Bryne M, Jenssen N, Boysen M
Department of Pathology, Norwegian Radium Hospital, Montebello, Oslo, Norway.
Virchows Arch. 1995;427(3):277-81. doi: 10.1007/BF00203395.
The characteristics of the deep invasive front area of squamous cell carcinomas may reflect tumour prognosis better than other parts of the tumour. Consequently, the authors have recently developed a simple malignancy grading system based solely on the characteristics of the deep invasive front area of oral squamous cell carcinomas, which has great prognostic value. Our previous materials were somewhat heterogeneous, and the prognostic value of our system needed to be confirmed in homogeneous patient material. In the present study of 95 T1-2/N0 glottic carcinomas all treated by radiation, the high prognostic value for invasive front grading of biopsy specimens is confirmed. The grading significantly predicted local recurrence, i.e. treatment failure (P = 0.001). Histological characteristics of the deep invasive front proved to be a better indicator of prognosis than the T-category (size of tumour), and our findings may be of value in the selection of treatment. Of the individual variables in the grading system (pattern of invasion, degree of keratinization, nuclear polymorphism and host response), pattern of invasion and degree of keratinization were the strongest prognosticators in the multivariate analyses. Invasive front characteristics may also prove to be of prognostic value in other cancers.
与肿瘤的其他部分相比，鳞状细胞癌深部浸润前沿区域的特征可能能更好地反映肿瘤预后。因此，作者最近仅基于口腔鳞状细胞癌深部浸润前沿区域的特征开发了一种简单的恶性分级系统，该系统具有很大的预后价值。我们之前的材料有些异质性，我们系统的预后价值需要在同质的患者材料中得到证实。在本研究中，95例均接受放疗的T1-2/N0声门癌患者中，活检标本浸润前沿分级的高预后价值得到了证实。该分级显著预测了局部复发，即治疗失败（P = 0.001）。深部浸润前沿的组织学特征被证明是比T分期（肿瘤大小）更好的预后指标，我们的发现可能对治疗选择有价值。在分级系统的各个变量（浸润模式、角化程度、核多形性和宿主反应）中，浸润模式和角化程度在多变量分析中是最强的预后指标。浸润前沿特征在其他癌症中可能也具有预后价值。
