American Journal of Surgical Pathology最新文献

{"title":"Insights From H3-Wildtype Diffuse Midline Glioma With EZHIP Overexpression.","authors":"Minjun Yan, Bo Wang, Bo Han, Zhuo Li, Xing Liu, Pinan Liu","doi":"10.1097/PAS.0000000000002388","DOIUrl":"10.1097/PAS.0000000000002388","url":null,"abstract":"","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":"748-750"},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CPZ: A Highly Sensitive Diagnostic Biomarker for the Differentiation Between Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma, Particularly in Poorly Differentiated Hepatocellular Carcinoma.","authors":"Minying Deng, Rongkui Luo, Lingli Chen, Huimei Wang, Wen Huang, Qi Song, Dongxian Jiang, Lei Xu, Jieakesu Su, Chen Xu, Yingyong Hou","doi":"10.1097/PAS.0000000000002393","DOIUrl":"10.1097/PAS.0000000000002393","url":null,"abstract":"<p><p>Carboxypeptidase Z (CPZ) is a newly identified member of the metallopeptidase family, primarily reported in rats; however, its distribution in normal human tissues and expression characteristics in tumor tissues remain unclear. This study uses high-throughput and mass production technology for tissue microarray (TMA) to perform immunohistochemical staining of CPZ, for the first time delineating its distribution and expression in normal tissues and various tumors throughout the body, to discuss its potential pathologic value. CPZ exhibited varying degrees of cytoplasmic positive expression in the normal hepatocytes, pancreatic islets, and gallbladder epithelium, with no expression observed in other normal tissues. The positive expression rates of CPZ in hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), metastatic liver tumors, and normal liver tissue were 90.8% (109/120), 27.7% (13/47), 0% (0/22), and 100% (81/81), respectively. The sensitivity and specificity for diagnosing HCC with any of the 3 markers (CPZ, arginase-1 (Arg-1), and hepatocyte paraffin antigen-1 (Hep Par-1)) positive were 96.7% (116/120) and 65.2% (45/69), respectively. The sensitivity and specificity for diagnosing HCC with all 3 markers positive were 70.8% (85/120) and 100% (69/69), respectively. The sensitivity and specificity for diagnosing HCC with both CPZ and Arg-1 positive were 79.2% (95/120) and 95.7% (66/69), respectively. The sensitivity and specificity for diagnosing HCC with both CPZ and Hep Par-1 positive were 76.7% (92/120) and 97.1% (67/69), respectively. The sensitivity and specificity for diagnosing HCC with both Arg-1 and Hep Par-1 positive were 72.5% (87/120) and 98.6% (68/69), respectively. The ROC curve indicated that the combined detection of CPZ, Arg-1, and Hep Par-1 had the best diagnostic value for HCC (AUC=0.939, P <0.001). However, for individual detection, CPZ had the highest AUC value among the 3 markers (AUC=0.908, P <0.001). CPZ was not observed to be positive in the majority of 897 cases of solid tumors. Utilizing the TMA repository, we propose for the first time that CPZ may serve as a useful adjunctive tool for the diagnosis or differential diagnosis of HCC in routine surgical pathology practice. CPZ shows a trend of superiority over Arg-1 and Hep Par-1, particularly in poorly differentiated HCC.</p>","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":"711-729"},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Analysis of Cutaneous Sarcomatoid Neoplasms Frequently Identifies Melanoma Driver Variants.","authors":"Louise A Jackett, Catherine Mitchell, Cameron Snell, Chelsee Hewitt, Shravan Yellenki, Hayden Snow, David Speakman, Chris Angel, Christine Khoo, Jia-Min Pang, Serigne N Lo, Richard A Scolyer, Stephen Fox, David Gyorki","doi":"10.1097/PAS.0000000000002390","DOIUrl":"10.1097/PAS.0000000000002390","url":null,"abstract":"<p><p>Primary cutaneous neoplasms that lack definitive histologic and immunophenotypic evidence of differentiation are a heterogeneous group of tumors with diverse prognoses and management options. These include undifferentiated and dedifferentiated melanoma (UM/DM), atypical fibroxanthoma (AFX), pleomorphic dermal sarcoma (PDS), and sarcomatoid squamous cell carcinoma. Diagnosis