Tumour budding evaluated in biopsy specimens is a useful predictor of prognosis in patients with cN0 early stage oral squamous cell carcinoma
Tumour budding evaluated in biopsy specimens is a useful predictor of prognosis in patients with cN0 early stage oral squamous cell carcinoma
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DOI：
10.1111/his.13144
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发表时间：
2017-05-01
期刊：
影响因子：
6.4
通讯作者：
Oyama, Tetsunari
中科院分区：
文献类型：
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作者：
Seki, Mai;Sano, Takaaki;Oyama, Tetsunari
目的：口腔鳞状细胞癌（OSCC）的预后取决于淋巴结转移（LNM）。我们最近报道了肿瘤出芽是舌和口腔底鳞状细胞癌（SCC）中LNM的一个很好的预测因素。我们的目的是评估肿瘤出芽是否是OSCC的一个良好预后因素。方法与结果：我们对209例OSCC的切口活检标本进行了常规的组织病理学检查和肿瘤出芽的新因素。探讨肿瘤出芽与LNM及预后的关系。在所有活检标本中使用全细胞角蛋白免疫染色评估出芽评分；用920物镜计数出芽焦数。单因素分析（P < 0.05）与LNM相关的显著因素为出芽评分（中高评分>= 3，高评分>= 5）、肿瘤分级（2和3）、肿瘤深度（>= 5 mm）、浸润模式（INF）、淋巴浸润和血管浸润。多因素分析发现出芽评分、INF和淋巴浸润是LNM的独立危险因素；特别是T1/2期和cN0期癌症患者的无复发生存相关的出芽评分采用Kaplan-Meier法和log-rank检验具有统计学意义。结论：肿瘤出芽评估可有效预测cN0早期OSCC的预后。在T1/2期和cN0期肿瘤，术前活检标本肿瘤萌芽评分为中等或较高时，应考虑预防性颈部清扫以预防LNM。
Aims: Oral squamous cell carcinoma (OSCC) prognosis depends upon lymph node metastasis (LNM). We have reported recently that tumour budding is a good predictive factor for LNM in squamous cell carcinoma (SCC) of the tongue and floor of the mouth (FOM). Our aim was to evaluate whether tumour budding is a good prognostic factor in OSCC.Methods and results: We examined conventional histopathological assessment and a new factor, tumour budding, in 209 cases of OSCC in incisional biopsy specimens. The relationship of tumour budding with LNM and prognosis was studied. The budding score was evaluated using immunostaining for pancytokeratin in all biopsies specimens; the number of budding foci was counted using a 920 objective lens. Significant factors using univariate analysis (P < 0.05) in association with LNM were the budding score (intermediate or high score >= 3; high score >= 5), tumour grade (2 and 3), tumour depth (>= 5 mm), infiltrative pattern (INF), lymphatic invasion and vessel invasion. In multivariate analysis, the budding score, INF and lymphatic invasion were found to be independent risk factors for LNM; in particular, budding score concerning relapse-free survival was statistically significant among patients with T1/2 stage and cN0 cancer using the Kaplan-Meier method and the log-rank test.Conclusions: The assessment of tumour budding is effective in predicting prognosis in cN0 early stage OSCC. In T1/2 stage and cN0 cancer, prophylactic neck dissection to prevent LNM should be considered when the tumour budding score regarding pre-operative biopsy specimens is intermediate or high.