Novel histological prognostic factors in gastric cancer

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Auditorium F202 of the Faculty of Medicine, Zoom link:

Topic of the dissertation

Novel histological prognostic factors in gastric cancer

Doctoral candidate

Bachelor of Medicine Niko Kemi

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Cancer and Translational Medicine Research Unit

Subject of study



Professor Olli Carpén, University of Helsinki


Docent Joonas Kauppila, University of Oulu

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Novel histological prognostic factors in gastric cancer

Gastric cancer is a disease with poor prognosis. Its only curative treatment option is surgery. Prognostic factors are used for planning of treatment after surgery. In this study hematoxylin-eosin stained slides that are routinely used for pathology reports were used.

The aim of the study was to assess novel prognostic factors from these routinely stained slides. Those prognostic factors could potentially be used to improve accuracy of estimating gastric cancer patients’ prognosis after surgery.

The study cohort consisted of 583 surgically treated patients from Oulu University Hospital and 158 patients from Central Finland Central Hospital. Their clinical data and diagnostic hematoxylin-eosin stained slides were used for the study. One of the prognostic factors, tumor-stroma ratio, was further studied with a systematic literature review and a meta-analysis of the studies of its prognostic significance in gastric cancer.

In this study tumor-stroma ratio that is based on amount of tumor cells and mostly connective tissue containing stroma, tumor budding that is based on counting single cells or small cell clusters detached from the tumor, stromal maturity that is based on structure of the stromal connective tissue and Klintrup-Mäkinen grade that is based on assessment of immune cells in the tumor’s edge were found to be independent prognostic factors in gastric cancer.

Assessments of tumor-stroma ratio and tumor budding had good reproducibility and assessments of stromal maturity and tumor budding had moderate reproducibility. Tumor-stroma ratio is a strong prognostic factor in gastric cancer based on the meta-analysis.

All the prognostic factors included in this study can be easily and quickly assessed from routinely stained slides. The prognostic factors that were studied could potentially be utilized for planning of gastric cancer patients’ treatment without additional costs in the future.
Last updated: 1.3.2023