Prognostic value of tumour-stroma ratio in nasopharyngeal carcinoma: a two-center retrospective study

Abstract Background Tumour-stroma ratio (TSR) is the proportion of tumour cells relative to surrounding stroma. This study aimed to investigate the prognostic impact of TSR, and to construct a prognostic nomogram in patients with nasopharyngeal carcinoma (NPC). Methods Clinico-pathological data of 2...

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Main Authors: Wenze Qiu, Wenjing Chen, Jiali Jiang, Ronghui Zheng, Yawei Yuan, Xing Lv, Jiangyu Zhang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Radiation Oncology
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Online Access:https://doi.org/10.1186/s13014-025-02627-6
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author Wenze Qiu
Wenjing Chen
Jiali Jiang
Ronghui Zheng
Yawei Yuan
Xing Lv
Jiangyu Zhang
author_facet Wenze Qiu
Wenjing Chen
Jiali Jiang
Ronghui Zheng
Yawei Yuan
Xing Lv
Jiangyu Zhang
author_sort Wenze Qiu
collection DOAJ
description Abstract Background Tumour-stroma ratio (TSR) is the proportion of tumour cells relative to surrounding stroma. This study aimed to investigate the prognostic impact of TSR, and to construct a prognostic nomogram in patients with nasopharyngeal carcinoma (NPC). Methods Clinico-pathological data of 206 patients treated at Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University for NPC were used as the training cohort. Assessment of TSR was performed on haematoxylin and eosin-stained slides and the correlation of TSR with survival outcomes was examined. A nomogram model comprising TSR was established and the clinical performance was evaluated by concordance index (C-index), calibration curve, time-dependent area under the curve (tAUC), and decision curve analysis (DCA). External validation was performed using cohort from Sun Yat-sen University Cancer Center (n = 343). Results High stroma ratio was proved to be an adverse prognostic factor for OS. A prognostic model integrating T stage, N stage and TSR for individual prediction of survival was constructed and graphically represented as a nomogram. Calibration curves indicated good agreement between the nomogram and actual observations. Moreover, the nomogram outperformed the commonly used staging systems. In addition, the nomogram could successfully classified patients into three different risk groups. The external validation cohort supported these findings. Conclusions TSR is a strong and independent prognostic factor for NPC patients. A nomogram that integrated T stage, N stage and TSR could serve as a precise and convenient model of risk stratification in predicting the prognosis of patients with NPC.
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spelling doaj-art-e475aba616a84b7bba11f5c66d388bc62025-08-20T02:34:15ZengBMCRadiation Oncology1748-717X2025-05-012011910.1186/s13014-025-02627-6Prognostic value of tumour-stroma ratio in nasopharyngeal carcinoma: a two-center retrospective studyWenze Qiu0Wenjing Chen1Jiali Jiang2Ronghui Zheng3Yawei Yuan4Xing Lv5Jiangyu Zhang6Department of Radiation Oncology, Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical UniversityDepartment of Pathology, First Affiliated Hospital of Guangzhou University of Chinese MedicineHealth Ward, Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical UniversityDepartment of Radiation Oncology, Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical UniversityDepartment of Radiation Oncology, Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical UniversityState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer CenterDepartment of Pathology, Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical UniversityAbstract Background Tumour-stroma ratio (TSR) is the proportion of tumour cells relative to surrounding stroma. This study aimed to investigate the prognostic impact of TSR, and to construct a prognostic nomogram in patients with nasopharyngeal carcinoma (NPC). Methods Clinico-pathological data of 206 patients treated at Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University for NPC were used as the training cohort. Assessment of TSR was performed on haematoxylin and eosin-stained slides and the correlation of TSR with survival outcomes was examined. A nomogram model comprising TSR was established and the clinical performance was evaluated by concordance index (C-index), calibration curve, time-dependent area under the curve (tAUC), and decision curve analysis (DCA). External validation was performed using cohort from Sun Yat-sen University Cancer Center (n = 343). Results High stroma ratio was proved to be an adverse prognostic factor for OS. A prognostic model integrating T stage, N stage and TSR for individual prediction of survival was constructed and graphically represented as a nomogram. Calibration curves indicated good agreement between the nomogram and actual observations. Moreover, the nomogram outperformed the commonly used staging systems. In addition, the nomogram could successfully classified patients into three different risk groups. The external validation cohort supported these findings. Conclusions TSR is a strong and independent prognostic factor for NPC patients. A nomogram that integrated T stage, N stage and TSR could serve as a precise and convenient model of risk stratification in predicting the prognosis of patients with NPC.https://doi.org/10.1186/s13014-025-02627-6Tumour-stroma ratioNasopharyngeal carcinomaPrognosisNomogram
spellingShingle Wenze Qiu
Wenjing Chen
Jiali Jiang
Ronghui Zheng
Yawei Yuan
Xing Lv
Jiangyu Zhang
Prognostic value of tumour-stroma ratio in nasopharyngeal carcinoma: a two-center retrospective study
Radiation Oncology
Tumour-stroma ratio
Nasopharyngeal carcinoma
Prognosis
Nomogram
title Prognostic value of tumour-stroma ratio in nasopharyngeal carcinoma: a two-center retrospective study
title_full Prognostic value of tumour-stroma ratio in nasopharyngeal carcinoma: a two-center retrospective study
title_fullStr Prognostic value of tumour-stroma ratio in nasopharyngeal carcinoma: a two-center retrospective study
title_full_unstemmed Prognostic value of tumour-stroma ratio in nasopharyngeal carcinoma: a two-center retrospective study
title_short Prognostic value of tumour-stroma ratio in nasopharyngeal carcinoma: a two-center retrospective study
title_sort prognostic value of tumour stroma ratio in nasopharyngeal carcinoma a two center retrospective study
topic Tumour-stroma ratio
Nasopharyngeal carcinoma
Prognosis
Nomogram
url https://doi.org/10.1186/s13014-025-02627-6
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