Stromal categorization has been used to classify many epithelial cancer types. We assessed the desmoplastic reaction and compared its significance with other stromal characteristics in early (cT1-2N0) oral tongue squamous cell carcinoma (OTSCC). In this multi-institutional study, we included 308 cases treated for early OTSCC at five Finnish university hospitals or at the A.C. Camargo Cancer Center in São Paulo, Brazil. The desmoplastic reaction was classified as immature, intermediate, or mature based on the amount of hyalinized keloid-like collagen and myxoid stroma. We compared the prognostic value of the desmoplastic reaction with a stromal grading system based on tumor-stroma ratio and stromal tumor-infiltrating lymphocytes. We found that a high amount of stroma with a weak infiltration of lymphocytes was associated statistically significantly with a worse disease-free survival with a hazard ratio (HR) of 2.68 (95% CI 1.26–5.69), worse overall survival (HR 2.95, 95% CI 1.69–5.15), and poor disease-specific survival (HR 2.66, 95% CI 1.11–6.33). Tumors having a high amount of stroma with a weak infiltration of lymphocytes were also significantly associated with a high rate of local recurrence (HR 4.13, 95% CI 1.67–10.24), but no significant association was found with lymph node metastasis (HR 1.27, 95% CI 0.37–4.35). Categorization of the stroma based on desmoplastic reaction (immature, intermediate, mature) showed a low prognostic value for early OTSCC in all survival analyses (P > 0.05). In conclusion, categorization of the stroma based on the amount of stroma and its infiltrating lymphocytes shows clinical relevance in early OTSCC superior to categorization based on the maturity of stroma.

基质分类已被用于分类许多上皮癌类型。我们评估了增生反应，并将其与早期（cT1-2N0）口腔舌鳞状细胞癌（OTSCC）的其他基质特征进行了比较。在这项多机构研究中，我们纳入了308例在5所芬兰大学医院或巴西圣保罗AC Camargo癌症中心接受过OTSCC早期治疗的患者。根据透明质化的瘢痕loid样胶原蛋白和粘液样基质的数量，该增塑反应被分类为未成熟，中等或成熟。我们根据基于肿瘤-基质比率和基质-肿瘤浸润淋巴细胞的基质分级系统，比较了该增生反应的预后价值。我们发现，大量间质和淋巴细胞浸润较弱与无病生存率具有统计学显着相关性，危险比（HR）为2.68（95％CI 1.26-5.69），总生存率较差（HR 2.95， 95％CI 1.69–5.15）和疾病特异性生存率低（HR 2.66，95％CI 1.11–6.33）。具有大量间质而淋巴细胞浸润较弱的肿瘤也与高局部复发率显着相关（HR 4.13，95％CI 1.67–10.24），但与淋巴结转移无显着相关性（HR 1.27， 95％CI 0.37–4.35）。根据增生反应（未成熟，中度，成熟）对基质进行分类显示，在所有生存分析中，早期OTSCC的预后价值较低（总体生存率较差（HR 2.95，95％CI 1.69–5.15），疾病特异性生存率较差（HR 2.66，95％CI 1.11–6.33）。具有大量间质而淋巴细胞浸润较弱的肿瘤也与高局部复发率显着相关（HR 4.13，95％CI 1.67–10.24），但与淋巴结转移无显着相关性（HR 1.27， 95％CI 0.37–4.35）。根据增生反应（未成熟，中间，成熟）对基质进行分类显示，在所有生存分析中，早期OTSCC的预后价值较低（总体生存率较差（HR 2.95，95％CI 1.69–5.15），疾病特异性生存率较差（HR 2.66，95％CI 1.11–6.33）。具有大量间质而淋巴细胞浸润较弱的肿瘤也与高局部复发率显着相关（HR 4.13，95％CI 1.67–10.24），但与淋巴结转移无显着相关性（HR 1.27， 95％CI 0.37–4.35）。根据增生反应（未成熟，中间，成熟）对基质进行分类显示，在所有生存分析中，早期OTSCC的预后价值较低（但未发现与淋巴结转移有显着相关性（HR 1.27，95％CI 0.37–4.35）。根据增生反应（未成熟，中度，成熟）对基质进行分类显示，在所有生存分析中，早期OTSCC的预后价值较低（但未发现与淋巴结转移有显着相关性（HR 1.27，95％CI 0.37–4.35）。根据增生反应（未成熟，中间，成熟）对基质进行分类显示，在所有生存分析中，早期OTSCC的预后价值较低（P > 0.05）。总之，基于基质及其浸润淋巴细胞的数量对基质进行分类显示出在早期OTSCC中的临床相关性优于基于基质成熟度的分类。