Prognostic significance of the Glasgow Microenvironment Score for lymph node metastasis in oral squamous cell
Punnya V Angadi1, Deepa R Mane1
1Department of Oral Pathology and Microbiology, VK Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER), Belgaum, Karnataka, India.
Objective:
The Glasgow Microenvironment Score (GMS) combines the tumor stroma percentage (TSP) with the inflammatory component of the tumor microenvironment and has demonstrated prognostic significance in several malignancies. This study explored the prognostic significance of the GMS in oral squamous cell carcinoma (OSCC).
Study Design:
Sixty patients with OSCC were examined for Klintrup-Makinen grade (KM) and TSP, which were then merged to generate a GMS. Ki-67 immunohistochemistry was performed to assess cellular proliferation. Clinicopathological characteristics and lymph node metastases were assessed using univariate and multivariate analyses.
Results:
The GMS score indicated that 27 (45%) cases were categorized as 0-KM strong, 10 (16.7%) as 1-KM weak/low TSP, and 23 (38.3%) as 2-KM weak/high TSP. A high GMS score (grade 2) was associated with the depth of invasion, increased Ki-67 index, low KM grade, and high TSP. It also showed a strong correlation with lymph node metastases and was identified as an independent prognostic indicator (OR: 22.0, CI: 2.97-163.21).
Conclusion:
The GMS, a cumulative scoring system for the tumor microenvironment, can be easily evaluated on standard H and E sections without the need for additional staining. A high GMS score, marked by elevated TSP and reduced inflammatory infiltration, emerged as a robust independent predictor of lymph node metastasis.
