Tumor-stroma ratio can predict lymph-node metastasis in cT1/2N0 oral tongue squamous cell carcinoma independent of tumor budding grade
Tumor-stroma ratio can predict lymph-node metastasis in cT1/2N0 oral tongue squamous cell carcinoma independent of tumor budding grade
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DOI：
10.1007/s10147-022-02249-y
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发表时间：
2022-10-05
影响因子：
3.3
通讯作者：
Yamasoba, Tatsuya
中科院分区：
文献类型：
--
作者：
Sakai, Toshihiko;Saito, Yuki;Yamasoba, Tatsuya
背景 cT1/2 口腔舌鳞状细胞癌 (OTSCC) 经常转移至颈部淋巴结。然而，预测颈部淋巴结转移（NLM）仍然具有挑战性。据报道，肿瘤出芽等级（TBG）和肿瘤间质比（TSR）的病理形态学评估可以预测淋巴结转移。因此，本研究旨在评估 OTSCC 中的 TBG 和 TSR，并探讨它们与隐匿性 NLM 和癌症复发的关系。方法收集2007年至2017年东京大学医院收治的cT1/2N0 OTSCC患者的临床病理资料。使用苏木精-伊红染色和细胞角蛋白AE1/AE3免疫染色评估TBG和TSR。结果 在 70 名患者中，16 名患者除了原发肿瘤切除术外还接受了选择性颈清扫术，而 54 名则没有。随访期间，35 名患者发现 NLM。在单变量分析中，NLM 与病理浸润深度 (pDOI) (p < 0.001)、TBG (p = 0.008) 和 TSR (p < 0.001) 相关，在多变量分析中，NLM 与 pDOI (p = 0.01) 和 TSR (p = 0.02) 相关。对于 pDOI 5 mm 且基质丰富的肿瘤患者，5 年无复发生存率 (RFS) 为 78%。结论 pDOI > 5 mm 和富含基质的肿瘤患者癌症复发的风险较高。 TSR 和 pDOI 可能是 cT1/2N0 OTSCC 有希望的 NLM 预测因子。
Background cT1/2 oral tongue squamous cell carcinoma (OTSCC) often metastasizes to cervical lymph nodes. However, predicting neck lymph-node metastasis (NLM) remains challenging. Pathomorphological evaluation of tumor budding grade (TBG) and tumor-stroma ratio (TSR) reportedly can predict lymph-node metastases. Hence, this study aimed to evaluate TBG and TSR in OTSCC and investigate their relationship to occult NLM and cancer relapse. Methods Clinicopathological data of patients with cT1/2N0 OTSCC treated at the University of Tokyo Hospital between 2007 and 2017 were collected. TBG and TSR were evaluated using hematoxylin-eosin staining and cytokeratin AE1/AE3 immunostaining. Results Out of 70 patients, 16 underwent elective neck dissection in addition to primary-tumor resection, whereas 54 did not. During follow-up, NLM was found in 35 patients. NLM correlated with the pathological depth of invasion (pDOI) (p < 0.001), TBG (p = 0.008), and TSR (p < 0.001) in univariate analysis and pDOI (p = 0.01) and TSR (p = 0.02) in multivariate analysis. The 5-year recurrence-free survival rate (RFS) was 78% for patients with a pDOI 5 mm and stroma-rich tumors. Conclusion Patients with a pDOI > 5 mm and stroma-rich tumors have a high risk for cancer relapse. TSR and pDOI may be promising NLM predictors in cT1/2N0 OTSCC.