Cervical lymph node metastasis in oral squamous cell carcinoma: a correlative study between histopathological malignancy grading and lymph node metastasis.
Cervical lymph node metastasis in oral squamous cell carcinoma: a correlative study between histopathological malignancy grading and lymph node metastasis.
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DOI：
10.4103/0970-9290.123385
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发表时间：
2013-09
期刊：
影响因子：
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通讯作者：
S. Acharya;A. T. Sivakumar;S. Shetty
中科院分区：
文献类型：
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作者：
S. Acharya;A. T. Sivakumar;S. Shetty
背景在过去的几十年里，组织学分级已被用作口腔鳞状细胞癌的预后因素和临床行为评估。与此同时，不同分级分类的预后价值仍存在争议。大多数组织病理学分级系统的一个主要问题是观察者内部和观察者之间的分歧。目的和目的 验证原发肿瘤的组织学评估在预测宫颈转移方面的预后效率，识别与宫颈转移最密切相关的肿瘤组织学特征，并通过使用 kappa 统计测量观察者内和观察者间的一致性来评估多因素分级 (MFG) 系统的可靠性。材料和方法 从我们机构 2007 年至 2010 年报告的 292 例鳞状细胞癌病例中随机选择 60 例。所有病例均根据 Modified Broders 描述系统和 Anneroth 等人的 MFG 系统进行分级。两名病理学家独立对肿瘤前沿进行分级，对淋巴结转移不知情。结果 MFG 显示组织学恶性程度与淋巴结转移之间存在显着关系。在分级的各个组成部分中，转移性和非转移性患者之间的核多态性和侵袭模式存在显着差异。观察者内部和观察者间的一致性是可以接受且令人满意的。结论 观察者之间中等至良好的一致性极大地提高了 MFG 系统的有效性。多因素恶性肿瘤分级可以作为颈部淋巴结转移的预测因子。
BACKGROUND Histologic grading has been used as a prognostic factor and for clinical behavior evaluation of oral squamous cell carcinoma for the past several decades. At the same time, the prognostic value of different grading classifications remains controversial. A major problem for most histopathological grading systems is the intraobserver and interobserver disagreement. AIMS AND OBJECTIVES To validate the prognostic efficiency of the histologic assessment of the primary tumor in predicting cervical metastasis, to identify those histologic features in the tumor most closely associated with cervical metastasis and to evaluate the reliability of the multifactorial grading (MFG) system by measuring intraobserver and interobserver agreement using kappa statistic. MATERIALS AND METHODS A set of 60 cases were chosen at random out of the 292 squamous cell carcinoma cases reported in our institution from 2007 to 2010. All cases were graded according to: Modified Broders' descriptive system and Anneroth et al., MFG system. Two Pathologists independently graded the tumor forefront blinded to the node metastasis. RESULTS The MFG showed a significant relation between the degree of histologic malignancy and presence of metastasis in the nodes. Among the components of grading, a significant difference was observed in the nuclear polymorphism and the pattern of invasion between the metastatic and non-metastatic patients. Intraobserver and interobserver agreement was acceptable and satisfactory. CONCLUSIONS Moderate to good agreement between observers greatly increases the validity of the MFG system. The multifactorial malignancy grading could serve as a predictor for metastasis in the cervical lymph nodes.