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Chen G, Sun H, Chen Y, Wang L, Song O, Zhang J, Li D, Liu X, Feng L. Perineural Invasion in Cervical Cancer: A Hidden Trail for Metastasis. Diagnostics (Basel) 2024; 14:1517. [PMID: 39061654 PMCID: PMC11275432 DOI: 10.3390/diagnostics14141517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
Perineural invasion (PNI), the neoplastic invasion of nerves, is an often overlooked pathological phenomenon in cervical cancer that is associated with poor clinical outcomes. The occurrence of PNI in cervical cancer patients has limited the promotion of Type C1 surgery. Preoperative prediction of the PNI can help identify suitable patients for Type C1 surgery. However, there is a lack of appropriate preoperative diagnostic methods for PNI, and its pathogenesis remains largely unknown. Here, we dissect the neural innervation of the cervix, analyze the molecular mechanisms underlying the occurrence of PNI, and explore suitable preoperative diagnostic methods for PNI to advance the identification and treatment of this ominous cancer phenotype.
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Affiliation(s)
- Guoqiang Chen
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
- Department of Gynecology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Hao Sun
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Yunxia Chen
- Department of Gynecology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Li Wang
- Department of Gynecology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Ouyi Song
- Department of Gynecology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Jili Zhang
- Department of Gynecology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Dazhi Li
- Department of Gynecology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Xiaojun Liu
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Lixia Feng
- Department of Gynecology, The People’s Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
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de Melo GM, de Medeiros GS, Gatti AP, Guilherme LH, das Neves MC, Rosano M, Callegari FM, Russell J, Abrahao M, Cervantes O. Perineural Invasion as Worsening Criterion for Salivary Gland Mucoepidermoid Carcinoma. Indian J Otolaryngol Head Neck Surg 2022; 74:6225-6235. [PMID: 36742669 PMCID: PMC9895527 DOI: 10.1007/s12070-021-02957-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023] Open
Abstract
Mucoepidermoid carcinomas (MECs) are a form of salivary gland malignancy. They are classified according to histological grade and perineural invasion (PNI). In another cancer subtypes, positive-PNI suggests increased poor prognosis; however, the role of isolated positive-PNI salivary gland MEC can still be better investigated as a risk factor. This study investigated whether isolated PNI is independently associated with poor outcomes. Retrospective study, cohort case-series, single-center hospital from 2009 to 2019. Patient demographics, primary tumor, intervention, and survival data are included. Univariate, multivariate, and Kaplan-Meier survival curve analyses were used for comparison.The study group consisted of 32 patients (15 PNI-positive tumors, and 17 PNI-negative tumors), all admitted for surgery. Univariate analysis showed differences in grade (p = 0.038), positive margins (p = 0.034), soft tissue invasion (p < 0.001), pathological stage (p = 0.014), recurrence (p = 0.015), distant metastasis (p = 0.015) and MEC related death (p = 0.015). The risk in PNI-positive patients to develop soft tissue invasion and positive surgical margins was OR = 8.57 and OR = 4.88, respectively. Multivariate analysis found age differences (p = 0.038), with OR = 1.08. The Disease Specific Survival (DSS) was worst in the PNI-positive group (log-rank p-value = 0.0011), where the probability of dying occurred in the 12-24 months period (log-rank p-value = 0.002). PNI-positive salivary gland MEC is an independent prognostic factor, with poor DSS, increased locoregional recurrence, close correlation with a more aggressive pattern of the disease, and should be reviewed as a high grade histological criteria. Our findings may imply changes in the clinical approach with a more aggressive attitude in the overall treatment.
