Perineural invasion predicts poor survival and cervical lymph node metastasis in oral squamous cell carcinoma.

IF 2.2 3区 医学
R Martínez-Flores, B Gómez-Soto, C Lozano-Burgos, S-E Niklander, M-A Lopes, W-A González-Arriagada
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引用次数: 0

Abstract

Background: Oral squamous cell carcinoma (OSCC) usually invades peripheral nerves through a process known as perineural invasion (PNI), recognized as an adverse factor considered for the administration of postoperative adjuvant therapy. The aim of this study was to assess the impact of PNI on survival and cervical lymph node metastasis in a cohort of OSCC patients.

Material and methods: Presence, location and extension of PNI were assessed in a cohort of 57 paraffin-embedded OSCC resections. Clinico-pathological variables were obtained from each case. Five-year overall survival (OS) and 5-year disease-specific survival (DSS) curves were constructed according to the Kaplan-Meier method and compared with log-rank test. The Cox proportional hazard model was used to assess the role of PNI as an independent risk factor related to poor survival, and a binary logistic regression was performed to estimate the predictive value of PNI for regional lymph node metastasis.

Results: PNI was observed in 49.1% of the cases, affecting only small nerves. Peritumoral PNI was the most common location, and multifocal PNI the most frequent extent. Most PNI positive cases had cervical metastasis (p=0.001), and PNI was more frequent in stages III-IV than in I-II (p=0.02). The five-year OS and the 5-year DSS decreased in PNI positive and peritumoral PNI cases. PNI was an independent risk factor for poor 5-year OS and poor 5-year DSS. The odds for cervical lymph node metastasis were of 6.076 (p=0.006) and 10.257 (p=0.007) for PNI and Tumor budding (TB) positive cases, respectively.

Conclusions: PNI is a frequent finding in OSCC and an independent risk factor for poor OS and DSS. PNI and TB are both risk factors associated to an increased likelihood for the development of lymph node metastasis. Therefore, we suggest further investigations to test the combined PNI-TB scoring system in risk stratification models for OSCC.

Abstract Image

Abstract Image

Abstract Image

围神经浸润预示着口腔鳞状细胞癌的不良生存率和颈部淋巴结转移。
背景:口腔鳞状细胞癌(OSCC)通常通过周围神经侵袭(PNI)的过程侵入周围神经,这被认为是术后辅助治疗的一个不利因素。本研究的目的是评估PNI对一组OSCC患者的生存和颈部淋巴结转移的影响。材料和方法:在57例石蜡包埋的OSCC切除术中评估PNI的存在、位置和扩展。从每个病例中获得临床病理变量。根据Kaplan-Meier法构建5年总生存(OS)和5年疾病特异性生存(DSS)曲线,并采用log-rank检验进行比较。采用Cox比例风险模型评估PNI作为与生存不良相关的独立危险因素的作用,并采用二元logistic回归估计PNI对区域淋巴结转移的预测价值。结果:49.1%的病例出现PNI,仅影响小神经。肿瘤周围PNI是最常见的部位,多灶PNI是最常见的范围。多数PNI阳性患者有宫颈转移(p=0.001),且PNI在III-IV期较I-II期多发(p=0.02)。PNI阳性和肿瘤周围PNI病例的5年OS和5年DSS下降。PNI是5年OS差和5年DSS差的独立危险因素。PNI阳性和TB阳性患者发生颈部淋巴结转移的几率分别为6.076 (p=0.006)和10.257 (p=0.007)。结论:PNI是OSCC中常见的发现,也是OS和DSS差的独立危险因素。PNI和TB都是与淋巴结转移可能性增加相关的危险因素。因此,我们建议进一步研究PNI-TB联合评分系统在OSCC风险分层模型中的应用。
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来源期刊
CiteScore
4.50
自引率
0.00%
发文量
52
期刊介绍: 1. Oral Medicine and Pathology: Clinicopathological as well as medical or surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, as well as orofacial neurological disorders, and systemic conditions with an impact on the oral cavity. 2. Oral Surgery: Surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, teeth, implants, oral surgical procedures. Surgical management of diseases affecting head and neck areas. 3. Medically compromised patients in Dentistry: Articles discussing medical problems in Odontology will also be included, with a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients. 4. Implantology 5. Periodontology
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