Department of Pathology, Tata Medical Center, Kolkata, West Bengal, India.
Department of Head and Neck Surgical Oncology, Tata Medical Center, Kolkata, West Bengal, India.
Head Neck. 2021 Feb;43(2):520-533. doi: 10.1002/hed.26499. Epub 2020 Oct 6.
The prognostic significance of various histopathologic lymph node-based biomarkers in oral squamous cell carcinoma (OSCC) needs further evaluation.
Retrospective analysis of 212 OSCC patients with regional metastasis to determine the association of extranodal extension (ENE), extent of ENE, size of metastatic deposit, lymph node yield (LNY), lymph node ratio (LNR), and topography of involvement with survival outcomes.
The presence of ENE, larger nodal deposit, higher pN stage, lymph nodes in the lower levels, and patients who did not receive adjuvant treatment had poor disease-free survival (DFS). In addition, more positive nodes and high LNR showed worse overall survival (OS). ENE beyond 5 mm resulted in poorer outcomes. Larger sizes of metastatic deposit predisposed to ENE. Multivariate analyses showed only lower level of neck involvement to affect both DFS and OS.
Lymph node metastasis to lower levels and other lymph node characteristics affect prognosis and must be considered in the evolution of staging systems for OSCC.
各种基于组织病理学淋巴结的生物标志物在口腔鳞状细胞癌（OSCC）中的预后意义需要进一步评估。
回顾性分析 212 例局部转移的 OSCC 患者，以确定结外扩展（ENE）、ENE 程度、转移灶大小、淋巴结检出量（LNY）、淋巴结比率（LNR）和受累部位与生存结果的关系。
存在 ENE、更大的淋巴结沉积、更高的 pN 分期、较低水平的淋巴结以及未接受辅助治疗的患者无疾病生存（DFS）较差。此外，更多的阳性淋巴结和高 LNR 显示出较差的总生存（OS）。ENE 超过 5mm 导致预后更差。较大的转移灶大小易导致 ENE。多变量分析显示，仅颈部较低水平的受累影响 DFS 和 OS。
淋巴结向较低水平转移和其他淋巴结特征影响预后，必须在 OSCC 分期系统的发展中加以考虑。
