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Poorly Differentiated Clusters Predict a Poor Prognosis for External Auditory Canal Carcinoma
Masaru Miyazaki1,2, Mikiko Aoki1, Yasuko Okado1,2
1Department of Pathology, Fukuoka University Hospital and School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
Poorly differentiated clusters (PDCs) in external auditory canal squamous cell carcinoma (SCC of the EAC) are a strong indicator of poor prognosis. High-grade PDCs predict worse outcomes, even with low-grade tumor budding.
Area of Science:
- Oncology
- Pathology
- Surgical Oncology
Background:
- Squamous cell carcinoma (SCC) of the external auditory canal (EAC) is rare and has a poor prognosis.
- Accurate prognostic biomarkers are needed for SCC of the EAC.
- Previous studies identified tumor budding and laminin 5-γ2 staining as prognostic indicators.
Purpose of the Study:
- To investigate the association between poorly differentiated clusters (PDCs) and prognosis in SCC of the EAC.
- To compare the prognostic value of PDCs with tumor budding in SCC of the EAC.
Main Methods:
- Histopathological and immunohistochemical analysis (cytokeratin AE1/AE3) of 31 pre-treatment biopsy SCC of the EAC samples.
- Definition of tumor budding (<5 cells) and PDCs (≥5 cells) in stromal clusters.
- Classification of tumors into low- and high-grade PDC density based on greatest PDC density scanning.
Main Results:
- Patients with high-grade PDCs had a significantly poorer outcome compared to those with low-grade PDCs.
- High-grade PDCs were associated with a poor prognosis, even in cases with low-grade tumor budding.
- Multivariate analysis confirmed high-grade PDCs as an independent predictor of poor prognosis.
Conclusions:
- PDC grade is a more accurate prognostic indicator than tumor budding for SCC of the EAC.
- PDC assessment can improve prognostic accuracy for patients with SCC of the EAC.
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