Novel pathological predictive factors for extranodal extension in oral squamous cell carcinoma: a retrospective cohort study based on tumor budding, desmoplastic reaction, tumor-infiltrating lymphocytes, and depth of invasion.
Novel pathological predictive factors for extranodal extension in oral squamous cell carcinoma: a retrospective cohort study based on tumor budding, desmoplastic reaction, tumor-infiltrating lymphocytes, and depth of invasion.
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DOI：
10.1186/s12885-022-09393-8
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发表时间：
2022-04-13
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影响因子：
3.8
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中科院分区：
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结外侵犯是口腔鳞状细胞癌预后不良的因素。通过临床和/或放射学检查识别ENE是困难的，从而导致不必要的颈部解剖。目前，没有明确的预测ENE。因此，我们的目的是确定组织学预测ENE的常规组织病理学检查活检和手术切除标本。这项回顾性研究包括186例手术切除的OSCC和83例匹配的活检标本。与肿瘤微环境相关的临床特征，包括促结缔组织增生反应（DR），肿瘤出芽（TB）和肿瘤浸润淋巴细胞（TILs），使用苏木精和伊红染色的原发性OSCC和颈淋巴结清扫标本进行了评估。这些组织学特征分为两组：DR-未成熟（DR-I）和DR-成熟（DR-M）; TB-高（TB-H）和TB-低（TB-L）;以及TILs-低（TILs-L）和TILs-高（TILs-H）。临床浸润深度（cDOI）和病理浸润深度（pDOI）分别适用于活检和切除; DOI以DOI > 10 mm和DOI ≤ 10 mm为标准。分析这些组织病理学特征与ENE的临床病理学关系以及ENE的独立危险因素。评估ENE的组织学预测因素。活检和切除标本中存在的DR、TILs和TB的组织学状态与ENE的组织学状态具有较高的准确性。DR-I、TILs-L和TB-H与淋巴结转移、cDOI和pDOI显著相关。双变量和多变量分析显示，TB-H和pDOI > 10 mm是存在ENE（ENE +）的独立因素。切除标本中TB-H/pDOI > 10 mm的组合显示出关于ENE +的高特异性（91%）和准确性（83%）。尽管在活检中没有证实独立因素，但DR-I和TILs-L与ENE +显著相关（p < 0.001）。活检组织中DR-1/TILs-L/cDOI > 10 mm的组合对ENE +表现出高灵敏度和特异性（分别为70%和77%，p < 0.001）。这些组织学预测因子甚至可以检测到较小的ENE（< 2 mm）。原发性OSCC的肿瘤微环境状态与ENE显著相关，TB-H是ENE的独立危险因素。活检标本中DR-I/TILs-L/cDOI > 10 mm和切除标本中TB-H/pDOI > 10 mm的组织学状态是ENE的有用预测因子。在线版本包含补充材料，可通过10.1186/s12885-022-09393-8获得。
Extranodal extension (ENE) is a poor prognostic factor for oral squamous cell carcinoma (OSCC). Identifying ENE by clinical and/or radiological examination is difficult, thereby leading to unnecessary neck dissections. Currently, no definitive predictors are available for ENE. Thus, we aimed to determine the histological predictors of ENE by routine histopathological examination using biopsy and surgically resected specimens. This retrospective study included 186 surgically resected OSCC and 83 matched biopsy specimens. Clinical features associated with the tumor microenvironment, including desmoplastic reaction (DR), tumor budding (TB), and tumor-infiltrating lymphocytes (TILs), were evaluated using hematoxylin and eosin-stained primary OSCC and neck dissection specimens. These histological features were divided into two groups: DR-immature (DR-I) and DR-mature (DR-M); TB-high (TB-H) and TB-low (TB-L); and TILs-low (TILs-L) and TILs-high (TILs-H). Clinical depth of invasion (cDOI) and pathological DOI (pDOI) were adapted for biopsies and resections, respectively; DOI was evaluated as DOI > 10 mm and DOI ≤ 10 mm. The clinicopathological relationships between these histopathological features and ENE and the independent risk factors for ENE were analyzed. The histological predictors of ENE were evaluated. The histological status of DR, TILs, and TB present in biopsy and resection specimens showed high accuracy with that of ENE. DR-I, TILs-L, and TB-H were significantly associated with lymph node metastasis, cDOI, and pDOI. Bivariate and multivariate analyses revealed that TB-H and pDOI > 10 mm in resections were independent factors for the presence of ENE (ENE +). The combination of TB-H/pDOI > 10 mm in resection specimens showed high specificity (91%) and accuracy (83%) regarding ENE + . Although there proved to be no independent factors in biopsies, DR-I and TILs-L were significantly associated with ENE + (p < 0.001). The combination of DR-I/TILs-L/cDOI > 10 mm in biopsies exhibited high sensitivity and specificity with ENE + (70% and 77%, respectively, p < 0.001). These histological predictors could detect even minor ENE (< 2 mm). The tumor microenvironment status in primary OSCC was significantly associated with that of ENE, and TB-H was an independent risk factor for ENE. The histological status of DR-I/TILs-L/cDOI > 10 mm in biopsy specimens and TB-H/pDOI > 10 mm in resection specimens is a useful predictor of ENE. The online version contains supplementary material available at 10.1186/s12885-022-09393-8.
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影响因子：
8.8
作者：
Dhanda J;Triantafyllou A;Liloglou T;Kalirai H;Lloyd B;Hanlon R;Shaw RJ;Sibson DR;Risk JM
通讯作者：
Risk JM
影响因子：
3.9
作者：
HASE, K;SHATNEY, C;VIERRA, M
通讯作者：
VIERRA, M
影响因子：
3.8
作者：
Fu, Jin-Ye;Zhu, Ling;Zhang, Zhi-Yuan
通讯作者：
Zhang, Zhi-Yuan
影响因子：
1
作者：
Lop, Joan;Rigo, Antoni;Leon, Xavier
通讯作者：
Leon, Xavier
影响因子：
6.2
作者：
Huang, Shao Hui;Hwang, David;O'Sullivan, Brian
通讯作者：
O'Sullivan, Brian