Clinical Value of Tumor-Stroma Ratio Combined with KRAS/NRAS/BRAF Gene Status in Prognostic Assessment of Patients with Colorectal Cancer
10.3971/j.issn.1000-8578.2025.24.1252
- VernacularTitle:肿瘤间质比联合KRAS/NRAS/BRAF基因状态在结直肠癌患者预后评估中的临床价值
- Author:
Ziyang ZHANG
1
;
Yuanfei LI
2
;
Yuntong GUO
3
;
Gen ZHU
4
;
Guang YANG
1
;
Yu WANG
1
Author Information
1. The First Clinical Medical School of Shanxi Medical University, Taiyuan 030000, China.
2. Department of Digestive Oncology, First Hospital of Shanxi Medical University, Taiyuan 030000, China.
3. Department of Gastrointestinal Surgery, First Hospital of Shanxi Medical University, Taiyuan 030000, China.
4. Laboratory of Rheumatology and Immunology, First Hospital of Shanxi Medical University, Taiyuan 030000, China.
- Publication Type:CLINICALRESEARCH
- Keywords:
Colorectal cancer;
Tumor microenvironment;
Tumor-stroma ratio;
Relapse-free survival
- From:
Cancer Research on Prevention and Treatment
2025;52(8):676-681
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical value of tumor-stroma ratio (TSR) in combination with KRAS, BRAF, NRAS, and microsatellite status for prognostic assessment of patients with colorectal cancer. Methods A total of 51 colorectal cancer cases meeting the inclusion and exclusion criteria were enrolled in this study. TSR levels were evaluated through optical microscopy. The KRAS/NRAS/BRAF mutation profiles and microsatellite status were determined in accordance with genetic testing results. Clinical data, pathological characteristics, and survival outcomes were systematically recorded. Results Among the 51 patients with colorectal cancer, 19 (37.3%) were categorized into the low stromal group and 32 (62.7%) into the high stromal group. Statistically significant differences were observed between the two groups in drug resistance, M stage, TNM stage, neural invasion, and microsatellite status (P<0.05). Compared with patients exhibiting high TSR, those with low TSR demonstrated significantly increased recurrence rates (5 vs. 21 cases, P=0.007), shortened disease-free survival (34.21 vs. 14.34 months, P=0.001), and reduced overall survival (38.79 vs. 23.09 months, P=0.021). Multivariate Cox regression analysis identified N stage, M stage, TNM stage, neural invasion, lymphovascular invasion, and TSR as independent risk factors for disease-free survival. N stage, M stage, neural invasion, lymphovascular invasion, and TSR emerged as independent prognostic factors for overall survival (P<0.05). Although the combined models of TSR with KRAS, NRAS, BRAF, and microsatellite status, respectively, demonstrated overall statistical significance (P<0.05), none of the dummy variables in these models reached individually statistical significance (P>0.05), and therefore cannot be considered independent prognostic factors. Conclusion TSR serves as an independent predictor of poor prognosis in advanced colorectal cancer, with patients exhibiting low TSR demonstrating a significantly higher risk of recurrence and metastasis than those with high TSR. For patients with colon cancer undergoing first-line palliative chemotherapy after postoperative recurrence, histopathological assessment of TSR in primary tumor sites holds prognostic value and may serve as a relevant factor for evaluating treatment resistance in clinical management.
