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Poor Correlation of Histologic Parameters Between Biopsy and Resection Specimen in Early Stage Oral Squamous Cell Carcinoma.

口腔早期鳞状细胞癌的活检和切除标本组织学参数相关性较差

Dik EA,Ipenburg NA,Adriaansens SO,Kessler PA,van Es RJ,Willems SM

Abstract

Infiltration depth, perineural growth (PG), vascular invasive growth (VG), and infiltrative growth (IG) are associated with regional metastases in oral squamous cell carcinomas (OSCCs). Preoperative knowledge of these parameters could facilitate the treatment planning of the neck. The aim of this study was to evaluate if the biopsy specimen correlates with the resection specimen.
In total, 149 patients with a pT1-2cN0 OSCC were included. Biopsy thickness and tumor thickness were analyzed. Occurrence of PG, VG, and IG was determined on biopsy and resection specimens and correlated with the N status and survival. Sensitivity, specificity, positive and negative predictive value, and diagnostic gain of the biopsy specimen were calculated.
N+ patients showed PG, VG, and IG significantly more often in the resection specimen compared with N- patients (P = .02, P = .001, and P = .001, respectively). Histologic parameters in the biopsy specimens did not correlate with N status or survival. The positive diagnostic gain for biopsy specimens with PG, VG, and IG was 57%, 40%, and 19%, respectively. The negative diagnostic gain was 2%, 0%, and 22%, respectively.
Histologic parameters in biopsy specimens do not represent the resection specimen. Determination of histologic parameters in routinely taken biopsy specimens of OSCC is not helpful in deciding whether to treat the neck.

摘要

目的 浸润深度、神经周围生长(PG)、血管侵袭性生长(VG)以及浸润性生长(IG)与口腔鳞状细胞癌(OSCCs)的区域淋巴结转移相关。术前获知这些参数能指导颈部手术治疗计划。本研究旨在评估活检标本与切除标本是否存在相关性

方法 共计149例pT1-2cN0 OSCC,分析活检标本中的浸润深度和肿瘤的浸润深度,判读活检和切除标本中PG、VG及IG的情况,分析它们与淋巴结转移和生存率的相关性,计算活检标本中PG、VG及IG的敏感性、特异性、阳性预测值和阴性预测值。

结果 切除标本中有淋巴结转移的病人,显示PG、VG和IG的发生频率远多于淋巴结无转移的病人(P值分别为0.02、0.001和0.001)。活检标本中的组织学参数与淋巴结转移或生存率无相关。活检标本中PG、VG和IG的敏感性分别为57%、 40%和19%,特异性分别为2%、0%和22%。

结论 活检标本中的组织学参数不能代表切除标本中的组织学参数,OSCC常规活检标本中组织学参数的判读对决定是否行颈部手术处理没有帮助。

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