Department of Pathology, All India Institute of Medical Sciences, RISHIKESH, INDIA.
Turk Patoloji Derg. 2022;38(3):227-234. doi: 10.5146/tjpath.2021.01566.
The oral squamous cell carcinoma (OSCC) treatment protocol depends upon lymph node metastasis. Elective neck dissection for early-stage OSCC (pT1/T2) elective neck dissection reduces the morbidity rate. It also reduces the overall survival and thus it becomes important to detect lymph node metastasis in early-stage OSCC.
Various histomorphological parameters have been studied to predict nodal metastasis in early-stage OSCC. We aim to evaluate these parameters in the context of nodal metastasis. 78 cases of early-stage OSCC were included in the study with histopathologic parameters like tumor size, grade, tumor depth of invasion (DOI), lymphovascular invasion (LVI), perineural invasion (PNI), worst pattern of invasion (WPOI), and lymph node level.
Out of the 78 patients, 32 patients had lymph node metastasis. T stage, DOI, LVI, and WPOI showed statistically significant deviance from the null model (P-values of 0.007, 0.01, 0.04 and 0.02 respectively). The Odds Ratio (OR) of T stage, DOI, LVI and WPOI were 4.45 (95% C.I =1.47-14.1), 4.4 (95% C.I =1.32-15.88), 8.12 (95% C.I =1.002-198.20), and 3.39 (95% C.I =1.24-9.74) respectively. On multivariate analysis (Firth logistic regression) using DOI, LVI, and WPOI as independent variables, only T-stage and WPOI retained statistical significance.
The prognostic information supplied by evaluating DOI, LVI, and WPOI warrants the inclusion of these parameters in the standard reporting format for all cases of OSCC.
口腔鳞状细胞癌（OSCC）的治疗方案取决于淋巴结转移。对于早期 OSCC（pT1/T2），选择性颈部清扫术可降低发病率。它还降低了总体生存率，因此在早期 OSCC 中检测淋巴结转移变得很重要。
已经研究了各种组织形态学参数来预测早期 OSCC 的淋巴结转移。我们旨在评估这些参数在淋巴结转移方面的作用。本研究纳入了 78 例早期 OSCC 病例，包括肿瘤大小、分级、肿瘤浸润深度（DOI）、淋巴血管侵犯（LVI）、神经周围侵犯（PNI）、侵袭最差模式（WPOI）和淋巴结水平等组织病理学参数。
在 78 例患者中，有 32 例发生了淋巴结转移。T 分期、DOI、LVI 和 WPOI 与零模型有统计学差异（P 值分别为 0.007、0.01、0.04 和 0.02）。T 分期、DOI、LVI 和 WPOI 的优势比（OR）分别为 4.45（95%置信区间为 1.47-14.1）、4.4（95%置信区间为 1.32-15.88）、8.12（95%置信区间为 1.002-198.20）和 3.39（95%置信区间为 1.24-9.74）。多变量分析（Firth 逻辑回归）使用 DOI、LVI 和 WPOI 作为自变量，只有 T 分期和 WPOI 保留统计学意义。
评估 DOI、LVI 和 WPOI 提供的预后信息证明有必要将这些参数纳入所有 OSCC 病例的标准报告格式中。
