Tumor Microenvironment Prognostic Risk and Its Association With MUC5AC in Ampullary Carcinoma

© 2023 College of American Pathologists..

CONTEXT.—: The tumor-host interaction in the tumor microenvironment (TME) affects the prognosis of patients with malignant tumors. TME assessed via tumor budding (BD) and tumor-infiltrating lymphocyte (TIL) had a prognostic impact in patients with nonampullary small intestinal and colorectal carcinomas. In ampullary carcinoma (AC), MUC5AC was recently revealed as a significant prognosticator, but studies about the TME have not been conducted.

OBJECTIVE.—: To assess TME-based prognostic risk in AC.

DESIGN.—: We generated a collective TME risk index based on high-grade BD at the invasive front (BD3) and high density of stromal-TIL (>5%) in 64 surgically resected ACs. We evaluated its predictive values for overall survival (OS) and recurrence-free survival (RFS). We also investigated the relationship of TME to MUC5AC expression.

RESULTS.—: TME prognostic risk index was classified into low-risk (BDLow/TILHigh; 26 of 64; 41%), intermediate-risk (BDLow/TILLow or BDHigh/TILHigh; 23; 36%), and high-risk (BDHigh/TILLow; 15; 23%) groups. Higher TME prognostic risk was associated with higher tumor grade (P = .03), lymphovascular invasion (P = .05), and MUC5AC immunopositivity (P = .02). TME prognostic risk index displayed better predictive ability for both OS (53.9 versus 46.1 versus 42.2) and RFS (24.8 versus 16.9 versus 15.3) than BD or TIL alone. In multivariate analysis, TME prognostic risk index was an independent prognosticator for OS (P = .003) and RFS (P = .03).

CONCLUSIONS.—: TME risk index in combination with BD and TIL was a stronger predictor of prognostic risk stratification than either BD or TIL alone for both OS and RFS in patients with AC. MUC5AC may modulate the interaction between tumor cells and immunity toward enhancing invasiveness in TME.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:147

Enthalten in:

Archives of pathology & laboratory medicine - 147(2023), 9 vom: 01. Sept., Seite 1060-1074

Sprache:

Englisch

Beteiligte Personen:

Jun, Sun-Young [VerfasserIn]
Lee, Eui-Jin [VerfasserIn]
Kim, Sang-Il [VerfasserIn]
An, Soyeon [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
MUC5AC protein, human
Mucin 5AC

Anmerkungen:

Date Completed 01.09.2023

Date Revised 05.09.2023

published: Print

Citation Status MEDLINE

doi:

10.5858/arpa.2022-0131-OA

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM349585466