| Abstract (croatian) | hrcak.srce.hr/medicina 408 medicina fluminensis 2016, Vol. 52, No. 3, p. 408-414 Sažetak. Cilj: Utvrditi gradus invazivne tumorske fronte (GITF) u karcinomu pločastih stanica usne šupljine (KPSUŠ), usporediti ga s tradicionalnim histološkim gradusom te ispitati prognostičku vrijednost obaju načina gradiranja. Materijali i metode: Na HE-obojanim mikroskopskim preparatima 86 KPSUŠ-a, odstranjenim na Klinici za maksilofacijalnu kirurgiju KBC-a Rijeka, određen je gradus invazivne tumorske fronte i ispitana njegova povezanost s kliničkopatološkim prognostičkim parametrima kao što su patološki T stadij (pT stadij), patološki N stadij limfnih čvorova (pN stadij), klinički stadij bolesti (TNM stadij) te dužina preživljavanja pacijenata. Podatci o tradicionalnom histološkom gradusu dobiveni su iz patohistološkog nalaza. Rezultati: Tradicionalni histološki gradus nije bio značajno povezan s kliničkim parametrima niti preživljavanjem pacijenata (P = 0,906). Visoki GITF bio je povezan s pozitivnim limfnim čvorovima (P = 0,006) i kliničkim stadijem bolesti (P = 0,025), dok s patološkim T stadijem nije dobivena statistička povezanost (P = 0,086). U univarijatnoj analizi visoki GITF bio je povezan s kraćim preživljavanjem pacijenata (P = 0,001), a u multivarijatnoj analizi se pokazao prognostičkim čimbenikom (P = 0,006). Za pojedinačne parametre koji određuju GITF poput upalnog infiltrata, načina invazije te stupnja keratinizacije također je utvrđena prognostička vrijednost u univarijatnoj (P < 0,001, P = 0,013, tj. P = 0,009) i multivarijatnoj analizi. Zaključak: GITF ima veću prognostičku vrijednost u odnosu na tradicionalni histološki gradus. Njegovo određivanje može pomoći u prepoznavanju pacijenata s većim rizikom za povrat bolesti nakon kirurškog odstranjenja tumora, kojima bi koristile dodatne metode liječenja. |
| Abstract (english) | Aim: To establish invasive tumor front grade (ITFG) in squamous cell carcinoma of the oral cavity (OCSCC), compare it with traditional histological grade and to investigate the prognostic value of both. Materials and methods: The whole tumor-tissue sections, stained with HE of 86 OCSCC cases were evaluated for the invasive tumor front grade and compared with the clinicopathological prognostic parameters such as pathological stage (pT stage), pathological lymph node stage (pN stage), clinical stage (TNM stage) and length of survival of patients. Tissue has been disposed at the Department of Maxillofacial Surgery, University Hospital Rijeka. Data of traditional histological grade were obtained from previous histological findings. Results: Traditional histological grade was not significantly associated with clinical parameters or survival of patients (P = 0.906). High ITFG was associated with positive lymph nodes (P = 0.006) and clinical stage of disease (P = 0.025), but not to pathological T stage (P = 0.086). In univariate analysis high ITFG was associated with shorter survival of patients (P = 0.001), and multivariate analysis showed it as the independent prognostic factor (P = 0.006). For individual parameters that determine ITFG like inflammatory infiltrate, way of invasion and degree of keratinization was also established statistically significant prognostic value in univariate (P < 0.001, P = 0.013, i.e., P = 0.009) and multivariate analysis. Conclusion: ITFG has greater prognostic value than the traditional histological grade. Determination of ITFG may help identify patients with a higher risk of disease recurrence after surgical removal of the tumor, which would use additional methods of treatment. |
