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https://www.arca.fiocruz.br/handle/icict/56162
EXPLORING THE COMBINATION OF TUMOR-STROMA RATIO, TUMOR-INFILTRATING LYMPHOCYTES, AND TUMOR BUDDING WITH WHO HISTOPATHOLOGICAL GRADING ON EARLY-STAGE ORAL SQUAMOUS CELL CARCINOMA PROGNOSIS
Câncer bucal
Brotamento tumoral
Relação tumor-estroma
Classificação da OMS
Sistema
Author
Affilliation
Universidade Estadual de Campinas. Escola de Odontologia Departamento de Diagnóstico Bucal. Piracicaba, SP, Brasil.
Universidade Estadual de Campinas. Escola de Odontologia. Programa de Pós-Graduação em Biologia Oral. Piracicaba, SP, Brasil / Universidade de Western Paulista. Escola de Odontologia. Presidente Prudente, SP, Brasil.
Federal Universidade de Alfenas. Instituto de Ciências Biomédicas. Departamento de Patologia e Parasitologia. Alfenas, MG, Brasil.
Universidade Estadual Oeste do Paraná. Faculdade de Odontologia. Centro de Ciências Biológicas e do Saúde. Cascavel, PR, Brasil.
Oswaldo Fundação Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Molecular Biologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Escola de Odontologia. Departamento de Propedêutica. Salvador, BA, Brasil.
Department of Pathology. University of Turku. Turku, Finland / Department of Oral and Maxillofacial Diseases. University of Helsinki. Helsinki, Finland.
Department of Oral and Maxillofacial Diseases. University of Helsinki. Helsinki, Finland / Cancer and Translational Medicine Research Unit. Medical Research Center Oulu. University of Oulu and Oulu University Hospital. Oulu, Finland.
Department of Oral and Maxillofacial Surgery. Queen Alexandra Hospital. Portsmouth, UK.
Universidade Estadual de Campinas. Escola de Odontologia Departamento de Diagnóstico Bucal. Piracicaba, SP, Brasil / Universidade Estadual de Campinas. Escola de Odontologia. Programa de Pós-Graduação em Biologia Oral. Piracicaba, SP, Brasil.
Universidade Estadual de Campinas. Escola de Odontologia. Programa de Pós-Graduação em Biologia Oral. Piracicaba, SP, Brasil / Universidade de Western Paulista. Escola de Odontologia. Presidente Prudente, SP, Brasil.
Federal Universidade de Alfenas. Instituto de Ciências Biomédicas. Departamento de Patologia e Parasitologia. Alfenas, MG, Brasil.
Universidade Estadual Oeste do Paraná. Faculdade de Odontologia. Centro de Ciências Biológicas e do Saúde. Cascavel, PR, Brasil.
Oswaldo Fundação Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Molecular Biologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Escola de Odontologia. Departamento de Propedêutica. Salvador, BA, Brasil.
Department of Pathology. University of Turku. Turku, Finland / Department of Oral and Maxillofacial Diseases. University of Helsinki. Helsinki, Finland.
Department of Oral and Maxillofacial Diseases. University of Helsinki. Helsinki, Finland / Cancer and Translational Medicine Research Unit. Medical Research Center Oulu. University of Oulu and Oulu University Hospital. Oulu, Finland.
Department of Oral and Maxillofacial Surgery. Queen Alexandra Hospital. Portsmouth, UK.
Universidade Estadual de Campinas. Escola de Odontologia Departamento de Diagnóstico Bucal. Piracicaba, SP, Brasil / Universidade Estadual de Campinas. Escola de Odontologia. Programa de Pós-Graduação em Biologia Oral. Piracicaba, SP, Brasil.
Abstract
Background: While the relevance of the World Health Organization histopathological grading system as a prognostic tool for oral squamous cell carcinoma has received many critics, other histopathological features such as tumor-troma ratio, tumorinfiltrating lymphocytes, and tumor budding are displaying promising results. Here, we evaluated the prognostic impact of the incorporation of tumor-stroma ratio, tumor-infiltrating lymphocytes, and tumor budding into World Health Organization histopathological grading for patients with oral squamous cell carcinoma. Methods: A total of 95 patients with early-stage oral squamous cell carcinoma were enrolled in the study, and World Health Organization tumor grading, tumor-stroma ratio, tumor-infiltrating lymphocytes, and tumor budding were evaluated in surgical slides stained with hematoxylin and eosin. Survival analyses for cancer-specific survival and disease-free survival were performed using Cox regression models, and receiver operating characteristic curves were applied for assessment of the performance of the combinations. Results: Tumor-stroma ratio (stroma-rich) was significantly and independently associated with both shortened cancer-specific survival and poor disease-free survival, individually and in combination with World Health Organization histopathological grading. The combination of tumor-stroma ratio with World Health Organization grading did not improve the discriminatory ability compared to tumor-stroma ratio alone. Although low tumor-infiltrating lymphocytes were associated with shortened cancer-specific survival, the association did not withstand multivariate analysis. However, in combination with World Health Organization grading, low tumor-infiltrating lymphocytes were independently associated with poor cancer-specific survival. The
combination of tumor-infiltrating lymphocytes and World Health Organization histopathological grading displayed a better discrimination of poor cancer-specific survival than tumor-infiltrating lymphocytes alone, but not at a significant level. Conclusion: Our findings support tumor-stroma ratio as a potential prognostic marker for patients with oral squamous cell carcinoma, and the incorporation of tumor-infiltrating lymphocytes into the World Health Organization grading system improves the prognostic ability of the tumor grading alone.
Keywords in Portuguese
Características histopatológicasCâncer bucal
Brotamento tumoral
Relação tumor-estroma
Classificação da OMS
Sistema
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