Clinicopathological Significances of Tumor-Stroma Ratio (TSR) in Colorectal Cancers: Prognostic Implication of TSR Compared to Hypoxia-Inducible Factor-1α Expression and Microvessel Density

• Published in: Current oncology (Toronto) Vol. 28; no. 2; pp. 1314 - 1324
• Main Authors: Kang, Guhyun, Pyo, Jung-Soo, Kim, Nae-Yu, Kang, Dong-Wook
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 22.03.2021; MDPI AG
• Subjects: clinicopathological significance; colorectal cancers; hypoxia-inducible factor-1; microvessel density; tumor–stroma ratio; microvessel density; tumor–stroma ratio; colorectal cancers; clinicopathological significance; hypoxia-inducible factor-1
• ISSN: 1718-7729; 1198-0052; 1718-7729
• DOI: 10.3390/curroncol28020125

The present study aimed to elucidate the clinicopathological significance and prognostic implications of tumor-stroma ratio (TSR) in colorectal cancers (CRCs). TSRs were investigated in 266 human CRC specimens. The correlations between TSR and clinicopathological characteristics and survival were evaluated. The hypoxia-inducible factor-1α (HIF-1α) immunohistochemical expression of tumor cells and microvessel density (MVD) of stroma were compared between stroma-low and stroma-high subgroups. Results: Stroma-low was found in 185 of 266 CRCs (69.5%). Stroma-low was significantly correlated with less frequent vascular and perineural invasion and distant metastasis than stroma-high. HIF-1α of tumor cells was more highly expressed in the stroma-high subgroup than in the stroma-low subgroup. In addition, MVD was significantly higher in the stroma-high subgroup compared to the stroma-low subgroup. The stroma-low rate was increased considerably in CRCs with a mucinous component and decreased in CRCs with a micropapillary component. There were significant correlations between stroma-low and better overall and recurrence-free survivals. Similar to the literature, we observed that stroma-low was significantly correlated with favorable tumor behaviors and better survival. The microscopic examination of TSR can be useful for predicting the prognosis of CRC patients.