Prognostic Impact of Histological Scores of Tumor Microenvironment in Gall Bladder Carcinoma

Background: Tumor microenvironment plays a critical role in the survival and growth of cancer cells. Tumor stroma percentage (TSP), Kintrup-Makinen (KM) grade – which indicates the density of inflammatory cells at the invasive front of the tumor – and Glasgow microenvironment score (GCS) – which combines TSP and KM grade – were assessed for their prognostic value in gall bladder carcinoma (GBC). Materials and Methods: TSP, KM grade, and GMS were used as histological scores to evaluate 50 consecutive cases of GBC in resection specimens. The association of these scores with clinicopathologic variables and survival probabilities was assessed. Results: High TSP was associated with the presence of perineural invasion, and high KM grade was associated with the female gender. Higher GMS was associated with higher T stage and the presence of perineural invasion. High TSP was associated with poor survival probabilities, while a better survival outcome was associated with higher KM grades and low GMS. Conclusion: There is a substantial association between clinicopathologic variables such as perineural invasion, gender, and tumor stage with TSP, KM grade, and GMS. Evaluating these histological scores is practical and cost-effective to identify the biologic characteristics of tumor microenvironment and prognosis in cases of GBC.