| Objective(s): The development of colorectal cancer is the result of synergistic interaction between tumor and mesenchymal components.In this study,we analyzed the parenchyma-mesenchymal of colorectal cancer microenvironment to investigate the impact of tumor stroma ratio on patients’ prognosis;explored the impact of tumor deposits on patients’ prognosis and analyzed the pathological factors related to the formation of tumor deposits.Methods: Information on cases of confirmed colorectal cancer with radical surgical resection at the First People’s Hospital of Yunnan Province from January 1,2018 to December 31,2019 was collected through a case system.Disease-free survival was determined by case review and outpatient and telephone follow-up through December31,2022.Tumor hematoxylin-eosin stained sections were observed under x100 magnification,and areas where tumor cells were present all around were selected to assess the tumor stroma ratio,and the correlation between the tumor stroma ratio,tumor deposits and clinicopathological characteristics of colorectal cancer patients was analyzed using the chi-square test.The Kaplan-Meier method and Log rank test were used to analyze the influence of tumor stroma ratio,tumor deposits and prognosis of colorectal cancer patients.COX univariate and multifactor regression were used to analyze the risk factors associated with the disease-free survival of patients.Results: 1.163 colorectal cancer patients included in the study were measured for tumor stroma ratio,with a mean value of 47.18% and a median value of 50%;using 50%as the threshold,the tumor stroma ratio was divided into high interstitial ratio group(TSR≥50%)and low interstitial ratio group(TSR<50%);2.χ~2 test results of patients’ tumor deposits and clinicopathological factors showed that cancer nodules were associated with p T stage(χ~2=3.836,P=0.050),p N stage(χ~2=55.544,P<0.001),vascular infiltration(χ~2=3.893,P=0.048),tumor stroma ratio(χ~2=5.242,P=0.022)and tumor TNM stage(χ ~2=44.274,P<0.001)were correlated.3.The patients included in the study were followed up for a mean of 40 months,among which 83 cases were in the high interstitial ratio group and 80 cases were in the low interstitial ratio group.27 cases recurred in the high interstitial ratio group and 10 cases recurred in the low interstitial ratio group,and the K-M curve results suggested a statistically significant difference in the 3-year disease-free survival between the two groups(Log-rank test χ~2=8.947,P=0.003).There were 117 cases in the tumor deposits negative group,46 cases in the tumor deposits positive group,17 cases of recurrence in the tumor deposits negative group,and 20 cases of recurrence in the tumor deposits positive group.The K-M curve results suggested that there was a statistically significant difference in the 3-year disease-free survival between the two groups(Log-rank test χ~2= 19.762,P < 0.001),and the prognosis of patients in the high tumor stroma ratio group and the tumor deposits positive group was worse.The results of COX multifactor regression analysis showed that the tumor stroma ratio(HR=2.330,P=0.026),tumor deposits(HR=3.587,P=0.007),and the degree of tumor differentiation(HR=2.531,P=0.006)were independent risk factors for poor prognosis of colorectal cancer patients.Conclusion(s):1.The tumor stroma ratio can reflect the characteristics of tumormesenchymal interaction to a certain extent,and HE staining has the advantages of simplicity and reproducibility in assessing the tumor stroma ratio of colorectal cancer.2.The correlation between tumor deposits and lymph node metastasis,tumor stroma ratio,vascular infiltration indicates that the occurrence of tumor deposits may be the result of the combined effect of multiple factors.3.The tumor stroma ratio and tumor deposits are independent risk factors for disease-free survival in colorectal cancer;the dichotomous quantification of tumor stroma ratio has potential clinical value for the prognosis study of colorectal cancer. |
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