Chatzistefanou Ioannis, Lubek Joshua, Markou Konstantinos, Ord Robert A
Department of Oral and Maxillofacial Surgery, 401 General Military Hospital, Athens, Greece.
Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD, USA.
J Craniomaxillofac Surg. 2017 Jun;45(6):821-825. doi: 10.1016/j.jcms.2017.02.022. Epub 2017 Feb 24.
The role of perineural invasion (PNI) in the management of patients with oral squamous cell carcinoma (OSSC) is still controversial, and there is no consensus regarding the most appropriate therapeutic approach. The purpose of this study is to review the findings in the literature describing OSCC as a neurotropic malignancy, with the aim of correlating perineural invasion with treatment decisions and disease prognosis.
A literature search was conducted of references based on the MEDLINE and Cochrane Database of Systematic Reviews, with subject keywords including four main categories: perineural invasion, perineural spread, oral squamous cell cancinoma, neurotropic carcinoma.
In this systematic review and analysis, more than 350 publications met the eligibility criteria of the authors.
Perineural invasion (PNI) is a widely recognized indicator of poor prognosis in oral cancer patients, strongly correlating with aggressive tumor behavior, disease recurrence, and increased morbidity and mortality. Elective neck dissection could be an indicator in improving neck control in PNI-positive patients, while the addition of adjuvant postoperative radiotherapy may not significantly improve survival rates. Various molecular markers have been correlated with perineural tumor spread, but further investigations are required before targeting PNI as part of advanced cancer therapies.
神经周围浸润（PNI）在口腔鳞状细胞癌（OSSC）患者管理中的作用仍存在争议，对于最合适的治疗方法也未达成共识。本研究的目的是回顾文献中关于OSCC作为一种嗜神经恶性肿瘤的研究结果，旨在将神经周围浸润与治疗决策和疾病预后相关联。
基于MEDLINE和Cochrane系统评价数据库进行文献检索，主题关键词包括四个主要类别：神经周围浸润、神经周围扩散、口腔鳞状细胞癌、嗜神经癌。
在本次系统评价和分析中，超过350篇出版物符合作者的纳入标准。
神经周围浸润（PNI）是口腔癌患者预后不良的一个广泛认可的指标，与侵袭性肿瘤行为、疾病复发以及发病率和死亡率增加密切相关。选择性颈部清扫可能是改善PNI阳性患者颈部控制的一个指标，而术后辅助放疗的加入可能不会显著提高生存率。各种分子标志物已与神经周围肿瘤扩散相关，但在将PNI作为晚期癌症治疗的一部分进行靶向治疗之前，还需要进一步研究。
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