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Prognostic value and tumour microenvironment characteristics of the Glasgow Microenvironment Score in primary triple-negative breast cancer
  1. Xunxi Lu1,
  2. Yue Wang2,
  3. Mengting He3,
  4. Zongchao Gou4
  1. 1Department of Pathology, Sichuan University West China Hospital, Chengdu, Sichuan, China
  2. 2Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, Shanghai, China
  3. 3West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
  4. 4Department of Breast Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China
  1. Correspondence to Dr Zongchao Gou, Department of Breast Surgery, Sichuan University West China Hospital, Chengdu, Sichuan 610041, China; fdchao{at}


Aims The Glasgow Microenvironment Score (GMS) reflects the tumour microenvironment (TME) status by combining inflammatory cell infiltration and the tumour-stroma percentage. This study aimed to investigate the prognostic value and TME characteristics of the GMS for patients with triple-negative breast cancer (TNBC).

Methods A total of 123 patients with stage I-III TNBC were enrolled in this study. The association between GMS and clinicopathological characteristics was examined using the Pearson’s χ2 test or Fisher’s exact test. Kaplan-Meier plots were used to compare survival among the three GMS groups. Cox regression analyses were conducted to test the HR. Microenvironment Cell Populations-counter algorithm was used to estimate the TME components of each case.

Results We found that higher GMS score tended to exhibit the lower nuclear grade (p=0.016), more positive lymph nodes (p=0.014) and later tumour, node, metastases stage (p=0.012). GMS was an independent prognostic factor for disease-free survival in TNBC, and GMS 2 showed the worst prognosis (HR=6.42, p=0.028). GMS 0 was more infiltrated with cytotoxic lymphocytes, including CD8+ T cells (p=0.037) and natural killer cells (p=0.005), while GMS 2 was enriched in more endothelial cells (p=0.014) and fibroblasts (p=0.008).

Conclusion Our study suggested that the GMS is a prognostic indicator for patients with TNBC. As an accessible and effective index, the GMS may be a promising tool to help clinicians assess prognostic risk and TME for patients with TNBC.

  • breast neoplasms
  • biomarkers, tumor
  • breast diseases

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Handling editor Cheok Soon Lee.

  • XL and ZG contributed equally.

  • Contributors All authors contributed to the article. Conception and design: ZG. Pathological assessment: XL and YW. Data collection and analysis: ZG and MH. Manuscript writing: XL and ZG. Final approval of manuscript: all authors. ZG acts as guarantor for this work and the conduct of the study.

  • Funding This study was supported by Post-Doctor Research Project, West China Hospital, Sichuan University (2021HXBH080) and Natural Science Foundation of Sichuan Province (2022NSFSC1385).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.