Deciphering site-specific histopathological parameters with potential clinical value in head and neck squamous cell...

Area of Science:

• Oncology
• Pathology
• Cancer Research

Background:

• Head and neck squamous cell carcinoma (HNSCC) lacks reliable histological prognosticators beyond basic grading.
• Current grading systems for HNSCC have disputed clinical relevance.
• There is a need for improved histological markers to predict patient outcomes in HNSCC.

Purpose of the Study:

• To identify site-specific and tumor compartment histological characteristics as prognostic factors in HNSCC.
• To assess the impact of morphological and immunophenotypic features on overall survival in HNSCC patients.
• To determine the prognostic value of invasive margin features, including CD8 and PD-L1 expression.

Main Methods:

• Analysis of morphological and immunophenotypic features in 248 HNSCC patients with over 20 years of follow-up.
• Assessment of tumor cells, immune microenvironment, and invasive margin characteristics.
• Correlation of histological findings with overall survival and disease stage.

Main Results:

• Site-specific characteristics were observed: laryngeal/hypopharyngeal (keratinization, cannibalism, anaplasia), oropharyngeal (high grade, necrosis), and oral (keratin pearls, eosinophils, perineural invasion).
• Unfavorable prognosticators included CD8 distribution homogeneity, perineural invasion, and sparse lymphocytic host response in the invasive margin (LHR-IM).
• Perineural invasion and LHR-IM independently predicted unfavorable prognosis, alongside disease stage; other features showed no prognostic association.

Conclusions:

• Perineural invasion and LHR-IM are confirmed histological risk factors in HNSCC.
• These factors should be incorporated into routine pathology reports for HNSCC.
• Site-specific histological features may enhance deep learning algorithms for HNSCC grading.