requires careful correlation between the clinicopathologic and molecular features, and the finding of a MAPK pathway variant commonly associated with melanoma may support the diagnosis of melanoma over other tumors in this group. To examine the frequency of typical melanoma-associated MAPK pathway-related variants ( BRAF, NRAS, KIT, GNAQ, GNA11 ) among a cohort of primary cutaneous sarcomatoid neoplasms, we conducted a retrospective analysis of 37 cases of immunohistologically unclassifiable primary cutaneous neoplasms, submitted for targeted NGS analysis. All cases lacked a history of a prior relevant tumor, were negative for melanocytic markers (S100, SOX10, HMB45, and Melan-A), or showed <5% staining with 1 or 2 of these markers. Other lineage markers were negative. We identified typical melanoma driver variants in 7 cases (7/37, 19%), including NRAS (5/37, 14%), KIT (1/37, 3%), and GNAQ (1/37, 3%). There were no significant differences in age, sex, tumor site, or mitotic rate between patients with and without a melanoma driver variant. Melanoma cases were thicker (16.3 vs. 9.25 mm, P =0.041) and more likely to show epithelioid cell phenotype ( P =0.008). In our cohort, nearly 20% of patients with immunohistologically unclassifiable cutaneous tumors could be reclassified as having primary UM/DM after molecular testing, thereby opening alternative management pathways.</p>","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":"650-657"},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Society of Urological Pathology Consensus on Cancer Precursor Lesions. Working Group 1: The Prostate.","authors":"Kenneth A Iczkowski, Angelo M De Marzo, Neeraj Agarwal, David M Berman, Alessia Cimadamore, Samson W Fine, Nancy Greenland, Francesca Khani, Massimo Loda, Tamara L Lotan, Murali Varma, Arul Chinnaiyan, Gianluca Giannarini, Jiaoti Huang, Rodolfo Montironi, George J Netto, Adeboye O Osunkoya, Timothy Ratliff, Glen Kristiansen, Liang Cheng, Geert J L H van Leenders","doi":"10.1097/PAS.0000000000002430","DOIUrl":"https://doi.org/10.1097/PAS.0000000000002430","url":null,"abstract":"<p><p>Working Group 1 at ISUP's Cancer Precursors meeting (September 2024) evaluated 5 putative precursors of invasive prostate cancer: high-grade prostatic intraepithelial neoplasia (HGPIN), intraductal carcinoma (IDC), atypical intraductal proliferation (AIP), atypical adenomatous hyperplasia (AAH)/adenosis, and proliferative inflammatory atrophy (PIA). Objectives were to compile recent evidence, interrogate current practices, and vote on recommendations, with 67% approval defined as consensus. Consensus was reached against the reporting of the low-grade form of PIN. HGPIN need not be reported when concomitant cancer or atypical small acinar proliferation suspicious for cancer exists adjacent to it, for biopsy or prostatectomy specimens. Finally, while the clinical significance of unifocal HGPIN in biopsies remains uncertain, there is stronger evidence for multifocal isolated HGPIN as a predictor of subsequent cancer detection. By consensus, multifocal HGPIN should continue being reported. Slight refinement was achieved regarding IDC criteria. The consensus opinion was that a dense cribriform to solid proliferation need not demonstrate marked nuclear atypia/ pleomorphism to qualify as IDC. The inverse scenario of marked atypia without dense cribriform/solid proliferation fell just short (65%) of consensus for IDC. Redesignating cribriform HGPIN as AIP achieved consensus. AIP found alone or with grade group 1 cancer warrants an explanatory comment. However, agreement was not attained to report AIP in the presence of invasive cancer, in either needle biopsy or prostatectomy. Finally, the optional reporting of PIA or AAH/adenosis in biopsies as pertinent negatives both fell short of consensus. This guidance should help pathologists standardize reporting, staying focused on the clinically actionable aspects of these lesions.