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Affiliation(s)
- Giulianno Molina de Melo
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo - UNIFESP/EPM, São Paulo, Brazil
- Department of Head and Neck Surgery, Beneficencia Portuguesa of Sao Paulo Hospital, São Paulo, Brazil
| | - Giovanni Simoes de Medeiros
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo - UNIFESP/EPM, São Paulo, Brazil
| | - Arthur Paredes Gatti
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo - UNIFESP/EPM, São Paulo, Brazil
| | - Luiz Henrique Guilherme
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo - UNIFESP/EPM, São Paulo, Brazil
| | - Murilo Catafesta das Neves
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo - UNIFESP/EPM, São Paulo, Brazil
- Department of Head and Neck Surgery, Beneficencia Portuguesa of Sao Paulo Hospital, São Paulo, Brazil
| | - Marcello Rosano
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo - UNIFESP/EPM, São Paulo, Brazil
- Department of Head and Neck Surgery, Beneficencia Portuguesa of Sao Paulo Hospital, São Paulo, Brazil
| | | | - Jonathon Russell
- Endoscopic and Robotic Thyroid and Parathyroid Surgery, Otolaryngology - Head and Neck Surgery, Head and Neck Endocrine Surgery, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Marcio Abrahao
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo - UNIFESP/EPM, São Paulo, Brazil
| | - Onivaldo Cervantes
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo - UNIFESP/EPM, São Paulo, Brazil
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Li C, Wang M, Cheng X, Jiang Y, Xiao H. Nerve invasion as an independent predictor of poor prognosis in gastric cancer after curative resection. Medicine (Baltimore) 2022; 101:e30084. [PMID: 35984131 PMCID: PMC9387962 DOI: 10.1097/md.0000000000030084] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The study aims to reveal the clinical significance of perineural invasion (PNI) for gastric cancer prognosis and determine the risk factors of PNI in gastric cancer. This study retrospectively analyzed 350 patients who were diagnosed with GC and underwent curative surgical resection. Variables used to analyze survival included gender, age, degree of differentiation, T classification, lymph node metastasis, lymphovascular invasion, nerve invasion, mucinous adenocarcinoma component, and signet ring cell carcinoma component. The tumors of all patients were surgically resected. All resected specimens were stained with hematoxylin-eosin and immunohistochemical. The data for the patient's lymphovascular invasion and PNI came from the collected pathological reports. The results of the survival analysis showed that T staging (P < .001), lymph node metastasis (P < .001), lymphovascular invasion (P = .013), PNI (P = .001), and signet ring cell carcinoma components (P = .046) affect the survival time and have a statistically significant difference. Multivariate analysis indicated that the positivity of PNI was an independent prognostic factor (P = .014). T staging (P = .006) and lymph node metastasis (P = .013) were independent prognostic parameters too. Using the Spearman correlation analysis, the following clinicopathological indicators were associated with PNI positivity, such as tumor differentiation, T staging, lymph node metastasis, vascular invasion, and signet ring cell carcinoma components (P < .05). PNI is an independent marker of poor prognosis in patients with gastric cancer.
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Affiliation(s)
- Chunsheng Li
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Avenue, Changchun, China
| | - Mingchuan Wang
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Avenue, Changchun, China
| | - Xianbin Cheng
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Avenue, Changchun, China
| | - Yang Jiang
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Avenue, Changchun, China
| | - Huijie Xiao
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Avenue, Changchun, China
- *Correspondence: Huijie Xiao, Department of Gastrointestinal, Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China (e-mail: )
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Peraza A, Gómez R, Beltran J, Amarista F. Mucoepidermoid carcinoma. An update and review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:713-720. [DOI: 10.1016/j.jormas.2020.06.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
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Zhao B, Lv W, Mei D, Luo R, Bao S, Huang B, Lin J. Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis. J Clin Pathol 2020; 73:544-551. [PMID: 31980559 DOI: 10.1136/jclinpath-2019-206372] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 12/22/2019] [Accepted: 12/23/2019] [Indexed: 12/24/2022]
Abstract
AIMS The prognostic significance of perineural invasion (PNI) for gastric cancer (GC) patients was under debate. This study aimed to review relevant studies and evaluate the impact of PNI on the survival outcome of GC patients. METHODS Systematic literature search was performed using PubMed and Embase databases. The relevant data were extracted, and the association between PNI and clinicopathological characteristics or survival outcome in GC patients were evaluated using a fixed-effect model or random-effect model. RESULTS A total 13 studies involving 7004 GC patients were included in this meta-analysis. The positive rate of PNI was 35.9% (2512/7004) in GC patients, ranging from 6.9% to 75.6%. There were significant relationships between PNI and a series of unfavourable clinicopathological factors including undifferentiated histology type (OR: 1.78, 95% CI 1.37 to 2.33, p<0.001; I2=75.3%), diffuse type (OR: 1.96, 95% CI 1.07 to 3.60, p=0.029; I2=79.5%), lymphatic invasion (OR: 7.00, 95% CI 3.76 to 13.03, p<0.001; I2=83.6%), vascular invasion (OR: 5.79, 95% CI 1.59 to 21.13, p=0.008; I2=95.8%), deeper tumour invasion (OR: 4.79, 95% CI 3.65 to 6.28, p<0.001; I2=65.0%) and lymph node metastasis (OR: 3.60, 95% CI 2.37 to 5.47, p<0.001; I2=89.6%). In addition, PNI was significantly associated with worse survival outcome in GC patients (HR: 1.69, 95% CI 1.38 to 2.06, p<0.001; I2=71.0%). CONCLUSION PNI was frequently detected in surgically resected specimens of GC patients, and it was a predictive factor for survival outcomes in these patients.
