Sawazaki-Calone I, Rangel Alca, Bueno A G, Morais C F, Nagai H M, Kunz R P, Souza R L, Rutkauskis L, Salo T, Almangush A, Coletta R D
Oral Pathology and Oral Medicine, Dentistry School, Western Paraná State University, Cascavel, Brazil.
Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
Oral Dis. 2015 Sep;21(6):755-61. doi: 10.1111/odi.12343. Epub 2015 Apr 24.
This study evaluated the association of four histopathological grading systems (WHO grading system, malignancy grading of the deep invasive margins (MG), histological risk (HR) model, and tumor budding and depth of invasion (BD) model) with clinicopathological parameters and outcome of 113 oral squamous cell carcinomas to identify their roles in prognosis.
Demographic and clinical features were obtained from patients' records. Sections from all paraffin-embedded blocks were evaluated according to the four grading systems. Demographic and clinical associations were analyzed using chi-square test, and correlations between the grading systems were established with the Spearman's rank correlation test. Survival curves were performed with Kaplan-Meier method, and multivariate analysis based on Cox proportional hazard model was calculated.
Significant associations with survival were observed for WHO grading system and BD model in the univariate analysis, but only the BD model was significantly associated with disease outcome as an independent prognostic marker. Age, tumor size, and presence of regional metastasis were also independent markers of reduced survival.
A significant association between the BD model and outcome of OSCC patients was observed, indicating this new histopathological grading system as a possible prognostic tool.
本研究评估了四种组织病理学分级系统（世界卫生组织分级系统、深部浸润边缘恶性程度分级（MG）、组织学风险（HR）模型以及肿瘤芽生与浸润深度（BD）模型）与113例口腔鳞状细胞癌的临床病理参数及预后的相关性，以确定它们在预后中的作用。
从患者记录中获取人口统计学和临床特征。根据这四种分级系统对所有石蜡包埋块的切片进行评估。使用卡方检验分析人口统计学和临床相关性，并通过Spearman秩相关检验建立分级系统之间的相关性。采用Kaplan-Meier方法绘制生存曲线，并基于Cox比例风险模型进行多变量分析。
在单变量分析中，观察到世界卫生组织分级系统和BD模型与生存有显著相关性，但只有BD模型作为独立的预后标志物与疾病预后显著相关。年龄、肿瘤大小和区域转移的存在也是生存降低的独立标志物。
观察到BD模型与口腔鳞状细胞癌患者的预后之间存在显著相关性，表明这种新的组织病理学分级系统可能是一种预后工具。
