Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2013, Vol 29, Num, 1     (Pages: 027-035)

The Prognostic Value of Tumor-Stroma Proportion in Laryngeal Squamous Cell Carcinoma

Mehtat ÜNLÜ 1, Hasan Oğuz ÇETİNAYAK 2, Devrim ÖNDER 3, Cenk ECEVİT 4, Fadime AKMAN 2, Ahmet Ömer İKİZ 4, Emel ADA 5, Bilge KARAÇALI 3, Sülen SARIOĞLU 1

1 Department of Pathology, Dokuz Eylül University, Faculty of Medicine, İZMİR, TURKEY
2 Department of Radiation Oncology, Dokuz Eylül University, Faculty of Medicine, İZMİR, TURKEY
3 Department of Electrical and Electronics Engineering, Institute of Technology, İZMİR, TURKEY
4 Department of Otorhinolaryngology, Dokuz Eylül University, Faculty of Medicine, İZMİR, TURKEY
5 Department of Radiology, Dokuz Eylül University, Faculty of Medicine, İZMİR, TURKEY

DOI: 10.5146/tjpath.2013.01144
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Objective: Tumor-stroma proportion of tumor has been presented as a prognostic factor in some types of adenocarcinomas, but there is no information about squamous cell carcinomas and laryngeal carcinomas.

Material and Method: Five digital images of the tumor sections were obtained from 85 laryngeal carcinomas. Proportion of epithelial tumor component and stroma were measured by a software tool, allowing the pathologists to mark 205.6 μm2 blocks on areas as carcinomatous/stromal, by clicking at the image. Totally, 3.451 mm2 tumor areas have been marked to 16.785 small square blocks for each case.

Results: Median follow up was 48 months (range 3-194). The mean tumor-stroma proportion was 48.63+18.18. There was no difference for tumor-stroma proportion when tumor location, grade, stage and perinodal invasion were considered. Although the following results were statistically insignificant, the mean tumor-stroma proportion was the lowest (37.46±12.49) for subglottic carcinomas, and it was 52.41±37.47, 50.86+19.84 and 44.56±16.91 for supraglottic, transglottic and glottic cases. The tumor-stroma proportion was lowest in cases with perinodal invasion and the highest in cases without lymph node metastasis (44.72±20.23, 47.77±17.37, 50.05±17.34). Tumor-stroma proportion was higher in the basaloid subtype compared with the classical squamous cell carcinoma (53.76±14.70 and 48.63±18.38 respectively). The overall and disease-free survival analysis did not reveal significance for tumor-stroma proportion (p=0.08, p=0.38). Only pathological stage was an independent factor for overall survival (p=0.008).

Conclusion: This is the first series investigating tumor-stroma proportion as a prognostic marker in laryngeal carcinomas proposing a new method, but the findings do not support tumor-stroma proportion as a prognostic marker.

Keywords : Laryngeal neoplasms, Prognosis, Stromal cell, Tumor