The prognostic significant of tumor budding, tumor stroma ratio and tumor-infiltrating lymphocytes in gallbladder adenocarcinoma

Abstract

Tumor microenvironment plays an important role in onset and progression of the cancer. Tumor budding (TB), tumor stroma and tumorinfiltrating lymphocytes are component of the tumor microenvironment. It was aim to determine the relationship of TB, tumor stroma ratio (TSR) and tumor-infiltrating lymphocytes (TILs) with clinicopathological prognostic parameters in gallbladder adenocarcinoma.Material and Method: Thirty cholecystectomy cases that were diagnosed as adenocarcinoma between 2010 and 2020, that did not receive neoadjuvant therapy and of which archive slides could be accessed, were included in the study. TB, TSR and TILs were evaluated. A p<0.05 value was statistically significant.Results: High TB score was significantly associated with higher histological grade (p=0.008), higher pT stage, lymphovascular invasion (LVI) (p=0.038), lymph node metastasis (p=0.046) and distant metastasis (p=0.036) . Patients with high TB scores had a shorter overall survival (p<0.001). In the high TILs group, lower histological grade (p=0.004), less LVI (p=0.029), fewer distant metastases (p=0.021) and lower TSR (p=0.008) were detected. Increased TSR was associated with higher histological grade (p=0.015) and increased distant metastasis (p=0.013). There was no significant effect of TSR on overall survival (p=0.239). Conclusion:TB can be used as a new prognostic biomarker in gallbladder cancers due to its simple and low cost to determine and also its effectiveness in determining the prognosis. We have concluded that it is early to recommend TILs and TSR as the prognostic indicators in gallbladder cancers. In the future, further studies can be conducted on a larger number of gallbladder cancer cases with a multicenter participation to clarify the prognostic value of TILs and TSR.

Association of tumor budding and tumor infiltrating lymphocytes with clinicopathological parameters in gallbladder carcinoma

“…The study of tumor budding and TILs in GBC is particularly important due to the limited literature available on this subject [ 6 – 9 ]. As of now, there has been only one study in the literature that evaluated the association of both TILs and tumor budding in GBC.…”

“…As of now, there has been only one study in the literature that evaluated the association of both TILs and tumor budding in GBC. Secinti et al [ 6 ] conducted this study, assessing the prognostic role of these biomarkers. Their study revealed significant associations between high tumor budding and adverse clinicopathological features, including higher tumor grade, advanced tumor stage, nodal and distant metastasis, as well as lymphovascular invasion.…”