口腔鳞状细胞癌的结外侵犯：临床和组织病理学分析。

Extranodal extension in oral squamous cell carcinoma: clinical and histopathological analysis.

机构信息

Department of Oral Oncology, Division of Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima Japan.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2024 Jun;137(6):632-639. doi: 10.1016/j.oooo.2024.03.008. Epub 2024 Mar 22.

DOI:10.1016/j.oooo.2024.03.008

PMID:38679502

Abstract

OBJECTIVE

Extranodal extension (ENE) is an important prognostic factor in oral squamous cell carcinoma (OSCC). This study aimed to evaluate the clinical significance of stratifying minor or major ENE in OSCC.

STUDY DESIGN

This retrospective cohort study included 75 patients who had undergone neck dissection for OSCC and were classified as pN+. ENE was measured using hematoxylin-eosin-stained specimens and stratified into major (ENEma, >2 mm) and minor (ENEmi, ≤2 mm) by distance. Their association with survival, locoregional relapse, and distant metastases were assessed.

RESULTS

Of 49 patients with pathological ENE, 23 had ENEmi, and 26 had ENEma. The 5-year overall survival (OS) was 38%, 66%, and 76% in the ENEma, ENEmi, and no ENE groups, respectively. Compared with no ENE, ENEma was associated with significantly decreased 5-year cumulative OS and disease-specific survival. ENEma was a risk factor for decreased OS (HR: 2.54, 95% CI: 1.04-6.18, P = .040) in the multivariable Cox regression analysis, and was associated with distant metastasis.

CONCLUSION

In patients with OSCC, ENEma is associated with a significantly poorer prognosis; therefore stratifying ENE is clinically relevant. ENEma may increase the risk of distant metastasis; therefore, new treatment modalities that contribute to distant metastasis control are required.

摘要

目的

结外侵犯（ENE）是口腔鳞状细胞癌（OSCC）的一个重要预后因素。本研究旨在评估在 OSCC 中对 minor 或 major ENE 进行分层的临床意义。

研究设计

本回顾性队列研究纳入了 75 例因 OSCC 而行颈清扫术且被分类为 pN+的患者。使用苏木精-伊红染色标本测量 ENE，并通过距离将其分为 major（ENEma，>2mm）和 minor（ENEmi，≤2mm）。评估其与生存、局部区域复发和远处转移的关系。

结果

在 49 例有病理 ENE 的患者中，23 例有 ENEmi，26 例有 ENEma。ENEma、ENEmi 和无 ENE 组的 5 年总生存率（OS）分别为 38%、66%和 76%。与无 ENE 相比，ENEma 与 5 年累积 OS 和疾病特异性生存率显著降低相关。ENEma 是 OS 降低的危险因素（HR：2.54，95%CI：1.04-6.18，P=0.040），与远处转移相关。