Stolnicu Simona, Allison Douglas, Tessier-Cloutier Basile, Momeni-Boroujeni Amir, Hoang Lien, Ieni Antonio, Felix Ana, Terinte Cristina, Pesci Anna, Mateoiu Claudia, Hodgson Anjelica, Guerra Esther, de Brot Louise, Lastra Ricardo R, Kiyokawa Takako, Ali-Fehmi Rouba, Kheil Mira, Dundr Pavel, Roma Andres, Fadare Oluwole, Turashvili Gulisa, Oliva Esther, Devins Kyle M, Baiocchi Glauco, Cibula David, Soslow Robert A
Department of Pathology, University of Medicine, Pharmacy, Science and Technology 'George E Palade' of Targu Mures, Targu Mures, Romania.
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Pathology. 2025 Feb;57(1):17-26. doi: 10.1016/j.pathol.2024.07.008. Epub 2024 Sep 30.
The aim of this study was to determine whether the presence and extent of lymphovascular invasion (LVI) is prognostic in surgical stage I cervical squamous cell carcinoma (SCC). All available tumour slides and/or paraffin blocks from 426 patients with stage I cervical SCC treated surgically with curative intent were collected from 18 institutions and retrospectively analysed. Presence and extent of LVI (focal <5 spaces, extensive ≥5 spaces) were assessed on scanning magnification in large haematoxylin and eosin slide sets in 366 cases. Progression-free survival (PFS) was calculated as the time from surgery to first progression or death or last follow-up, whichever occurred first. Overall survival (OS) was defined as the time from surgery to death or last follow-up. Clinicopathological and statistical analyses were performed on 97 patients with the International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IA and 329 patients with stage IB SCC of the cervix. LVI, both focal and extensive, was more frequent in stage IB than in stage IA (p<0.001). Patients with stage IB carcinomas with extensive LVI had worse PFS [hazard ratio (HR) 2.86; 95% confidence interval (CI) 1.49, 5.49; p=0.005] and OS (HR 2.88; 95% CI 1.38, 6.02; p=0.012) than those with focal or no LVI. In stage IA, in contrast, the presence and extent of LVI did not associate with PFS (p=0.926) or OS. Extensive LVI was not statistically correlated with PFS and OS in substages IA1, IA2 or IB2. PFS (HR 3.7; 95% CI 1.61, 8.46; p<0.001) and OS (HR 4.18; 95% CI 1.58, 11.04; p=0.002) in stage IB1, and PFS (HR 7.78; 95% CI 0.87, 69.82; p=0.039) in stage IB3 were diminished in the presence of extensive LVI. In conclusion, in patients with FIGO stage I cervical SCC, the presence and extent of LVI has prognostic significance in stage IB carcinoma, and quantifying LVI is recommended.
本研究的目的是确定淋巴管侵犯（LVI）的存在及其程度在手术分期为I期的宫颈鳞状细胞癌（SCC）中是否具有预后价值。从18家机构收集了426例接受根治性手术治疗的I期宫颈SCC患者的所有可用肿瘤切片和/或石蜡块，并进行回顾性分析。在366例病例的苏木精和伊红大切片组中，在扫描放大倍数下评估LVI的存在及其程度（局灶性<5个间隙，广泛性≥5个间隙）。无进展生存期（PFS）计算为从手术到首次进展、死亡或最后一次随访的时间，以先发生者为准。总生存期（OS）定义为从手术到死亡或最后一次随访的时间。对97例国际妇产科联盟（FIGO）2018年IA期患者和329例宫颈IB期SCC患者进行了临床病理和统计分析。LVI，无论是局灶性还是广泛性，在IB期比IA期更常见（p<0.001）。IB期伴有广泛性LVI的癌患者的PFS[风险比（HR）2.86；95%置信区间（CI）1.49，5.49；p=0.005]和OS（HR 2.88；95%CI 1.38，6.02；p=0.0。012）比伴有局灶性LVI或无LVI的患者更差。相比之下，在IA期，LVI的存在及其程度与PFS（p=0.926）或OS无关。在IA1、IA2或IB2亚期中，广泛性LVI与PFS和OS无统计学相关性。在IB1期，伴有广泛性LVI时PFS（HR 3.7；95%CI 1.61，8.46；p<0.001）和OS（HR 4.18；95%CI 1.58，11.04；p=0.002）降低，在IB3期PFS（HR 7.78；95%CI 0.87，69.82；p=0.039）降低。总之，在FIGO I期宫颈SCC患者中，LVI的存在及其程度在IB期癌中具有预后意义，建议对LVI进行量化。
