Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, 751003, India.
Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, 751003, India.
Clin Oral Investig. 2020 Feb;24(2):747-755. doi: 10.1007/s00784-019-02921-0. Epub 2019 May 28.
The role of tumour thickness (TT), depth of invasion (DOI) from two different reference points (TT2 and TT3), perineural invasion (PNI) and lymphovascular invasion (LVI) were evaluated to predict lymph node metastasis (LNM) in oral squamous cell carcinoma (OSCC). Reference points for measuring the DOI were suggested.
Paraffin-embedded tissues of excisional biopsy cases diagnosed as OSCC were sectioned and stained in haematoxylin and eosin to study variables like TT1, TT2, TT3, PNI and LVI. Out of total 150 cases collected for the study, 136, 123 and 149 cases were qualified for analysis of TT1, TT2 and TT3 respectively. The association with LNM was studied using chi square test of independence. A binary logistic regression model (BLC) was developed to indicate high-risk cases.
Receiver operating curve analysis suggested an optimum cut-off value. A significant correlation of TT1 (> 8.64, RR = 1.642, p = 0.018) and TT2 (> 7.64, RR = 2.041, p = 0.016), PNI (p = 0.028) and LVI (p = 0.000) were found with LNM. A mathematical model was suggested as Z = - 1.866 + 0.101TT2 + 2.106VI + e, where Z = log [(p/(1 - p)] p = probability of the case experiencing the event of interest.
With the suggestion of a standardised reference point to measure DOI for the first time, this study has shown an association of TT1, TT2, PNI and LVI with LNM in Indian Population. The mathematical model can help in identifying high-risk cases in OSCC.
Such studies would offer avenues for the pre-surgery assessment of depth of invasion and tumour thickness before performing neck dissection, thereby decreasing morbidity.
评估肿瘤厚度（TT）、来自两个不同参考点的浸润深度（DOI）（TT2 和 TT3）、神经周围侵犯（PNI）和脉管侵犯（LVI）在预测口腔鳞状细胞癌（OSCC）淋巴结转移（LNM）中的作用。提出了测量 DOI 的参考点建议。
对经手术切除活检诊断为 OSCC 的石蜡包埋组织进行切片并进行苏木精和伊红染色，以研究 TT1、TT2、TT3、PNI 和 LVI 等变量。在总共收集的 150 例病例中，分别有 136、123 和 149 例病例符合 TT1、TT2 和 TT3 分析的条件。使用独立性卡方检验研究与 LNM 的关联。建立二项逻辑回归模型（BLC）以指示高危病例。
接受者操作特征曲线分析建议了最佳截断值。TT1（>8.64，RR=1.642，p=0.018）和 TT2（>7.64，RR=2.041，p=0.016）以及 PNI（p=0.028）和 LVI（p=0.000）与 LNM 之间存在显著相关性。建议了一种数学模型，Z=-1.866+0.101TT2+2.106VI+e，其中 Z=-log [(p/(1-p)]，p=病例发生感兴趣事件的概率。
本研究首次提出了标准化参考点来测量 DOI，结果表明 TT1、TT2、PNI 和 LVI 与印度人群中的 LNM 相关。该数学模型可帮助识别 OSCC 中的高危病例。
此类研究将为在进行颈部解剖之前进行术前评估肿瘤厚度和浸润深度提供途径，从而降低发病率。
