Background: Colorectal carcinoma ranks the third-largest in the world, and second as the cause of death from cancer. Risk factors include precursor lesions such as adenomas and dysplasia and diets of high in calorie and animal fat accompanied by lack of physical activity. In addition to grading and histological staging, the prognosis is also influenced by the reaction between the tumor and the stroma (Tumor-Stroma Ratio / TSR) based on a comparison between the percentage of carcinomas and stroma, which is one of the most recent prognostic factors and is still not widely used.

Objective: To analyze the correlation between Tumor-Stroma Ratio (TSR) with histological grading and staging in colorectal adenocarcinoma.

Methods: 40 histopathological slide samples from the operating tissue of patients with a diagnosis of colorectal adenocarcinoma with hematoxylin-eosin staining assessed staging, grading and TSR scores. If the carcinoma component <30% (TSR-Low), carcinoma 40%-60% (TSR-Intermediate) and carcinoma >70% (TSR-High). 

Results and discussion: Most histological grading distributions are moderately differentiated, most staging is stage II, and the highest TSR score is Intermediate TSR. Based on the Spearman correlation test, it was found that there was a strong correlation between TSR scores with grading (p = 0.0001, r = +0.747) and a weak correlation between TSR and staging (p = 0.012, r = +0.395).

Conclusions: TSR is a prognostic factor in colorectal adenocarcinoma patients and should be reported in the diagnosis of an Anatomic Pathologist.

Keywords: Tumor-Stroma Ratio, colorectal prognosis.