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Affiliation(s)
- Bochao Zhao
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China.,Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Wu Lv
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Di Mei
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Rui Luo
- Department of Central Laboratory, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Shiyang Bao
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Baojun Huang
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jie Lin
- Department of General Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
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Cao Y, Li R, Cheng L, Chen N, Li J, Yu D. p75 Nerve Growth Factor Receptor as a Specific Nerve Marker in the Diagnosis of Perineural Invasion of Squamous Cell Carcinoma. Am J Clin Pathol 2019; 151:574-583. [PMID: 30895287 DOI: 10.1093/ajcp/aqz011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/29/2018] [Accepted: 01/28/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Perineural invasion (PNI) is an important factor in tumor prognosis. We evaluated p75 nerve growth factor receptor (p75NGFR) as a neuromarker for perineural invasion of squamous cell carcinoma. METHODS A comparison of H&E, and S100 and p75NGFR immunohistochemical staining methods, using sequential sections from 29 samples, for identification nerve bundles and PNI diagnosis, was carried out. RESULTS p75NGFR and S100 correctly identified more nerve bundles than H&E. Accuracy of p75NGFR was higher than that of S100, but there was no significant difference from H&E. The accuracy of nerve bundle identification by p75NGFR and S100 showed no significant difference among different histopathologic grades of squamous cell carcinomas. p75NGFR gave mild staining of small vessels, while S100 gave strong staining of smooth muscle and glandular tissue. CONCLUSIONS p75NGFR specifically stains nerve tissue and is better than S100 and H&E in identifying nerve bundles. p75NGFR is expected to become a new neuromarker.
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Affiliation(s)
- Yong Cao
- College of Stomatology, Guangxi Medical University, Nanning, China
| | - Rouxi Li
- College of Stomatology, Guangxi Medical University, Nanning, China
| | - Li Cheng
- College of Stomatology, Guangxi Medical University, Nanning, China
| | - Nian Chen
- College of Stomatology, Guangxi Medical University, Nanning, China
| | - Jing Li
- Department of Stomatology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Dahai Yu
- Department of Stomatology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Chandra P, Nath S. Perineural Spread of Mucoepidermoid Carcinoma of Parotid Gland Involving V, VI, and VII Cranial Nerves Demonstrated on Positron Emission Tomography/Computed Tomography. Indian J Nucl Med 2017; 32:245-246. [PMID: 28680219 PMCID: PMC5482031 DOI: 10.4103/ijnm.ijnm_39_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Perineural spread (PNS) in head and neck malignancies has been associated with extremely poor prognosis. Through this interesting case, we demonstrate the PNS of a mucoepidermoid carcinoma of parotid gland with simultaneous involvement of V, VI, and VII cranial nerves identified on positron emission tomography/computed tomography.
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Affiliation(s)
- Piyush Chandra
- Department of Nuclear Medicine, MIOT International, Chennai, Tamil Nadu, India
| | - Satish Nath
- Department of Nuclear Medicine, MIOT International, Chennai, Tamil Nadu, India
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