Caruntu Ana, Moraru Liliana, Lupu Mihai, Ciubotaru Diana Alina, Dumitrescu Marius, Eftimie Lucian, Hertzog Radu, Zurac Sabina, Caruntu Constantin, Voinea Oana Cristina
Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania.
Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, "Titu Maiorescu" University, 031593 Bucharest, Romania.
J Clin Med. 2021 May 27;10(11):2343. doi: 10.3390/jcm10112343.
squamous cell carcinoma (SCC) is the second most common type of malignancy worldwide. Skin and mucosa of the head and neck areas are the most frequently affected. An aggressive behavior in SCC is not easily detected, and despite all efforts, mortality in these types of cancer did not show major improvements during recent decades. In this study, we aim to determine the role of histological features available through standard pathology assessment in SCC and their relation with tumor behavior and patients' survival.
in a group of one hundred patients diagnosed with SCC involving the head and neck areas, we assessed the presence of four histological features (tumor/stroma ratio, immune infiltration at the front of invasion, tumor-budding activity, and tumor necrosis), their correlations with tumor type (mucosal or cutaneous), tumor clinicopathological characteristics, and their prognostic potential.
the comparison between histological features in cutaneous versus mucosal SCC reveals no significant differences for any of the four parameters assessed. We found significant correlations between tumor/stroma ratio and lymphatic metastasis ( = 0.0275), perineural invasion ( = 0.0006), and clinical staging ( = 0.0116). Immune infiltration at the front of invasion revealed similar correlations with lymph node involvement ( = 0.002), perineural invasion ( = 0.0138), and clinical staging ( = 0.0043). Tumor budding and tumor necrosis correlated with the size of the tumor ( = 0.0077 and = 0.0004) and the clinical staging ( = 0.0039 and = 0.0143). In addition, tumor budding was significantly correlated with perineural invasion ( = 0.0454). In mucosal SCC, patients with improved outcome revealed high values for the tumor/stroma ratio ( = 0.0159) and immune infiltration at the front of invasion ( = 0.0274). However, the multivariate analysis did not confirm their independent prognostic roles.
extended histological assessments that include features such as tumor/stroma ratio, immune infiltration at the front of invasion, tumor budding, and tumor necrosis can be an easy, accessible method to collect additional information on tumor aggressiveness in skin and mucosa SCC affecting the head and neck areas.
鳞状细胞癌（SCC）是全球第二常见的恶性肿瘤类型。头颈部区域的皮肤和黏膜是最常受累的部位。SCC的侵袭性行为不易被察觉，尽管付出了诸多努力，但近几十年来这类癌症的死亡率并未有显著改善。在本研究中，我们旨在确定通过标准病理评估可得的组织学特征在SCC中的作用及其与肿瘤行为和患者生存的关系。
在一组100例被诊断为头颈部SCC的患者中，我们评估了四种组织学特征（肿瘤/基质比、侵袭前沿的免疫浸润、肿瘤芽生活性和肿瘤坏死）的存在情况，它们与肿瘤类型（黏膜或皮肤）、肿瘤临床病理特征的相关性以及它们的预后潜力。
皮肤SCC与黏膜SCC组织学特征的比较显示，所评估的四个参数中的任何一个均无显著差异。我们发现肿瘤/基质比与淋巴转移（P = 0.0275）、神经周围浸润（P = 0.0006）和临床分期（P = 0.0116）之间存在显著相关性。侵袭前沿的免疫浸润与淋巴结受累（P = 0.002）、神经周围浸润（P = 0.0138）和临床分期（P = 0.0043）显示出相似的相关性。肿瘤芽生和肿瘤坏死与肿瘤大小（P = 0.0077和P = 0.0004）以及临床分期（P = 0.0039和P = 0.0143）相关。此外，肿瘤芽生与神经周围浸润显著相关（P = 0.0454）。在黏膜SCC中，预后较好的患者肿瘤/基质比（P = 0.0159）和侵袭前沿的免疫浸润（P = 0.0274）值较高。然而，多变量分析未证实它们的独立预后作用。
扩展的组织学评估，包括肿瘤/基质比、侵袭前沿的免疫浸润、肿瘤芽生和肿瘤坏死等特征，可能是一种简便、可行的方法，用于收集有关影响头颈部区域皮肤和黏膜SCC肿瘤侵袭性的额外信息。
