{
  "abstract": "Objective: To evaluate a histology‐derived score (HDS) integrating tumor–stroma ratio (TSR), tertiary lymphoid structures (TLS), and tumor budding (TB) for prognostic stratification in colorectal cancer (CRC) and assess its incremental prognostic value.\n\nMethods: A total of 559 patients with CRC were retrospectively enrolled and randomly split 7:3 into a training cohort (n = 392) and an internal validation cohort (n = 167). TSR, TLS, and TB were assessed on hematoxylin and eosin (H&E)‐stained sections to construct the HDS, with predefined low‐ (3–4), intermediate‐ (5–6), and high‐risk (7–8) groups. Independent prognostic factors were identified using multivariable Cox regression and incorporated into a nomogram. The incremental prognostic value of HDS was assessed by comparing nested models using the concordance index (C‐index), likelihood‐ratio test (LRT), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).\n\nResults: Multivariable Cox regression identified HDS (HDShigh vs. HDSlow: HR = 3.10, 95% CI: 1.75–5.47, p < 0.001), TNM stage (III vs. I: HR = 3.26, 95% CI: 1.49–7.12, p < 0.001), and lymphovascular invasion (LVI) (yes vs. no: HR = 1.70, 95% CI: 1.09–2.64, p = 0.020) as independent prognostic factors for disease‐free survival (DFS). Adding HDS to TNM + LVI increased the C‐index from 0.709 to 0.738 in the training cohort (LRT, p < 0.001; NRI = 0.454, p = 0.012; IDI = 0.050, p < 0.001) and from 0.655 to 0.669 in the internal validation cohort (LRT, p = 0.033; NRI = 0.313, p = 0.148; IDI = 0.029, p = 0.044). The nomogram showed good discrimination, calibration, and clinical utility in both cohorts.\n\nConclusions: HDS provided incremental prognostic information beyond TNM stage and LVI in CRC. The HDS‐based nomogram may facilitate individualized prognostic assessment, although external multicenter validation is required.",
  "abstract_shown": true,
  "affiliations": [
    "Graduate School Bengbu Medical University Bengbu Anhui People's Republic of China",
    "Department of Pathology Anqing Municipal Hospital, Anqing Hospital Affiliated to China Pharmaceutical University Anqing Anhui People's Republic of China",
    "Department of General Surgery Anqing Municipal Hospital, Anqing Hospital Affiliated to China Pharmaceutical University Anqing Anhui People's Republic of China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Meng Tian"
    },
    {
      "affs": [
        2
      ],
      "name": "Jianwei Yuan"
    },
    {
      "affs": [
        1
      ],
      "name": "Quanquan Hu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Lanlan Xuan",
      "orcid": "0000-0002-2496-7676"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dq2nxd6yfnmey.bib",
  "cited_by": 0,
  "doi": "10.1002/cam4.72495",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13735894/",
  "id": "dq2nxd6yfnmey",
  "issns": [
    "2045-7634"
  ],
  "landing_url": "https://doi.org/10.1002/cam4.72495",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2730|Colorectal Cancer Surgical Treatments"
    ]
  ],
  "openalex": "W7225302832",
  "pdf_url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cam4.72495",
  "pmcid": "PMC13735894",
  "pmid": "42984327",
  "published": "2026-11-05",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/dq2nxd6yfnmey.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:21:28Z",
      "native_id": "PMC13735894",
      "source": "pmc",
      "url": "https://doi.org/10.1002/cam4.72495"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Colorectal Cancer Surgical Treatments",
      "subfield": "oncology"
    }
  ],
  "title": "A Histology‐Derived Score Integrating Tumor–Stroma Ratio, Tertiary Lymphoid Structures, and Tumor Budding Improves Prognostic Stratification in Colorectal Cancer",
  "title_text": "A Histology‐Derived Score Integrating Tumor–Stroma Ratio, Tertiary Lymphoid Structures, and Tumor Budding Improves Prognostic Stratification in Colorectal Cancer",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:28Z",
  "url": "https://research.draconitic.com/paper/dq2nxd6yfnmey",
  "venue": "Cancer Medicine",
  "versions": []
}