Head and Neck Oncology Department, Tata Memorial Hospital, Mumbai, India.
Head and Neck Oncology Department, Tata Memorial Hospital, Mumbai, India.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Apr;129(4):369-376. doi: 10.1016/j.oooo.2019.12.016. Epub 2020 Feb 5.
We observed that a prominent strip of depapillated mucosa surrounded tongue carcinomas. This study evaluates its correlation with other prognosticating factors.
This prospective study included treatment naïve squamous carcinomas of tongue operated between January and December 2018. Patients with any disorder that could possibly influence the presence of depapillation were excluded, and stratified based on the presence (Group A) and absence (Group B) of depapillation surrounding the tumor. Data sets included biochemical test, clinical variables, and postoperative histologic features. A multivariate logistic regression was performed to identify the association of these factors.
Group A comprised 62.8% (n = 76/121) of the entire cohort, which was reasonably distributed for tumor and host factors. A greater number of inadequate margins were found in Group A. Clinical factors significantly associated with depapillation included higher preoperative platelet count (>250.5), infection rates, and Clavien-Dindo scores. Perineural invasion and lymphocytic infiltrate were significantly associated with Group A, particularly in early tumors (P = .040).
Local invasion and inflammation results in papilla dysfunction clinically appearing as depapillation, leading to accumulation of neurotransmitters and a favorable environment for neural infiltration. We suggest peritumoral depapillation to be a clinical surrogate for perineural invasion, especially in early tongue cancers.
我们观察到，一条明显的去黏膜带环绕着舌癌。本研究评估其与其他预后因素的相关性。
这是一项前瞻性研究，纳入了 2018 年 1 月至 12 月期间手术治疗的未经治疗的原发性舌鳞状细胞癌患者。排除任何可能影响去黏膜的疾病的患者，并根据肿瘤周围是否存在去黏膜（A 组）和不存在去黏膜（B 组）进行分层。数据集包括生化检查、临床变量和术后组织学特征。采用多变量逻辑回归分析这些因素的相关性。
A 组（n=76/121）占整个队列的 62.8%，肿瘤和宿主因素分布合理。A 组中发现更多的切缘不足。与去黏膜相关的临床因素包括较高的术前血小板计数（>250.5）、感染率和 Clavien-Dindo 评分。神经周围侵犯和淋巴细胞浸润与 A 组显著相关，特别是在早期肿瘤中（P=0.040）。
局部浸润和炎症导致乳头功能障碍，临床上表现为去黏膜，导致神经递质的积累和有利于神经浸润的环境。我们建议肿瘤周围的去黏膜是神经周围侵犯的临床替代指标，特别是在早期舌癌中。
