Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 8;22(1):1287.
doi: 10.1186/s12885-022-10386-w.

Patterns and prognostic predictive value of perineural invasion in esophageal squamous cell carcinoma

Yu Ma #  1 , Jie Chen #  1 , Xi Yao #  2 , Zhenzhen Li  1 , Wensheng Li  1 , Hongtao Wang  3 , Jianfei Zhu  4
Affiliations

Patterns and prognostic predictive value of perineural invasion in esophageal squamous cell carcinoma

Yu Ma et al. BMC Cancer. .

Abstract

Background: The pathological phenotype of perineural invasion (PNI) in squamous cell carcinoma (ESCC) is prevalent but highly heterogeneous.

Methods: Postoperative specimens from all patients with ESCC at Shaanxi Provincial People's Hospital were evaluated for PNI using haematoxylin and eosin (H&E) staining and S100 immunohistochemistry (IHC). We determined the correlation between PNI status and clinical outcomes.

Results: Among 349 ESCC cases, PNI was identified in 127 patients (36.3%), and four subtypes of PNI were identified in our study. Correlation analysis confirmed that PNI was related to tumour invasion depth (pT stage) and lymph node status (pN stage) (P < 0.05). Multivariate analysis showed that PNI (P = 0.001) was an independent factor affecting disease-free survival (DFS) in ESCC, and a similar result was found for overall survival (OS) (P = 0.017). Further analysis revealed that PNI status was a prognostic factor of DFS (P < 0.001) and OS (P = 0.003) exclusively in pN-negative patients. We also found that patients with the PNI-a subtype had better DFS (P = 0.002) and OS (P = 0.002) than patients with the other three subtypes (PNI-b, c, d).

Conclusion: The pathological phenotypes of PNI are diverse, and the identification of PNI subtypes has important clinical guiding value.

Keywords: Esophageal squamous cell carcinoma; Perineural invasion; Prognosis; TNM stage.

PubMed Disclaimer

Conflict of interest statement

All authors do not have conflict of interest.

Figures

Fig. 1
Fig. 1
A flowchart of this study
Fig. 2
Fig. 2
Representative histological characteristics of PNI in ESCC. Typical features of HE staining (a) and IHC staining (b) of PNI-a; typical features of HE staining (c) and IHC staining (d) of PNI-b; typical features of HE staining (e) and IHC staining (f) of PNI-c; typical features of HE staining (g) and IHC staining (h) of PNI-d. PNI, perineural invasion; ESCC, oesophageal squamous cell carcinoma; H&E, haematoxylin and eosin; IHC, immunohistochemistry
Fig. 3
Fig. 3
Survival curves of ESCC patients with different PNI statuses. a DFS of ESCC according to PNI status. b OS of ESCC according to PNI status. ESCC, oesophageal squamous cell carcinoma; PNI, perineural invasion; DFS, disease-free survival; OS, overall survival
Fig. 4
Fig. 4
Survival curves of ESCC patients with different PNI subtypes. a DFS of ESCC according to different PNI subtypes; b OS of ESCC according to different PNI subtypes. ESCC, oesophageal squamous cell carcinoma; PNI, perineural invasion; DFS, disease-free survival; OS, overall survival
Fig. 5
Fig. 5
Effects of PNI status on ESCC survival in different pN stages. a DFS of patients with pN-negative ESCC according to PNI status; b OS of patients with pN-negative ESCC according to PNI status; c DFS of patients with pN-positive ESCC according to PNI status; d OS of patients with pN-positive ESCC according to PNI status. ESCC, oesophageal squamous cell carcinoma; PNI, perineural invasion; DFS, disease-free survival; OS, overall survival
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Zeng H, Chen W, Zheng R, Zhang S, Ji JS, Zou X, et al. Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries. Lancet Glob Health. 2018;6(5):e555–e567. doi: 10.1016/S2214-109X(18)30127-X. - DOI - PubMed
    1. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115–132. doi: 10.3322/caac.21338. - DOI - PubMed
    1. Mansour NM, Groth SS, Anandasabapathy S. Esophageal adenocarcinoma: screening, surveillance, and management. Annu Rev Med. 2017;68:213–227. doi: 10.1146/annurev-med-050715-104218. - DOI - PubMed
    1. Coleman HG, Xie SH, Lagergren J. The epidemiology of esophageal adenocarcinoma. Gastroenterology. 2018;154(2):390–405. doi: 10.1053/j.gastro.2017.07.046. - DOI - PubMed