis was performed based on criteria for high TSR. Results: The estimated rate of high TSR was 0.605 (95% confidence interval (CI) 0.565–0.644) in overall malignant tumors. The rates of high TSR ranged from 0.276 to 0.865. The highest rate of high TSR was found in endometrial cancer (0.865, 95% CI 0.827–0.895). The estimated high TSR rates of colorectal, esophageal, and stomach cancers were 0.622, 0.529, and 0.448, respectively. In overall cases, patients with high TSR had better OS and DFS than those with low TSR (hazard ratio (HR) 0.631, 95% CI 0.542–0.734, and HR 0.564, 95% CI 0.0.476–0.669, respectively). Significant correlations with OS were found in the breast, cervical, colorectal, esophagus, head and neck, ovary, stomach, and urinary tract cancers. In addition, there were significant correlations of DFS in breast, cervical, colorectal, esophageal, larynx, lung, and stomach cancers. In endometrial cancers, high TSR was significantly correlated with worse OS and DFS. Conclusions: The rate of high TSR was different in various malignant tumors. TSR can be useful for predicting prognosis through a routine microscopic examination of malignant tumors.

show abstract

Tumour-stroma ratio (TSR) in breast cancer: comparison of scoring core biopsies versus resection specimens

et al. 2023

View full text Add to dashboard Cite

Purpose Tumour-stroma ratio (TSR) is an important prognostic and predictive factor in several tumour types. The aim of this study is to determine whether TSR evaluated in breast cancer core biopsies is representative of the whole tumour. Method Different TSR scoring methods, their reproducibility, and the association of TSR with clinicopathological characteristics were investigated in 178 breast carcinoma core biopsies and corresponding resection specimens. TSR was assessed by two trained scientists on the most representative H&E-stained digitised slides. Patients were treated primarily with surgery between 2010 and 2021 at Semmelweis University, Budapest. Results Ninety-one percent of the tumours were hormone receptor (HR)-positive (luminal-like). Interobserver agreement was highest using 100 × magnification (κcore = 0.906, κresection specimen = 0.882). The agreement between TSR of core biopsies and resection specimens of the same patients was moderate (κ = 0.514). Differences between the two types of samples were most frequent in cases with TSR scores close to the 50% cut-off point. TSR was strongly correlated with age at diagnosis, pT category, histological type, histological grade, and surrogate molecular subtype. A tendency was identified for more recurrences among stroma-high (SH) tumours (p = 0.07). Significant correlation was detected between the TSR and tumour recurrence in grade 1 HR-positive breast cancer cases (p = 0.03). Conclusions TSR is easy to determine and reproducible on both core biopsies and in resection specimens and is associated with several clinicopathological characteristics of breast cancer. TSR scored on core biopsies is moderately representative for the whole tumour.

show abstract

An easy and practical prognostic parameter: tumor–stroma ratio in Luminal, Her2, and triple-negative breast cancers

Cited by 5 publications

References 20 publications

Utility of Indigenously Developed Square Grid Method for Evaluation of Tumor-Stroma Ratio and Stromal Tumor-Infiltrating Lymphocytes in Invasive Breast Carcinoma: A Pilot Study

Utility of Indigenously Developed Square Grid Method for Evaluation of Tumor-Stroma Ratio and Stromal Tumor-Infiltrating Lymphocytes in Invasive Breast Carcinoma: A Pilot Study

Significance of Tumor–Stroma Ratio (TSR) in Predicting Outcomes of Malignant Tumors

Tumour-stroma ratio (TSR) in breast cancer: comparison of scoring core biopsies versus resection specimens

Contact Info

Product

Resources

About