Hamada Mei, Ebihara Yasuhiro, Yoshida Saori, Saito Naoko, Enoki Yuichro, Inoue Hitoshi, Matsumura Satoko, Nakahira Mitsuhiko, Yasuda Masanori, Sugasawa Masashi
Pathology, Saitama Medical University International Medical Center, Saitama, JPN.
Pathology, Saitama Medical University, Saitama, JPN.
Cureus. 2023 Feb 1;15(2):e34516. doi: 10.7759/cureus.34516. eCollection 2023 Feb.
The depth of invasion (DOI) of tongue squamous cell carcinoma (SCC) is an important prognostic factor. The definition is clear for pathological DOI (pDOI), but the treatment strategy is determined by the preoperative clinical DOI (cDOI). Few studies have investigated the difference between these DOIs. The purpose of this study was to obtain the correlation equation between cDOI and pDOI for Stage I/II tongue SCC and to consider the points to be noted in actual clinical practice.
In this retrospective study, 58 patients with clinical stage I/II tongue SCC were included. Correlations between cDOI and pDOI were obtained for all 58 cases, as well as for 39 cases which excluded superficial and exophytic lesions.
The overall cDOI and pDOI median values were 8.0 and 5.5 mm, respectively; the 2.5 mm reduction was significant (p < 0.01). The correlation equation was pDOI = 0.81 × cDOI-0.23 (r = 0.73). Furthermore, re-analysis of the 39 cases revealed that pDOI = 0.84 × cDOI-0.37 (r = 0.62). Hence, a derived equation pDOI = 0.84 × (cDOI-0.44) was obtained to predict pDOI from cDOI.
This study indicated that it is necessary to consider contraction due to specimen fixation by subtracting the thickness of the mucosal epithelium. Clinical T1 cases with a cDOI of 5 mm or less had a pDOI of 4 mm or less, and it would be expected to have low positive rate of neck lymph node metastasis.
舌鳞状细胞癌（SCC）的浸润深度（DOI）是一个重要的预后因素。病理DOI（pDOI）的定义明确，但治疗策略由术前临床DOI（cDOI）决定。很少有研究调查这两种DOI之间的差异。本研究的目的是获得I/II期舌SCC的cDOI与pDOI之间的相关方程，并考虑实际临床实践中应注意的要点。
在这项回顾性研究中，纳入了58例临床I/II期舌SCC患者。对所有58例病例以及排除浅表和外生性病变的39例病例进行了cDOI与pDOI之间的相关性分析。
总体cDOI和pDOI的中位数分别为8.0和5.5mm；减少2.5mm具有显著性（p < 0.01）。相关方程为pDOI = 0.81×cDOI - 0.23（r = 0.73）。此外，对39例病例的重新分析显示，pDOI = 0.84×cDOI - 0.37（r = 0.62）。因此，得到了一个从cDOI预测pDOI的推导方程pDOI = 0.84×（cDOI - 0.44）。
本研究表明，有必要通过减去黏膜上皮的厚度来考虑标本固定导致的收缩。cDOI为5mm或更小的临床T1病例，其pDOI为4mm或更小，预计颈部淋巴结转移阳性率较低。
