Montalto Nausica, Battocchio Simonetta, Contro Giacomo, Gaudioso Piergiorgio, Mularoni Francesca, Ruaro Alessandra, Ramacciotti Giulia, Cazzador Diego, Spinato Giacomo, Carobbio Andrea Luigi Camillo, Taboni Stefano, Zanoletti Elisabetta, Piazza Cesare, Nicolai Piero, Ferrari Marco
Unit of Otorhinolaryngology-Head and Neck Surgery, Azienda Ospedale Università di Padova, Padova, Italy.
Unit of Pathology, ASST Spedali Civili di Brescia, Brescia, Italy.
Head Neck. 2025 Apr;47(4):1223-1238. doi: 10.1002/hed.28025. Epub 2024 Dec 17.
The anatomy of the tongue is three-dimensionally complex and is thought to play a central role in the local growth of oral tongue squamous cell carcinoma (OTSCC). Understanding patterns of tumor extension could improve a multimodal therapeutic approach. Thus, the main aim of this study was to provide a histological and microanatomical analysis of surgical specimens after compartmental surgery for OTSCC.
The present prospective observational study included primary cT3 OTSCC (according to the eighth edition of the TNM classification) treated in an academic tertiary referral center with curative compartmental surgery, from July 2016 to July 2019. Analysis of histologic macrosections allowed assessment of standard pathologic parameters as well as a detailed analysis of the position of OTSCC cells from microanatomic and topographic standpoints.
Of the 28 patients included, 71.4% were males, with a mean age of 64.9 years. Nine (32.1%) patients presented satellitosis, which was always located within the T-N tract. OTSCCs displaying satellitosis had a significantly higher median pathologic depth of invasion (DOI). A radiologic and pathological DOI > 15 mm significantly predicted the presence of satellites. There was a significant relationship between the presence of satellites and both positive lymph nodes and distant metastases.
Approximately one-third of cases of intermediate-to-advanced OTSCC are characterized by tumor satellites located in the T-N tract. DOI exceeding 15 mm and the presence of clinically appreciable nodal metastases best predict the presence of satellitosis. Satellite-bearing OTSCC behave more aggressively, with an increased risk of distant metastasis and reduced survival.
舌的解剖结构在三维空间上较为复杂，被认为在口腔舌鳞状细胞癌（OTSCC）的局部生长中起核心作用。了解肿瘤扩散模式有助于改进多模式治疗方法。因此，本研究的主要目的是对OTSCC进行分区手术后的手术标本进行组织学和微观解剖分析。
本前瞻性观察性研究纳入了2016年7月至2019年7月在一所学术性三级转诊中心接受根治性分区手术治疗的原发性cT3 OTSCC（根据TNM分类第八版）。对组织学大体切片的分析有助于评估标准病理参数，并从微观解剖和地形学角度对OTSCC细胞的位置进行详细分析。
纳入的28例患者中，71.4%为男性，平均年龄64.9岁。9例（32.1%）患者出现卫星灶，均位于T-N束内。出现卫星灶的OTSCC的中位病理浸润深度（DOI）显著更高。放射学和病理学DOI>15mm显著预测卫星灶的存在。卫星灶的存在与阳性淋巴结和远处转移均存在显著关系。
大约三分之一的中晚期OTSCC病例的特征是肿瘤卫星灶位于T-N束内。DOI超过15mm和临床上可察觉的淋巴结转移的存在最能预测卫星灶的存在。有卫星灶的OTSCC行为更具侵袭性，远处转移风险增加，生存率降低。
