Tumour budding activity and cell nest size determine patient outcome in oral squamous cell carcinoma: proposal for an adjusted grading system
Tumour budding activity and cell nest size determine patient outcome in oral squamous cell carcinoma: proposal for an adjusted grading system
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DOI：
10.1111/his.13173
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发表时间：
2017-06-01
期刊：
影响因子：
6.4
通讯作者：
Weichert, Wilko
中科院分区：
文献类型：
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作者：
Boxberg, Melanie;Jesinghaus, Moritz;Weichert, Wilko
口腔鳞状细胞癌（OSCC）是一种常见的恶性肿瘤，临床病程多变。在癌症中，一个公认的生存预测指标是肿瘤分级；然而，在OSCC中，根据世界卫生组织（WHO）的分级没有独立的预后影响。最近，一种对肺鳞状细胞癌患者预后影响较大的新型分级方案被提出。方法和结果为了探讨该方案是否适用于上气消化道，我们回顾性评估了157例未经化疗和放疗的OSCCs，这些OSCCs具有完整的临床随访数据，并对肿瘤出芽活性（BA）、细胞巢大小（CNS）、角化程度、基质含量、核大小和有丝分裂计数进行了标准化治疗。组织形态学特征与临床病理资料和患者预后相关。与肺鳞状细胞癌一样，高BA和小CNS与总生存期、疾病特异性生存期和无病生存期缩短显著相关。基于这两种预后标志物的总评分的三级分级系统被证明是一个强大的年龄、分期和性别无关的生存预后指标，与良好分化（G1）肿瘤相比，中分化（G2）肿瘤的总生存风险比为2.1，低分化（G3）肿瘤的总生存风险比为3.4 （P < 0.001）。结论：我们几乎准确地总结并验证了最近提出的肺鳞癌分级算法对预后的强烈影响。我们的数据可能为未来在空气消化道中广泛应用的与预后高度相关的鳞状细胞癌分级系统铺平道路。
AimsOral squamous cell carcinoma (OSCC) is a common malignancy with a variable clinical course. One of the established survival predictors in carcinomas in general is tumour grade; in OSCC, however, grading according to the World Health Organization (WHO) has no independent prognostic impact. Recently, a novel grading scheme associated with high impact on patient outcome has been proposed for squamous cell carcinoma of the lung.Methods and resultsTo probe whether this scheme could be applied to the upper aerodigestive tract, we retrospectively evaluated 157 chemo- and radiotherapy-naive OSCCs with complete clinical follow-up data and standardized treatment for tumour budding activity (BA), cell nest size (CNS), extent of keratinization, stromal content, nuclear size and mitotic count. Histomorphological characteristics were correlated with clinicopathological data and patient outcome. As in squamous cell carcinoma of the lung, high BA and small CNS were correlated significantly with shortened overall, disease-specific and disease-free survival. A three-tiered grading system based on a sum score of these two prognostic markers proved to be a strong age-, stage- and sex-independent prognosticator for survival with a hazard ratio for overall survival of 2.1 for intermediately differentiated (G2) tumours and 3.4 for poorly differentiated (G3) tumours compared to well-differentiated (G1) tumours (P < 0.001).ConclusionsWe recapitulated and validated almost exactly the strong prognostic impact of a grading algorithm proposed recently for squamous cell carcinoma of the lung in OSCC. Our data may pave the way for a prognostically highly relevant future squamous cell carcinoma grading system broadly applicable in the aerodigestive tract.