Tumor microenvironment is important in the progression and survival of cancer cells. We evaluated the prognostic significance of tumor stroma percentage (TSP), Klintrup–Mäkinen (KM) grade, which reflects the density of inflammatory cells of the tumor, and Glasgow microenvironment score (GMS), a combination of TSP and KM grade, in advanced gastric cancers. A total of 196 pT3 and pT4 gastric cancers were histologically evaluated using TSP, KM grade, and GMS. These were correlated with other clinicopathologic factors including patients’ survival. High TSP (78 cases), low KM grade (124 cases), and higher GMS (score 0, 72 cases; 1, 53 cases; and 2, 71 cases) were correlated with poor differentiation, diffuse type, presence of lymphovascular invasion, perineural invasion, and lymph node metastasis. High TSP was significantly correlated with low KM grade (p < 0.001). High TSP (HR, 3.079, 95% CI, 1.612–5.883, p = 0.001), low KM grade (3.201, 1.774–5.776, p < 0.001), and higher GMS (12.274, 3.684–40.895, p < 0.001) were independent poor prognostic factors. TSP, KM grade, and GMS are significantly associated with clinicopathologic behavior and patients’ survival. Assessing these factors is a feasible and cost-effective way to identify tumor microenvironment with different biological features and prognosis of gastric cancer patients.
Bibliographical noteFunding Information:
This research was supported by a grant of Korea University Anam Hospital, Seoul, Republic of Korea (Grant No. O1700371). A total of 196 surgically resected pT3 and pT4 gastric adenocarcinomas were retrieved from the Department of Pathology, Korea University Anam hospital, from January 2009 to December 2012. We excluded pT1 and pT2 cases because tumor stromal components were not clearly defined in the invasive front of the tumor in mucosa, submucosa, and proper muscle, as in the subserosa or serosa. Patients who received neoadjuvant chemotherapy were excluded. Clinical data including age, sex, survival months, and survival status were reviewed. Pathologic data including tumor location, Borrmann type, Lauren classification, tumor size, grade, pT category, lymphovascular invasion (LVI), perineural invasion (PNI), lymph node (LN) status, distant metastasis, and resection marginal status were reviewed.
This research was supported by a grant of Korea University Anam Hospital, Seoul, Republic of Korea (Grant No. O1700371).
© 2018 APMIS. Published by John Wiley & Sons Ltd
- Gastric cancer
- Glasgow microenvironment score
- Klintrup–Mäkinen grade
- tumor microenvironment
- tumor stroma percentage
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Immunology and Allergy
- Microbiology (medical)