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Prognostic effects of histology‐based tumour microenvironment scores in resected distal bile duct cancer
Author(s) -
Hwang Hye W,
Kim Joo Y,
Lee Seung E,
Choi Yoo S,
Hong SookHee,
Lee Tae J.,
Kim Mi K.,
Park Eon S.,
Hong Soon A.
Publication year - 2020
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.14163
Subject(s) - medicine , hazard ratio , histology , confidence interval , gastroenterology , bile duct , proportional hazards model , multivariate analysis , overall survival
Aims Histology‐based tumour microenvironment (TME) scores are useful in predicting the prognosis of gastrointestinal cancer. However, their prognostic roles in distal bile duct cancer (DBDC) have not been previously studied. This study aimed to evaluate the prognostic significance of the TME scores using the Klintrup–Mäkinen (KM) grade, tumour stroma percentage (TSP) and the Glasgow microenvironment score (GMS) in resected DBDC. Methods and results Eighty‐one patients with DBDC who underwent curative resection were enrolled. DBDC was graded according to KM grade, TSP and GMS. A high KM grade was found in 19 patients (24%) and a high TSP was found in 47 patients (58%). A high TSP was significantly correlated with a low KM grade ( P < 0.001). The distribution of the GMS, which was developed by combining the KM grade and TSP, was as follows: 0 ( n = 19, 24%), 1 ( n = 19, 24%) and 2 ( n = 43, 52%). A low KM grade, high TSP and high GMS were significantly associated with short overall survival (OS) ( P < 0.001) and relapse‐free survival (RFS) ( P < 0.001). Furthermore, multivariate analysis showed that a low KM grade [hazard ratio (HR) = 3.826; confidence interval (CI) = 1.650–8.869; P = 0.014], high TSP (HR = 2.193; CI = 1.173–4.100, P = 0.002) and high GMS (HR = 7.148; CI = 2.811–18.173) were independent prognostic factors for short RFS; a low KM grade (HR = 4.324; CI = 1.594–11.733) and high GMS (HR = 6.332; CI = 2.743–14.594) were independent prognostic factors for short OS. Conclusion Histology‐based TME scores, including the KM grade, TSP and GMS, are useful for predicting the survival of patients with resected DBDC.