Department of Oral and Maxillofacial Surgery and Central Laboratory, Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China.
Central Laboratory, Nanjing Stomatological Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, Jiangsu, China.
Virchows Arch. 2021 Jul;479(1):109-119. doi: 10.1007/s00428-020-03008-y. Epub 2021 Jan 13.
Depth of invasion (DOI) and pattern of invasion (POI) indicate tumor invasiveness of oral squamous cell carcinoma (OSCC). However, preoperative DOI evaluation is challenging, and the correlations between DOI and POI are unknown. We aimed to assess DOI and worst pattern of invasion (WPOI) in early-stage OSCC, and evaluate the preoperative predictive ability of biopsy pattern of invasion (BPOI) for WPOI and DOI. This retrospective study included n = 444 OSCC patients with pT1-2N0M0. The prognostic value of DOI, WPOI, and BPOI and the predictive prognostic option for WPOI and DOI by BPOI were assessed. WPOI (1-3 vs 4-5), but not BPOI, predicted the lowest survival rate and highest DOI. To evaluate the difference between WPOI and BPOI, we conducted a POI type-matching analysis of patients with BPOI1-4 and WPOI1-5. Based on each WPOI type, the false-prediction rates (FPR) of BPOI types 1 (n = 23), 2 (n = 89), 3 (n = 252), and 4 (n = 80) were 52.17%, 52.81%, 36.90%, and 0%, respectively. BPOI4 perfectly predict WPOI 4-5. As the false-predicted BPOI 1-2 was almost WPOI2-3 (79.7%), regardless of the existed FPR, patients with BPOI1-2 have longer survival and lower DOI than those with BPOI 4. However, this phenomenon was not observed in BPOI3, because all false-predicted BPOI3 were WPOI4-5 with a high DOI. We provide an alternative predictive prognostic option for WPOI and DOI by evaluating BPOI during OSCC surgical planning, with the recommendation of conservative treatment in patients with BPOI 1-2.
侵犯深度（DOI）和侵犯模式（POI）表明口腔鳞状细胞癌（OSCC）的肿瘤侵袭性。然而，术前 DOI 评估具有挑战性，并且 DOI 与 POI 之间的相关性尚不清楚。我们旨在评估早期 OSCC 的 DOI 和最差侵犯模式（WPOI），并评估活检侵犯模式（BPOI）对 WPOI 和 DOI 的术前预测能力。这项回顾性研究纳入了 n = 444 例 pT1-2N0M0 期 OSCC 患者。评估了 DOI、WPOI 和 BPOI 的预后价值，以及 BPOI 对 WPOI 和 DOI 的预测预后选择。WPOI（1-3 级 vs 4-5 级），而不是 BPOI，预测了最低生存率和最高 DOI。为了评估 WPOI 和 BPOI 之间的差异，我们对 BPOI1-4 和 WPOI1-5 的患者进行了 POI 类型匹配分析。基于每个 WPOI 类型，BPOI 类型 1（n = 23）、2（n = 89）、3（n = 252）和 4（n = 80）的假预测率（FPR）分别为 52.17%、52.81%、36.90%和 0%。BPOI4 可完美预测 WPOI 4-5。由于假预测的 BPOI 1-2 几乎都是 WPOI2-3（79.7%），因此无论存在 FPR 如何，BPOI1-2 的患者的生存率都较长，DOI 较低。然而，这种现象在 BPOI3 中并未观察到，因为所有假预测的 BPOI3 都是 WPOI4-5，DOI 较高。我们通过在 OSCC 手术计划期间评估 BPOI 为 WPOI 和 DOI 提供了另一种预测预后选择，并建议对 BPOI1-2 的患者进行保守治疗。