</p>","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgM Immunohistochemical Expression is a Potential Risk Factor for Extracutaneous Dissemination in Patients With Primary Cutaneous Follicle Center Lymphoma.","authors":"Anne M R Schrader, Ruben A L de Groen, Rein Willemze, Patty M Jansen, Koen D Quint, Tom van Wezel, Ronald van Eijk, Dina Ruano, Cornelis P Tensen, Arjan Diepstra, Anke van den Berg, Lianne Koens, Naomi Kakiailatu, Maarten H Vermeer, Joost S P Vermaat","doi":"10.1097/PAS.0000000000002436","DOIUrl":"https://doi.org/10.1097/PAS.0000000000002436","url":null,"abstract":"<p><p>Primary cutaneous follicle center lymphoma (PCFCL) is a type of cutaneous B-cell lymphoma with an indolent behavior and a 5-year disease-specific survival of 95%. Given the difficulty of identifying patients at risk for developing extracutaneous dissemination (ECD), this study aimed to identify predictors in the clinical presentation, histopathology, immune phenotype, and genetic profile of PCFCL patients by comparing those who developed ECD with those whose disease remained skin limited (SL) during follow-up. After review of clinical data and histopathology, a total of 13 ECD-PCFCL patients and 15 SL-PCFCL patients with varying treatments were included from the Dutch Cutaneous Lymphomas Registry. At diagnosis, all patients presented with classic PCFCL lesions on the trunk or head-and-neck region, and histology indicated a predominance of centrocytes admixed with centroblasts. IgM expression was significantly more frequent in ECD-PCFCL (54%) than in SL-PCFCL (7%; P=0.006). Targeted next-generation sequencing (NGS) with a 200 B-cell lymphoma-related gene panel demonstrated known PCFCL-like mutations in both groups. In addition, ECD-PCFCL demonstrated an enrichment of mutations associated with the activated B-cell genotype, including MYD88 (n=2), and some unique mutations, such as in ERBB4 (n=4). In conclusion, this study identified IgM expression at diagnosis as a potential biomarker for extracutaneous spread in PCFCL. In IgM-positive cases, genetic testing may be warranted. Patients with uncommon mutational profiles, such as those resembling the ABC-DLBCL genotype, may particularly benefit from closer follow-up and consideration of more aggressive treatment, including immuno-polychemotherapy. As these observations were made in a limited number of patients, our results require validation in an independent cohort.</p>","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serous Borderline Tumors of the Testis and Paratestis: A Clinicopathologic Study of 19 Tumors Emphasizing Morphologic Spectrum and Clinical Outcome.","authors":"Ali Shahabi, Aleksei Konstantinov, Jesse K McKenney, Jason Lane, Chia-Sui Kao, Sean R Williamson, Reza Alaghehbandan, Liang Cheng, Ankur R Sangoi, Emily Chan, Kristine M Cornejo, Christopher G Przybycin","doi":"10.1097/PAS.0000000000002439","DOIUrl":"https://doi.org/10.1097/PAS.0000000000002439","url":null,"abstract":"<p><p>Serous borderline tumors of the testis and paratestis are rare, and experience with these neoplasms is limited. We report a series of 19 tumors, emphasizing their morphologic spectrum and clinical behavior. Eighteen tumors (95%) had conventional serous borderline tumor morphology identical to ovarian serous borderline tumors, and 1 case (5%) had a pattern resembling the epithelial subtype of noninvasive implants of serous borderline tumor. A component of micropapillary serous borderline tumor was present in 6 tumors (31%), including 1 that was exclusively micropapillary. Five tumors (26%) had associated autoimplants. Microinvasion was identified in 4 tumors (21%). One tumor had associated low-grade serous carcinoma, and 1 tumor had associated high-grade serous carcinoma. Immunohistochemical stains demonstrated diffuse expression of PAX8 in 12 of 12 (100%) cases. Estrogen receptor was diffusely positive in 11 of 12 (92%) cases and progesterone receptor was positive in 8 of 9 (89%) cases. D2-40 was negative in 7 of 9 (78%) cases and calretinin was negative in 11 of 11 cases (100%). Clinical follow-up data were available in 9 patients (47%) with pure serous borderline tumors, of which 4 had micropapillary features (44%), 3 had microinvasion (33%), and 2 had autoimplants (22%). None of these 9 patients experienced adverse outcomes related to serous borderline tumor over the follow-up period (mean: 94 mo, median: 85 mo, range: 17 to 204 mo). Serous borderline tumors of the testis and paratestis are identical morphologically to their ovarian counterparts and can be associated with similar histologic phenomena (microinvasion, autoimplants, and micropapillary features). Although they can develop associated serous carcinoma, we conclude that serous borderline tumors of the testis and paratestis (when pure) appear to show indolent behavior.