Dhanda Jagtar, Uppal Nugdeep, Chowlia Harpreet, Opie Neil, Al-Qamachi Laith, Shelat Devesh, Aslam Adil, Yuffa Arie, Martin Timothy, Risk Janet, Triantafyllou Asterios, Shaw Richard, Parmar Satyesh, Mehanna Hisham
Department of Oral and Maxillofacial Surgery, University Hospital Birmingham, Edgbaston, Birmingham, United Kingdom.
Department of Molecular & Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom.
Head Neck. 2016 Apr;38 Suppl 1:E1857-62. doi: 10.1002/hed.24335. Epub 2015 Dec 24.
Traditional approaches in oral squamous cell carcinoma (OSCC) management utilize biopsy tissue for diagnostic purposes only. Adverse prognostic features, such as the tumor depth, are usually determined from final resection specimens, but are seldom studied in biopsy tissue.
A preliminary study of 139 consecutive biopsies compared biopsy size with T classification, tumor site, and operator grade, and biopsy tumor depth with the true tumor depth.
This study demonstrated that biopsy size is independent of T classification (p = .44), subsite (p = .86), and operator grade (p = .10). The biopsy tumor depth significantly underrepresented true tumor depth (2.5 mm, 95% confidence interval [CI] = 2.4-2.9 vs 8.2 mm, 95% CI = 6.5-9.9; p < .001), confirming the limited prognostic utility of biopsies in OSCC.
A future clinical trial will compare the routine biopsy technique with standardized deeper biopsy techniques using punch biopsy to sample invasive fronts and investigate opportunities for up-front staging using a combination of histological features and epithelial and stromal molecular biomarkers in OSCC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1857-E1862, 2016.
口腔鳞状细胞癌（OSCC）传统的治疗方法仅将活检组织用于诊断目的。不良预后特征，如肿瘤深度，通常是根据最终切除标本确定的，但很少在活检组织中进行研究。
对139例连续活检进行初步研究，比较活检标本大小与T分类、肿瘤部位及术者分级，并比较活检肿瘤深度与实际肿瘤深度。
本研究表明，活检标本大小与T分类（p = 0.44）、亚部位（p = 0.86）及术者分级（p = 0.10）无关。活检肿瘤深度显著低于实际肿瘤深度（2.5mm，95%置信区间[CI]=2.4 - 2.9 vs 8.2mm，95%CI = 6.5 - 9.9；p < 0.001），证实活检在OSCC中的预后价值有限。
未来的一项临床试验将比较常规活检技术与使用打孔活检对浸润前沿进行取样的标准化深部活检技术，并研究在OSCC中结合组织学特征以及上皮和间质分子生物标志物进行术前分期的机会。©2015威利期刊公司。《头颈》38：E1857 - E1862，2016年。
