Prognostic significance of tumor budding,desmoplastic reaction,and lymphocytic infiltration in patients with gastric adenocarcinoma  

作　　者：Aysen Yavuz Kubra Simsek Anil Alpsoy Busra Altunay Elif Ocak Gedik Betul Unal Cumhur Ibrahim Bassorgun Ali Murat Tatli Gulsum Ozlem Elpek 

机构地区：[1]Department of Pathology,Akdeniz University Medical School,Antalya 07070,Türkiye [2]Department of Medical Oncology,Akdeniz University Medical School,Antalya 07070,Türkiye

出　　处：《World Journal of Gastrointestinal Pathophysiology》2024年第1期9-25,共17页世界胃肠病理生理学杂志（英文版）（电子版）

摘　　要：BACKGROUND Recent studies have shown that the tumor microenvironment significantly influences the behavior of solid tumors.In this context,Accumulated data suggests that pathological evaluation of tumor budding(TB),desmoplastic reaction(DR),and tumor-infiltrating lymphocytes(TILs)may be crucial in determining tumor behavior in the gastrointestinal tract.Regarding gastric adenocarcinoma(GAC),although some results suggest that TB and TILs may be effective in determining the course of the disease,the data do not agree.Moreover,very few studies have investigated the relationship between DR and survival.At present,the associations between tumor TB,DR and TILs in GAC patients have not been determined.AIM To establish the relationships between TB,DR,and TILs in patients with GAC and to assess their influence on prognosis.METHODS Our study group comprised 130 patients diagnosed with GAC.The definition of TB was established based on the International TB Consensus Conference.The DR was categorized into three groups according to the level of tumor stroma maturation.The assessment of TILs was conducted using a semiquantitative approach,employing a cutoff value of 5%.The statistical analysis of the whole group and 100 patients with an intestinal subtype of GAC was performed using SPSS version 27.RESULTS A significant correlation between peritumoral budding(PTB)and intratumoral budding(ITB)was noted(r=0.943).Tumors with high PTBs and ITBs had a greater incidence of immature DRs and low TILs(P<0.01).PTB and ITB were associated with histological subtype,lymph node metastasis(LNM),and stage(P<0.01).ITB,PTB,LNM,DR,and stage were significant risk factors associated with poor prognosis.The multivariate Cox regression analysis identified ITB,PTB,and LNM as independent prognostic variables(P<0.05).In intestinal-type adenocarcinomas,a positive correlation between PTB and ITB was noted(r=0.972).While univariate analysis revealed that LNM,stage,PTB,ITB,and DR were strong parameters for predicting survival(P<0.05),only PTB and ITB were fo

关 键 词：Gastric cancer Tumor budding Desmoplastic stroma Tumor-infiltrating lymphocytes PROGNOSIS 

分 类 号：R735[医药卫生—肿瘤] R563.1[医药卫生—临床医学]