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. 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.

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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

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