嗜神经侵犯、WPOI-5与口腔鳞状细胞癌临床病理特征及预后的关系  

Clinicopathological and prognostic significance of perineural invasion and WPOI-5 in oral squamous cell carcinoma

作　　者：郑珂[1] 李国平[1] 王丽梅 黄立[3] 张声[1] ZHENG Ke;LI Guo-ping;WANG Li-mei;HUANG Li;ZHANG Sheng(Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China;Department of Pathology, Ningde Municipal Hospital of Ningde Normal University, Ningde 352199, China;Deparment of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China)

机构地区：[1]福建医科大学附属第一医院病理科,福州350005 [2]宁德师范学院附属宁德市医院病理科,宁德352199 [3]福建医科大学附属第一医院口腔颌面外科,福州350005

出　　处：《临床与实验病理学杂志》2022年第6期675-680,共6页Chinese Journal of Clinical and Experimental Pathology

基　　金：福建省科技创新联合资金项目(2019Y9112)。

摘　　要：目的探讨嗜神经侵犯、WPOI-5在口腔鳞状细胞癌进展及预后评估中的意义。方法收集2012年1月~2016年12月福建医科大学附属第一医院手术切除的135例口腔鳞状细胞癌,评估嗜神经侵犯及WPOI-5与口腔鳞状细胞癌临床病理特征的相关性并进行生存分析。结果135例口腔鳞状细胞癌中嗜神经侵犯发生率为37.8%(51/135),多灶嗜神经侵犯与肿瘤浸润深度(P<0.001)、淋巴结转移(P<0.001)、淋巴结被膜外浸润(P=0.03)及较高的TNM分期(P<0.001)等因素相关,WPOI-5发生率为22.2%(30/135),与肿瘤浸润深度加深(P=0.006)、淋巴结转移(P=0.014)及较高的TNM分期(P=0.018)等因素相关。生存分析显示:伴嗜神经侵犯、WPOI-5的口腔鳞状细胞癌患者总生存率较低,且嗜神经侵犯是影响预后的独立危险因素。结论多灶嗜神经侵犯、WPOI-5与口腔鳞状细胞癌侵袭性增加相关,建议将单灶与多灶嗜神经侵犯加以区别。Purpose To investigate the role and prognostic significance of perineural invasion(PNI)and worst pattern of invasion type-5(WPOI-5)in oral squamous cell carcinomas(OSCC).Methods A total of 135 cases of OSCC were collected from the First Affiliated Hospital of Fujian Medical University from January 2012 to December 2016.The presence of PNI and WPOI-5 were evaluated and correlation between PNI and WPOI-5 with clinicopathological features was explored.Kaplan-Meier and Cox regression were used for survival analyses.Results PNI was found in 37.8%(51/135)of patients.Multifocal PNI was associated with greater depth of invasion(P<0.001),lymph-node metastasis(P<0.001),extranodal extension(P=0.03)and higher TNM stage(P<0.001).Patients with positive multifocal PNI reported a worse OS(HR=5.644,P<0.001).WPOI-5 was found in 22.2%(30/135)of patients and was associated with greater depth of invasion(P=0.006),lymph-node metastasis(P=0.014)and higher TNM stage(P=0.018).PNI and WPOI-5 were correlated with poor overall survival in oral squamous cell carcinoma patients.PNI might serve as an independent prognostic factor.Conclusion Multifocal PNI and WPOI-5 expression are correlated with increased aggressive behavior of oral squamous cell carcinoma.It is suggested to differentiated multifocal PNI from unifocal PNI in the standard pathological report of OSCC.

关 键 词：口腔肿瘤 鳞状细胞癌 嗜神经侵犯 WPOI-5 预后 

分 类 号：R739.8[医药卫生—肿瘤]