Tumor budding correlates with occult cervical lymph node metastasis and poor prognosis in clinical early-stage tongue squamous cell carcinoma
Tumor budding correlates with occult cervical lymph node metastasis and poor prognosis in clinical early-stage tongue squamous cell carcinoma
复制标题
临床早期舌鳞状细胞癌的肿瘤出芽与隐匿性颈部淋巴结转移和不良预后相关。
DOI：
10.1111/jop.12242
复制
发表时间：
2015-04-01
影响因子：
3.3
通讯作者：
Huang, Hongzhang
中科院分区：
文献类型：
--
作者：
Xie, Nan;Wang, Cheng;Huang, Hongzhang
背景
肿瘤出芽已被认为是各种人类癌症的预后因素。然而，早期（cT 1/2N 0）舌鳞状细胞癌的肿瘤出芽的预后价值仍然没有定论。本研究分析了cT 1/2N 0期舌鳞状细胞癌中肿瘤出芽与临床病理特征的关系及其预后意义。
方法
195例T1/2期舌鳞状细胞癌患者入组回顾性研究。对肿瘤浸润深度、肿瘤出芽强度及其他临床病理特征进行回顾性分析。采用Kaplan-Meier法评价总生存率。对于多变量分析，进行了考克斯比例风险回归模型。
结果
舌鳞癌中瘤芽的出现率约为85.6%。肿瘤出芽强度与淋巴结隐匿转移（P < 0.05）、局部复发（P < 0.01）、浸润深度（P <0.05）、浸润方式（P <0.01）密切相关。浸润深度与T分期及淋巴结转移有关（P <0.01）。高强度的肿瘤萌芽和更深的浸润深度都与总生存率降低相关。考克斯回归模型证明肿瘤出芽是临床早期舌鳞状细胞癌的独立预后因素。肿瘤局部复发也是舌鳞状细胞癌进展的预测因子。
结论
摘要肿瘤芽殖是舌鳞状细胞癌的常见现象。它可独立预测T1/2期舌鳞癌患者的预后，并可用于常规病理诊断和选择性淋巴结清扫的决策。
BACKGROUND
Tumor budding has been suggested to be a prognostic factor in various human cancers. However, the prognostic value of tumor budding for early-stage (cT1/2N0) tongue squamous cell carcinoma remains inconclusive. This study analyzed the correlation of tumor budding with the clinicopathologic features, and its prognostic significance for cT1/2N0 stage tongue squamous cell carcinoma.
METHODS
One hundred and ninety-five patients with T1/2 stage tongue squamous cell carcinoma enrolled in the retrospective study. Tumor invasive depth, the intensity of tumor budding, and other clinicopathological features were reviewed. Overall survivals were evaluated by the Kaplan-Meier method. For multivariable analysis, Cox's proportional hazards regression models were performed.
RESULTS
The frequency of tumor buds in tongue squamous cell carcinoma is about 85.6% in this study. The intensity of tumor budding showed strong correlations with occult lymph node metastasis (P < 0.05), local relapse (P < 0.01), worse invasive pattern (P < 0.01), and invasive depth (P < 0.05). The invasive depth was significantly associated with T classification (P < 0.01) and lymph node metastasis (P < 0.01). And both high intensity of tumor budding and deeper invasive depth correlated with reduced overall survival. Cox's regression models proved tumor budding to be an independent prognostic factor in clinical early-stage tongue squamous cell carcinoma. Tumor local relapses were also a predictor of tongue squamous cell carcinoma progression.
CONCLUSIONS
Tumor budding is a frequent event in tongue squamous cell carcinoma. It independently predicted prognosis of patients with T1/2 stage tongue squamous cell carcinoma and may be used for routing pathological diagnosis and the decision of elective lymph node dissection.