Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Department of Gynecologic Oncology, Shanxi Cancer Hospital, Taiyuan, China.
Eur J Surg Oncol. 2024 Jun;50(6):108313. doi: 10.1016/j.ejso.2024.108313. Epub 2024 Mar 28.
The study aimed to evaluate the accuracy of perineural invasion (PNI) diagnosis in cervical cancer, and to analyze the impact of PNI on the prognosis and postoperative adjuvant treatment decisions for cervical cancer.
A retrospective pathological review of PNI in cervical cancer was conducted from 2004 to 2016 in 15 hospitals.
This study included a total of 1208 cases, comprising 273 cases with PNI and 935 cases without. The false positive rate and false negative rate of PNI diagnosis were 5.35% (50/935) and 33.33% (91/273), respectively. Adenocarcinoma, deep stromal invasion, lymphovascular space invasion (LVSI) (+), and margin involvement were independent risk factors for PNI. Both 5-year overall survival rate (OS) and 5-year disease-free survival rate (DFS) of PNI group were worse than non-PNI group. PNI was an independent risk factor for 5-year OS and 5-year DFS. In cases receiving standard postoperative adjuvant treatment, among those with two intermediate-risk factors, both 5-year OS and DFS were worse in the PNI group. Among cases with three intermediate-risk factors or at least one high-risk factor, there was no difference in 5-year OS between the two groups, but 5-year DFS was worse in the PNI group.
The diagnosis of PNI in cervical cancer was not accurate. Adenocarcinoma, deep stromal invasion, LVSI, and margin involvement were independent risk factors for PNI. PNI was an independent risk factor for 5-year OS and DFS. PNI has the potential to serve as a new high-risk factor, thus providing guidance for postoperative adjuvant therapy.
本研究旨在评估宫颈癌神经周围侵犯（PNI）诊断的准确性，并分析 PNI 对宫颈癌预后和术后辅助治疗决策的影响。
对 2004 年至 2016 年 15 家医院的宫颈癌 PNI 进行回顾性病理审查。
本研究共纳入 1208 例患者，其中 273 例有 PNI，935 例无 PNI。PNI 诊断的假阳性率和假阴性率分别为 5.35%（50/935）和 33.33%（91/273）。腺癌、深肌层浸润、脉管间隙浸润（LVSI）（+）和边缘受累是 PNI 的独立危险因素。PNI 组的 5 年总生存率（OS）和 5 年无病生存率（DFS）均较非 PNI 组差。PNI 是 5 年 OS 和 5 年 DFS 的独立危险因素。在接受标准术后辅助治疗的病例中，在具有两个中危因素的病例中，PNI 组的 5 年 OS 和 DFS 均较差。在具有三个中危因素或至少一个高危因素的病例中，两组 5 年 OS 无差异，但 PNI 组 5 年 DFS 较差。
宫颈癌 PNI 的诊断并不准确。腺癌、深肌层浸润、LVSI 和边缘受累是 PNI 的独立危险因素。PNI 是 5 年 OS 和 DFS 的独立危险因素。PNI 有可能成为新的高危因素，为术后辅助治疗提供指导。
