肿瘤浸润深度对口腔鳞状细胞癌患者临床结局的预后预测价值
The Prognosis Predictive Value of Tumor Depth of Invasion on the Clinical Outcomes of Oral Squamous Cell Carcinoma Patients.
作者信息
Mohamed Talal Mohamed Ahmed Eltayib, Eltohami Yousif Idris
机构信息
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Nile University, Khartoum, Sudan.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan.
出版信息
J Maxillofac Oral Surg. 2025 Jun;24(3):699-706. doi: 10.1007/s12663-025-02524-1. Epub 2025 Apr 8.
OBJECTIVES
This study was conducted for the first time in the Sudan that aimed to assess whether the tumor depth of invasion (DOI) in oral squamous cell carcinoma (OSCC) is a prognosticator for regional nodal metastasis, locoregional recurrence, survival and identify the cutoff point for metastasis.
METHODS
Descriptive retrospective cross-sectional hospital based study carried out at Khartoum Teaching Dental Hospital (KTDH) and histopathology laboratory, University of Khartoum. Records of patients were retrieved from the archives of KTDH and the histopathological records were retrieved from archival specimens of Oral Pathology laboratory, University of Khartoum. Data of patients who underwent primary radical surgery for OSCC and neck dissection at KTDH were reviewed.
RESULTS
A total of 127 cases, 84 were males and 43 were females.Sixty-seven were snuff dippers.Thirty-six of the total number of snuff dippers favored the lower labial vestibule. Lower gingivolabial area was the favorite site for OSCC that encountered in 52 patients. In the present study, 93 of patients presented with stage IV and the predominant grade was well differentiated squamous cell carcinoma that found in 67 patients. There is a high significant association between depth of invasion and recurrence. Among 60 patients who developed recurrence, 55 of them had DOI ≥ 4 mm. From total of 24 patients with DOI > 4 mm, six patients died, and from total of 101 patients with DOI ≥ 4 mm, 62 patients died that indicated a high significant association between depth of invasion and death with a survival period 27.05 ± 23.08 months in patients with DOI ≥ 4 mm and 44.77 ± 19.20 months in patients with DOI < 4 mm. Patients with positive surgical margins were 9.9 timed more likely to develop recurrence.
CONCLUSIONS
DOI of OSCC is a reliable histological parameter to predict nodal metastasis, locoregional recurrence and survival with 4 mm cutoff point.
目的
本研究首次在苏丹开展，旨在评估口腔鳞状细胞癌（OSCC）的肿瘤浸润深度（DOI）是否为区域淋巴结转移、局部区域复发、生存的预后指标，并确定转移的临界值。
方法
在喀土穆教学牙科医院（KTDH）和喀土穆大学组织病理学实验室开展基于医院的描述性回顾性横断面研究。从KTDH的档案中检索患者记录，并从喀土穆大学口腔病理学实验室的存档标本中检索组织病理学记录。对在KTDH接受OSCC原发根治性手术和颈部清扫术的患者数据进行回顾。
结果
共127例患者，男性84例，女性43例。67例为鼻烟使用者。鼻烟使用者总数中的36例偏好下唇前庭。下牙龈唇沟区域是52例患者中OSCC最常发生的部位。在本研究中，93例患者为IV期，主要病理分级为高分化鳞状细胞癌，共67例。浸润深度与复发之间存在高度显著相关性。在60例出现复发的患者中，55例的DOI≥4mm。在DOI>4mm的24例患者中，6例死亡；在DOI≥4mm的101例患者中，62例死亡，这表明浸润深度与死亡之间存在高度显著相关性，DOI≥4mm患者的生存期为27.05±23.08个月，DOI<4mm患者的生存期为44.77±19.20个月。手术切缘阳性的患者复发可能性高9.9倍。
结论
OSCC的DOI是预测淋巴结转移、局部区域复发和生存的可靠组织学参数，临界值为4mm。
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