Perineural and vascular invasion in oral cavity squamous carcinoma: increased incidence on re-review of slides and by using immunohistochemical enhancement.
Perineural and vascular invasion in oral cavity squamous carcinoma: increased incidence on re-review of slides and by using immunohistochemical enhancement.
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DOI：
10.1043/1543-2165(2005)129
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发表时间：
2005-03
影响因子：
4.6
通讯作者：
Kevin A. Kurtz;H. Hoffman;M. Zimmerman;R. Robinson
中科院分区：
文献类型：
--
作者：
Kevin A. Kurtz;H. Hoffman;M. Zimmerman;R. Robinson
背景：周围神经侵犯和血管侵犯可能是口腔鳞状细胞癌患者的不良预后因素。然而，文献中神经周围和血管浸润的发生率各不相同，并且尚未评估使用免疫组织化学来增强其在口腔鳞状细胞癌中的检测。目的：通过复查原始常规苏木精-伊红染色切片，以及复查S100和CD31免疫组织化学染色的载片，以增强神经和血管的显像，确定先前评估的口腔鳞状细胞癌患者神经和血管浸润的发生率是否会增加。设计回顾40例口腔鳞状细胞癌，其周围神经和血管的侵犯状况已成为原始病理报告的一部分。我们检查了所有原始的常规染色切片，以及每个病例中含有肿瘤的组织块的S100和cd31染色切片。结果在原始报告中，30%（12/ 40）的肿瘤被确定为神经周围浸润，在作者对同一载玻片的重新审查中，62%（25/40）的肿瘤被确定为神经周围浸润，在S100染色时，82%（33/40）的肿瘤被确定为神经周围浸润。在原始报告中，30%（12/40）的肿瘤被发现有血管浸润，在作者对同一载玻片的重新审查中，35%（14/40）的肿瘤被发现有血管浸润，在CD31染色时，42%（17/40）的肿瘤被发现有血管浸润。假阳性和假阴性结果在原始报告中很常见。两种侵袭灶的数量与其在原始报告中的发现有关。在5年随访中，血管浸润与死亡有显著相关性，而非神经周围浸润。结论：虽然仔细复查常规染色玻片可以发现大量的神经周围和血管侵犯病例，但免疫组织化学增强可以进一步提高确定的准确性。
CONTEXT Perineural invasion and vascular invasion may be adverse prognostic factors in patients with oral cavity squamous cell carcinoma. However, the incidence of perineural and vascular invasion varies in the literature, and the use of immunohistochemistry to enhance their detection has not been evaluated in oral cavity squamous cell carcinomas. OBJECTIVE To determine if the previously assessed incidence of perineural and vascular invasion in cases of oral cavity squamous cell carcinoma would be increased by re-review of the original routinely hematoxylin-eosin-stained sections as well as review of slides stained immunohistochemically with S100 and CD31 to enhance visualization of nerves and vessels. DESIGN Forty cases of oral cavity squamous cell carcinoma in which the status of perineural and vascular invasion had been part of the original pathology report were reviewed. All original routinely stained slides were reviewed as well as S100- and CD31-stained sections of each case's tissue blocks that contained tumor. RESULTS Perineural invasion was identified in 30% (12/ 40) of tumors in the original reports, 62% (25/40) of the authors' re-review of the same slides, and 82% (33/40) when cases were stained with S100. Vascular invasion was identified in 30% (12/40) of tumors in the original reports, 35% (14/40) of the authors' re-review of the same slides, and 42% (17/40) when cases were stained with CD31. False-positive and false-negative results were common in the original reports. The number of foci of both types of invasion was related to its discovery in the original reports. Vascular invasion, but not perineural invasion, was significantly associated with death at 5-year follow-up. CONCLUSIONS Although careful re-review of routinely stained slides will detect a significant number of cases of perineural and vascular invasion, immunohistochemical enhancement further improves the accuracy of the determination.