</p>","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic Signatures of Gastric Adenocarcinoma By Tumor Location-Modified Laurén Classification: Highlighting the Molecular Heterogeneity of Mixed-Type Tumors.","authors":"Harrison M Drebin, Henry Walch, Edaise M Da Silva, Shoji Shimada, Walid Chatila, Miseker Abate, Santosha Vardhana, Michael Berger, Murray F Brennan, Daniel Coit, Vivian E Strong, Laura H Tang","doi":"10.1097/PAS.0000000000002432","DOIUrl":"https://doi.org/10.1097/PAS.0000000000002432","url":null,"abstract":"<p><p>Tumor location-modified Laurén classification (mLC) of gastric adenocarcinoma (GAC) integrates Laurén histologic subtype and tumor location. mLC has been previously proposed and clinically validated as an independent prognostic indicator. However, the genomic signatures of GAC within the mLC system are unknown, particularly among mixed tumors. This study aimed to characterize the genomic signatures of GAC using the mLC system and to elucidate the genomic patterns of morphologically distinct components of mixed tumors. Treatment-naive GAC tumors were classified according to the mLC into 4 subgroups: proximal-intestinal, distal-intestinal, diffuse, and mixed types. The latter included 2 components: mixed-intestinal and mixed-signet ring. Sections of formalin-fixed, paraffin-embedded tissues were subjected to next-generation targeted sequencing. Tumors from 103 patients were included. The proximal-intestinal (n=28), distal-intestinal (n=34), and diffuse (n=25) subgroups exhibited distinct genomic alteration patterns. Among microsatellite stable cases, the proximal-intestinal subgroup was enriched for alterations in TP53, ERBB2, CDKN2A, and SMAD4, whereas the diffuse subgroup had significantly more alterations in CDH1 and ARID1A. The distal-intestinal subgroup had significantly more TP53 alterations than the diffuse subgroup. At the pathway level, both the proximal-intestinal and distal-intestinal subgroups had significantly higher TP53 pathway alterations than the diffuse subgroup. The proximal-intestinal subgroup had a significantly higher percentage of cell cycle, PI3K, and TGF-ß alterations than the diffuse subgroup. Both the mixed-intestinal and mixed-signet ring components of mixed tumors (n=16) exhibited alteration patterns that partially resembled those of the distal-intestinal and diffuse subgroups. The matched components of mixed tumors shared some, but not all, alterations. Overall, this study demonstrated distinct genomic patterns among the proximal-intestinal, distal-intestinal, and diffuse subgroups in the mLC system. The gene alteration patterns in the mixed-intestinal and mixed-signet ring components of mixed tumors exhibited partial similarities with both the distal-intestinal and diffuse subgroups. Furthermore, this study emphasizes how employing a multisampling approach can uncover the molecular heterogeneity of histologically distinct components of mixed-type tumors.</p>","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting Prostatic Atypical Intraductal Proliferations: Call for a Different Approach.","authors":"Murali Varma, Glen Kristiansen, Gladell P Paner, Ming Zhou","doi":"10.1097/PAS.0000000000002437","DOIUrl":"https://doi.org/10.1097/PAS.0000000000002437","url":null,"abstract":"","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing the Diagnosis of Germ Cell Tumors in Patients Presenting With Metastatic Disease: A Series of 55 Cases Emphasizing Challenges Commonly Encountered in Core Biopsies.","authors":"Swati Bhardwaj, Mohammad Salimian, Andres Matoso, John Gross, Pedram Argani, Ezra