口腔鳞状细胞癌中侵袭最差模式在预测结外扩散方面的临床价值。
Clinical value of the worst pattern of invasion in predicting extranodal extension in oral squamous cell carcinoma.
作者信息
Higaki Mirai, Ando Toshinori, Obayashi Fumitaka, Ito Nanako, Hirota Suguru, Hamada Atsuko, Yamasaki Sachiko, Shintani Tomoaki, Koizumi Koichi, Yanamoto Souichi
机构信息
Division of Dentistry, Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
Center for Oral Clinical Examination, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
出版信息
Discov Oncol. 2025 Jul 4;16(1):1259. doi: 10.1007/s12672-025-03058-1.
OBJECTIVE
Extranodal extension (ENE) is one of the major influencing factors for the oncological outcomes in oral squamous cell carcinoma (OSCC). We aimed to elucidate the clinical features predictive of ENE in OSCC.
MATERIALS AND METHODS
We conducted a retrospective analysis of patients with OSCC who underwent neck dissection (ND) with a confirmed pN + status. Cases in which the histopathological evaluation was compromised by preoperative chemotherapy or radiotherapy were excluded. Histopathological evaluation of extent of ENE category and grading of worst pattern of invasion (WPOI) was compared for available cases.
RESULTS
Fifty-nine patients met the inclusion criteria for the study. Of these, 32/59 (54.2%) were ENE-positive. A higher incidence of ENE was observed in cases where ND was performed at a separate time from the primary tumor resection (odds ratio [OR] = 11.0, 95% confidence interval [95%CI] 2.23-54.5, P = 0.003). Additionally, a higher grade of WPOI (WPOI 4 or 5) was significantly associated with ENE occurrence (OR = 4.53, 95%CI 1.19-20.50, P = 0.026). A positive correlation between the WPOI grade and ENE extent was also identified (ρ = 0.412, P <.001).
CONCLUSION
We demonstrated an association between WPOI and ENE in patients with OSCC.
目的
结外侵犯（ENE）是影响口腔鳞状细胞癌（OSCC）肿瘤学预后的主要因素之一。我们旨在阐明OSCC中预测ENE的临床特征。
材料与方法
我们对接受了证实为pN+状态的颈清扫术（ND）的OSCC患者进行了回顾性分析。排除术前化疗或放疗影响组织病理学评估的病例。对可用病例比较ENE类别范围的组织病理学评估和最差浸润模式（WPOI）分级。
结果
59例患者符合研究纳入标准。其中，32/59（54.2%）为ENE阳性。在与原发肿瘤切除分开进行ND的病例中观察到更高的ENE发生率（优势比[OR]=11.0，95%置信区间[95%CI]2.23-54.5，P=0.003）。此外，更高等级的WPOI（WPOI 4或5）与ENE发生显著相关（OR=4.53，95%CI 1.19-20.50，P=0.026）。还确定了WPOI分级与ENE范围之间存在正相关（ρ=0.412，P<0.001）。
结论
我们证明了OSCC患者中WPOI与ENE之间存在关联。
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