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Tytuł:
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[Clinical evaluation of tumor-stroma ratio in pseudomyxoma peritonei from the appendix].
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Autorzy:
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Ma R; Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Li XB; Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Yan FC; Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Lin YL; Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Li Y; Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.; Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
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Źródło:
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Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences [Beijing Da Xue Xue Bao Yi Xue Ban] 2020 Apr 18; Vol. 52 (2), pp. 240-246.
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Typ publikacji:
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Journal Article
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Język:
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Chinese
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Imprint Name(s):
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Original Publication: Beijing : Beijing da xue, 2001-
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MeSH Terms:
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Appendix*
Hyperthermia, Induced*
Peritoneal Neoplasms*
Pseudomyxoma Peritonei*
Cytoreduction Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies
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References:
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Entry Date(s):
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Date Created: 20200420 Date Completed: 20200601 Latest Revision: 20231112
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Update Code:
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20240104
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PubMed Central ID:
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PMC7433462
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PMID:
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32306005
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Objective: To evaluate the effect of tumor-stroma ratio (TSR) on disease progression and prognosis of pseudomyxoma peritonei (PMP) from the appendix.
Methods: The study included 30 PMP patients with complete individual patient data, who underwent cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in Beijing Shijitan Hospital. Image-Pro Plus was used to quantitatively analyze the proportion of tumor and stromal areas in hematoxylin-eosin staining pathological images, from which TSR was derived. Correlation studies were conducted to evaluate the relationships between TSR and clinicopathological features, immunohistochemical characteristics, and prognosis of PMP.
Results: Among 30 PMP patients, there were 16 males (53.3%) and 14 females (46.7%), with the mean age of (54.9±2.3) years. There were 15 cases (50.0%) of low-grade mucinous carcinoma peritonei (LMCP) and high-grade mucinous carcinoma peritonei (HMCP), respectively, with vascular tumor emboli occurring in 4 cases (13.3%), nerve invasion occurring in 3 cases (10.0%), and lymphatic metastasis occurring in 4 cases (13.3%). The median peritoneal cancer index (PCI) score was 36 (range: 3-39). The median TSR was 8% (range: 2%-24%), with TSR≤10% in 19 cases (63.3%) and TSR>10% in 11 cases (36.7%). Immunohistochemistry showed that 16 cases (53.3%) had Ki67 label index ≤ 50% and 14 cases (46.7%) > 50%. The mutation rate of p53 was 56.7% and the loss rate of MMR protein was 11.8%. In addition, the expression rates of MUC2, MUC5AC, CDX2, CK7, and CK20 were 66.7%, 100.0%, 82.6%, 56.0%, and 92.3%, respectively. There were significant correlations between TSR and histopathological types, nerve invasion, Ki67 label index, and p53 mutation (P<0.05 for all). At the end of the last follow-up, 21 patients (70.0%) died and 9 patients (30.0%) survived, including 6 patients survived with tumor. The median overall survival (OS) was 12.7 months (95%CI: 10.4-11.5 months), and the 1-, 2-, and 3-year survival rates were 60.5%, 32.3%, and 27.7%, respectively. The median OS was 19.4 months (95%CI: 3.0-35.9 months) in the TSR≤10% group, versus 12.6 months (95%CI: 0.7-24.5 months) in the TSR>10% group (χ 2 =3.996, P=0.046).
Conclusion: TSR is correlated with histopathological types, tumor proliferation, invasion behaviors and prognosis of PMP, thus could be a new prognostic indicator for PMP.
