用于皮肤鳞状细胞癌风险分层的神经周围浸润：一项范围综述
Perineural Invasion for Risk Stratification in Cutaneous Squamous Cell Carcinoma: A Scoping Review.
作者信息
Crüts Emmy C, Moermans Myrthe M G, Abdul Hamid Myrurgia, Nelemans Patty J, Mosterd Klara
机构信息
Department of Dermatology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Grow Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.
出版信息
Dermatology. 2025;241(2):203-209. doi: 10.1159/000542772. Epub 2024 Nov 27.
BACKGROUND
Microscopic perineural invasion (mPNI) is a histopathological characteristic that can be found in cutaneous squamous cell carcinoma (cSCC). In the eighth edition of the American Joint Committee on Cancer (AJCC), mPNI defined as the involvement of nerves ≥0.1 mm and nerves deeper than the dermis is included in risk stratification of cSCC. The question remains whether other mPNI features are important for optimal cSCC staging. We aimed to summarize the evidence from published studies on the independent association between various mPNI features and the risk of recurrence, metastasis and disease-specific death in patients with cSCC.
SUMMARY
Embase, PubMed, and Web of Science were searched from January 2023 to February 2024 to identify studies that reported the prognostic impact of mPNI features in patients ≥18 years with histopathologically verified cSCC. Data on study and tumour characteristics were extracted. Nineteen studies met the inclusion criteria and evaluated one or more mPNI features in cSCC including nerve diameter, the extent of mPNI, the number of affected nerves, and depth of mPNI. Two studies provided evidence that "mPNI ≥0.1 mm" and "mPNI deeper than the dermis" are significantly and independently associated with poor prognosis after correction for other mPNI features and high-risk factors. One of these studies additionally identified "involvement of ≥3 nerves" as an independent and significant predictor of higher risk of local recurrence (HR, 2.17; 95% CI: 1.03-4.56; p = 0.04).
KEY MESSAGES
Besides "nerve diameter of ≥0.1 mm" and "depth of mPNI involvement," "involvement of multiple nerves" was found to be an independent risk factor for poor prognosis and should also be considered for appropriate risk stratification.
BACKGROUND
Microscopic perineural invasion (mPNI) is a histopathological characteristic that can be found in cutaneous squamous cell carcinoma (cSCC). In the eighth edition of the American Joint Committee on Cancer (AJCC), mPNI defined as the involvement of nerves ≥0.1 mm and nerves deeper than the dermis is included in risk stratification of cSCC. The question remains whether other mPNI features are important for optimal cSCC staging. We aimed to summarize the evidence from published studies on the independent association between various mPNI features and the risk of recurrence, metastasis and disease-specific death in patients with cSCC.
SUMMARY
Embase, PubMed, and Web of Science were searched from January 2023 to February 2024 to identify studies that reported the prognostic impact of mPNI features in patients ≥18 years with histopathologically verified cSCC. Data on study and tumour characteristics were extracted. Nineteen studies met the inclusion criteria and evaluated one or more mPNI features in cSCC including nerve diameter, the extent of mPNI, the number of affected nerves, and depth of mPNI. Two studies provided evidence that "mPNI ≥0.1 mm" and "mPNI deeper than the dermis" are significantly and independently associated with poor prognosis after correction for other mPNI features and high-risk factors. One of these studies additionally identified "involvement of ≥3 nerves" as an independent and significant predictor of higher risk of local recurrence (HR, 2.17; 95% CI: 1.03-4.56; p = 0.04).
KEY MESSAGES
Besides "nerve diameter of ≥0.1 mm" and "depth of mPNI involvement," "involvement of multiple nerves" was found to be an independent risk factor for poor prognosis and should also be considered for appropriate risk stratification.
背景
微观神经侵犯（mPNI）是皮肤鳞状细胞癌（cSCC）中可发现的一种组织病理学特征。在美国癌症联合委员会（AJCC）第八版中，mPNI定义为神经受累≥0.1毫米且神经位于真皮深层，其被纳入cSCC的风险分层。问题仍然在于，其他mPNI特征对于cSCC的最佳分期是否重要。我们旨在总结已发表研究中关于各种mPNI特征与cSCC患者复发、转移及疾病特异性死亡风险之间独立关联的证据。
总结
检索了Embase、PubMed和Web of Science数据库，时间跨度为2023年1月至2024年2月，以确定报告mPNI特征对组织病理学确诊的≥18岁cSCC患者预后影响的研究。提取了关于研究和肿瘤特征的数据。19项研究符合纳入标准，并评估了cSCC中的一种或多种mPNI特征，包括神经直径、mPNI范围、受累神经数量和mPNI深度。两项研究提供的证据表明，在对其他mPNI特征和高危因素进行校正后，“mPNI≥0.1毫米”和“mPNI深于真皮”与不良预后显著且独立相关。其中一项研究还确定“≥3条神经受累”是局部复发风险较高的独立且显著预测因素（HR，2.17；95%CI：1.03 - 4.56；p = 0.04）。
关键信息
除了“神经直径≥0.1毫米”和“mPNI受累深度”外，“多条神经受累”被发现是预后不良的独立危险因素，在进行适当的风险分层时也应予以考虑。
背景
微观神经侵犯（mPNI）是皮肤鳞状细胞癌（cSCC）中可发现的一种组织病理学特征。在美国癌症联合委员会（AJCC）第八版中，mPNI定义为神经受累≥0.1毫米且神经位于真皮深层，其被纳入cSCC的风险分层。问题仍然在于，其他mPNI特征对于cSCC的最佳分期是否重要。我们旨在总结已发表研究中关于各种mPNI特征与cSCC患者复发、转移及疾病特异性死亡风险之间独立关联的证据。
总结
检索了Embase、PubMed和Web of Science数据库，时间跨度为2023年1月至2024年2月，以确定报告mPNI特征对组织病理学确诊的≥18岁cSCC患者预后影响的研究。提取了关于研究和肿瘤特征的数据。19项研究符合纳入标准，并评估了cSCC中的一种或多种mPNI特征，包括神经直径、mPNI范围、受累神经数量和mPNI深度。两项研究提供的证据表明，在对其他mPNI特征和高危因素进行校正后，“mPNI≥0.1毫米”和“mPNI深于真皮”与不良预后显著且独立相关。其中一项研究还确定“≥3条神经受累”是局部复发风险较高的独立且显著预测因素（HR，2.17；95%CI：1.03 - 4.56；p =
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