肿瘤间质比在妇科肿瘤中的预后价值
Prognostic Value of Tumor-Stroma Ratio in Gynecologic Tumors
摘要: 肿瘤间质比(tumor-stroma ratio, TSR)作为反映肿瘤微环境中上皮与间质成分比例的定量指标，近年来在多种实体瘤中被证实与患者预后相关。在妇科肿瘤中TSR也与预后存在显著关联，但不同肿瘤类型间呈现异质性。子宫内膜癌中，间质丰富与无复发生存期下降显著相关，但TSR的独立预后价值可能受分子分型影响。卵巢癌中，间质贫乏患者无进展生存期显著延长，且可预测铂类化疗耐药和免疫治疗反应。宫颈癌中TSR的预后价值存在争议，单纯TSR可能不如间质质量特征重要；单细胞和空间转录组学揭示宫颈腺癌与鳞癌具有截然不同的肿瘤微环境景观，间质丰富在腺癌中常伴随免疫抑制，在鳞癌中可能伴随免疫活化，这可能是TSR预后意义不确定的根本原因。TSR作为低成本、高可行性、高可重复性的病理指标，在妇科肿瘤中具有预后价值，但存在显著的肿瘤类型和组织学亚型异质性。临床应用中需结合分子分型、组织学类型和间质质量特征综合解读。
Abstract: The tumor-stroma ratio (TSR), as a quantitative indicator reflecting the ratio of epithelial to stromal components in the tumor microenvironment, has been confirmed to be related to the prognosis of patients in various solid tumors in recent years. In gynecological tumors, TSR is also significantly associated with prognosis, but heterogeneity is presented among different tumor types. In endometrial cancer, stromal abundance is significantly associated with a decreased recurrence-free survival period, but the independent prognostic value of TSR may be affected by molecular typing. In ovarian cancer, the progression-free survival of patients with stromal poverty is significantly prolonged, and platinum-based chemotherapy resistance and immunotherapy response can be predicted. The prognostic value of TSR in cervical cancer is controversial. Simple TSR may not be as important as interstitial quality characteristics. Single-cell and spatial transcriptomics have revealed that cervical adenocarcinoma and squamous cell carcinoma have distinct tumor microenvironment landscapes. Rich stroma is often accompanied by immunosuppression in adenocarcinoma, while it may be accompanied by immune activation in squamous cell carcinoma. This may be the fundamental reason for the uncertain prognostic significance of TSR. As a low-cost, highly feasible and highly reproducible pathological indicator, TSR has prognostic value in gynecological tumors, but there is significant heterogeneity in tumor types and histological subtypes. In clinical applications, a comprehensive interpretation should be made in combination with molecular typing, histological types and interstitial quality characteristics.
文章引用：唐钰洁, 肖琳. 肿瘤间质比在妇科肿瘤中的预后价值[J]. 临床医学进展, 2026, 16(5): 2063-2070. https://doi.org/10.12677/acm.2026.1652012

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