Baraban","doi":"10.1097/PAS.0000000000002438","DOIUrl":"https://doi.org/10.1097/PAS.0000000000002438","url":null,"abstract":"<p><p>Germ cell tumors (GCTs) are the most common nonhematopoietic malignancies in young men and typically present as primary testicular masses. However, in ∼12% of cases, GCTs manifest as metastatic disease without a known testicular primary, leading to significant diagnostic challenges. We retrospectively reviewed 55 cases of GCTs presenting as metastases, focusing on the morphologic and immunohistochemical pitfalls encountered in core biopsy specimens. Among a total of 55 cases, seminoma was the most common histologic subtype (61%), followed by embryonal carcinoma (14%) and mixed GCTs (13%), with a median age of 44 years (range: 21 to 87 y). The most frequently biopsied metastatic sites were the retroperitoneum (55%) and left neck (22%). Notably, only 7% of cases had an identified testicular mass at diagnosis. Only a third (32%) of cases were submitted with an initial diagnosis of GCT, while 10% were misclassified as non-GCT malignancies. Histologic features such as crush artifact (83%) and necrosis (54%) frequently obscured morphology, leading to extensive IHC panels. Cytokeratin expression (particularly CAM 5.2 and AE1/3) was identified in 51% of cases, often confounding the diagnosis. A greater number of IHC stains were performed at outside institutions compared with intramurally (9 vs. 4, P=0.0001). The use of OCT3/4 and CD30 proved crucial in diagnosing seminomas and embryonal carcinomas, respectively. In rare cases (n=4) with atypical histology, fluorescence in situ hybridization (FISH) for isochromosome 12p provided additional diagnostic support. Diagnosing metastatic germ cell tumors in needle biopsies remains a significant challenge, often compounded by lack of a known testicular mass, cytokeratin expression, and confounding histologic features such as crush artifact and necrosis that could be used as clues rather than impediments to diagnosis. Awareness of these findings, along with careful integration of clinical context, histology, and immunohistochemistry, is critical to avoid misdiagnosis, particularly in light of the exquisite chemosensitivity of GCTs. The use of reliable markers like OCT3/4 and CD30, coupled with a high index of suspicion in men with retroperitoneal or left neck masses, can aid in improving diagnostic accuracy.</p>","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a New Histopathologic Risk Model in Early Oral Tongue Cancer: A Combination of a Modified Worst Pattern of Invasion and a New Tumor Budding Score.","authors":"Alhadi Almangush, Tuula Salo, Caj Haglund, Luiz Paulo Kowalski, Jaana Hagström, Ricardo D Coletta, Antti A Mäkitie, Ilmo Leivo","doi":"10.1097/PAS.0000000000002433","DOIUrl":"https://doi.org/10.1097/PAS.0000000000002433","url":null,"abstract":"<p><p>Oral tongue squamous cell carcinoma (OTSCC) is the most common cancer of the oral cavity. A new histopathologic risk assessment has been recently introduced and we sought to validate its prognostic value in a large multicenter cohort of early-stage OTSCC. A total of 310 cases treated for early-stage OTSCC were included in this study. The assessment of modified worst pattern of invasion and a recently developed tumor budding score were performed in hematoxylin and eosin-stained sections. A statistically significant association was observed in the multivariable analysis between high score of the new risk model and worse disease-specific survival (HR: 2.54, 95% CI: 1.48-4.37, P<0.001). Similarly, in disease-free survival, the high-risk group was significantly associated with poor survival (HR: 1.66, 95% CI: 1.07-2.58, P=0.024). In conclusion, the new histopathologic risk model is a powerful prognostic indicator and can be assessed as part of routine diagnostic practice. Early-stage OTSCC patients with a high-risk score have a poor prognosis and therefore require a multimodality treatment strategy with a close clinical follow-up.</p>","PeriodicalId":7772,"journal":{"name":"American Journal of Surgical Pathology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}