Divya G M, Thomas Shaji, Anila K R, Kannan S, Vimal Joseph, Varghese Bipin T, Iype Elizabeth M, George Nebu A, Mathew Aleyamma
Division of Head & Neck Services, Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala India.
Government Medical College, Kannur, Pariyaram, Kerala India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4307-4315. doi: 10.1007/s12070-024-04842-1. Epub 2024 Jul 8.
We aimed to determine the association between the worst pattern of tumor invasion (WPOI) and epithelial-mesenchymal transition (EMT) in early-stage oral tongue squamous cell carcinoma (OTSCC) with no adverse features and their impact on 2-year disease-free survival (DFS) and overall survival (OS) rates.
This prospective observational study included treatment-naive 50 patients who underwent primary surgery for OTSCC (pT1T2N0M0; AJCC 8th edition, with no adverse features) from June 1, 2020, to March 31, 2021 (minimum follow-up period, 2 years). WPOI (low- or high-invasive) and EMT (E-cadherin, N-cadherin, and vimentin expression at the tumor invasive front) were assessed.
High invasive WPOI was seen in 66% and low invasive in 34%. 80% of the patients had EMT. No statistically significant association was found between WPOI and EMT. The OS and DFS at 2 years were 90% and 80% respectively. WPOI had statistically significant impact on 2-year DFS (100% for low & 69.7% for high, -value 0.014). EMT did not significantly affect DFS or OS rates.
In early stage OTSCC with no adverse features, WPOI can be a promising predictor for disease recurrence. However, this should be validated for modifying treatment guidelines.
我们旨在确定早期无不良特征的口腔舌鳞状细胞癌（OTSCC）中肿瘤侵袭最差模式（WPOI）与上皮-间质转化（EMT）之间的关联，以及它们对2年无病生存率（DFS）和总生存率（OS）的影响。
这项前瞻性观察性研究纳入了2020年6月1日至2021年3月31日期间50例未经治疗的OTSCC患者（pT1T2N0M0；美国癌症联合委员会第8版，无不良特征），这些患者接受了原发手术（最短随访期为2年）。评估了WPOI（低侵袭性或高侵袭性）和EMT（肿瘤侵袭前沿的E-钙黏蛋白、N-钙黏蛋白和波形蛋白表达）。
66%的患者表现为高侵袭性WPOI，34%为低侵袭性。80%的患者发生了EMT。未发现WPOI与EMT之间存在统计学上的显著关联。2年时的OS和DFS分别为90%和80%。WPOI对2年DFS有统计学上的显著影响（低侵袭性为100%，高侵袭性为69.7%，P值为0.014）。EMT对DFS或OS率没有显著影响。
在无不良特征的早期OTSCC中，WPOI可能是疾病复发的一个有前景的预测指标。然而，这一点应通过修改治疗指南来进行验证。
