围神经侵入预测口腔状细胞癌的预后不佳:系统性审查和元分析
Luqing Zhang1, Yihan Guo1, Manabu Yamazaki2
1Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Journal of stomatology, oral and maxillofacial surgery
|February 6, 2026
概括
在口腔状细胞癌 (OSCC) 中,周围神经侵入 (PNI) 显著恶化了患者的存活率,并增加了复发风险. 识别PNI对于更好的风险评估和OSCC患者的治疗决策至关重要.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
- 临床研究 临床研究
背景情况:
- 口腔状细胞癌 (OSCC) 由于高复发率和不良预后,存在重大挑战.
- 周围神经侵入 (PNI),瘤细胞透神经,在OSCC中经常观察到,但它的预后价值仍在争论中.
研究的目的:
- 系统地审查和进行关于PNI对OSCC临床结果的预后影响的元分析.
- 澄清PNI与整体存活率,无病存活率,疾病特异性存活率和OSCC患者局部复发之间的关联.
主要方法:
- 对2015年至2025年间发表的研究进行系统搜索.
- 从多变量分析中对生存结果和局部复发的危险比率 (HR) 的元分析.
- 包括57项研究,其中包括来自23,580名患者的数据.
主要成果:
- PNI与总生存率 (HR=1.67),无病生存率 (HR=1.71) 和疾病特异性生存率 (HR=1.52) 的降低显著相关.
- PNI的存在显著增加了局部复发的风险 (HR=2.68).
- 亚组和灵敏度分析证实了这些强大的预后关联,尽管有适度的出版偏差.
结论:
- 在OSCC中,PNI是不良临床结果的独立预测因子.
- 将PNI状态纳入风险分层是指导手术管理和辅助疗法的关键.
- 未来的研究应该集中在标准化PNI诊断方法和探索分子机制上.
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