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. 2021 Jul 21;11(8):1308.
doi: 10.3390/diagnostics11081308.

The Diagnosis of Perineural Invasion: A Crucial Factor in Novel Algorithm of Coexistence of Conventional and Nerve-Sparing Radical Hysterectomy

Andrzej Skręt  1 , Joanna Ewa Skręt-Magierło  2 , Mariusz Książek  3 , Bogusław Gawlik  1 , Joanna Bielatowicz  1 , Edyta Barnaś  2
Affiliations

The Diagnosis of Perineural Invasion: A Crucial Factor in Novel Algorithm of Coexistence of Conventional and Nerve-Sparing Radical Hysterectomy

Andrzej Skręt et al. Diagnostics (Basel). .

Abstract

Nerve-sparing radical hysterectomy (NSRH) was introduced to mitigate adverse effects associated with conventional radical hysterectomy (CRH) in cervical cancer. However, the introduction of NSRH was compromised by possible existence of perineural invasion (PNI). Additionally, the coexistence of NSRH and CRH is currently the fact. The aim of the study was to review the literature and attempt to construct a novel and preliminary PNI diagnostic algorithm that would establish the coexistence of NSRH and CRH in one system of early-stage cervical cancer (ESCC) surgical treatment. This algorithm takes into account the PNI risk factors and current and future diagnostic methods such as imaging and biopsy.

Keywords: cervical cancer; diagnosis; perineural invasion.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Laparoscopic biopsy of uterine branches: (A). Scheme; (B). Laparoscopic view. Legends: HN—hypogastric nerve; UB—uterine branch; VB—bladder branch; IHP—inferior hypogastric plexus; SN—splanchnic nerve; U—ureter; B—bladder; 1—biopsy punch with thorn.
Figure 2
Figure 2
The tissue from laparoscopic biopsy. (A): Two nerve fibers (black arrows) surrounded by adipose tissue 1B, H&E, objective ×10; (B): Corresponding nerves highlighted with S100 immunohistochemical staining, objective ×10; (C): High magnification of nerve fiber, showing no evidence of perineural invasion, H&E, objective ×40; (D): Corresponding nerve fiber highlighted with S100 immunohistochemical staining, objective ×40.
Figure 3
Figure 3
The PNI diagnostic algorithm in ESCC patients qualified to surgical treatment with RH. The shadow areas are suggested methods applicable in future.
See this image and copyright information in PMC

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