Barrett Andrew W, Pratt Murray K, Sassoon Isabel, Bisase Brian S, Newman Laurence, Tighe John V, Norris Paul M, Dhanda Jag, Gulati Aakshay
Department of Histopathology, Queen Victoria Hospital NHSF Trust, East Grinstead, UK.
Maxillofacial Unit, Queen Victoria Hospital NHSF Trust, East Grinstead, UK.
J Oral Pathol Med. 2021 Jan;50(1):32-38. doi: 10.1111/jop.13104. Epub 2020 Sep 14.
Perineural invasion (PNI) and lymphovascular invasion (LVI) may be adverse prognostic indicators in squamous cell carcinoma (SCC) of the tongue.
The percentages of histological PNI and LVI were determined in 335 patients with tongue SCC. Sixty tumours originally reported as negative for these features were tested to determine how many more were positive with "immunohistochemical enhancement."
PNI was found in 141 (42.1%) and LVI in 51 (15.2%) patients. 79.4% of the 141 patients who had PNI and 72.6% of the 51 with LVI had a T3 or T4 tumour. Lymph node metastasis was identified in 145 (51.2%) of the 280 patients who had undergone neck dissection; 58.2% of the 141 patients with PNI and 80.4% of the 51 patients with LVI had lymph node metastasis. There was a highly statistically significant correlation between PNI with increasing pT (P < .00001) and pN (P < .0001) stage, and a statistically significant correlation between LVI and pT stage (P < .001), the association of LVI with pN status could not be reliably tested statistically. Immunohistochemistry for S100 identified five further cases of PNI, but review of the original H&E showed the feature was present in four and had been missed at original reporting. CD31 identified three further possible cases of LVI and D2-40 none. The endothelium of some vascular channels was positive for both CD31 and D2-40 and cross-reactivity with other cells compromised interpretation.
Histological identification of PNI and LVI per se remains of uncertain prognostic significance. "Immunohistochemical enhancement" offered little benefit.
神经周围浸润（PNI）和淋巴管浸润（LVI）可能是舌鳞状细胞癌（SCC）的不良预后指标。
测定了335例舌SCC患者的组织学PNI和LVI百分比。对最初报告这些特征为阴性的60个肿瘤进行检测，以确定经“免疫组化增强”后还有多少个呈阳性。
141例（42.1%）患者发现有PNI，51例（15.2%）患者发现有LVI。141例有PNI的患者中79.4%以及51例有LVI的患者中72.6%有T3或T4肿瘤。在280例行颈部清扫术的患者中，145例（51.2%）发现有淋巴结转移；141例有PNI的患者中58.2%以及51例有LVI的患者中80.4%有淋巴结转移。PNI与pT分期增加（P <.00001）和pN分期增加（P <.0001）之间存在高度统计学显著相关性，LVI与pT分期之间存在统计学显著相关性（P <.001），LVI与pN状态之间的关联无法进行可靠的统计学检验。S100免疫组化又发现5例PNI，但复查原始苏木精-伊红（H&E）切片显示该特征在4例中存在，最初报告时被漏诊。CD31又发现3例可能的LVI，D2-40未发现。一些血管通道的内皮细胞CD31和D2-40均呈阳性，且与其他细胞的交叉反应影响了结果判读。
PNI和LVI本身的组织学鉴定的预后意义仍不确定。“免疫组化增强”作用不大。
