Evaluation of the association between perineural invasion and clinical and histopathological features of cervical cancer

Abstract

Abstract. Perineural invasion (PNI) has been investigated as a new prognostic factor in a number of carcinomas. However, studies on PNI in cervical cancer are limited, and inconsistent conclusions have been reported by different groups. The aim of the present study was to analyze the relationship between perineural invasion (PNI) and clinical and histopathological features of cervical cancer, and to evaluate the clinical significance of PNI of cervical cancer. Retrospective review identified 206 patients with cervical cancer who underwent radical hysterectomy plus pelvic lymphadenectomy between December 2012 and August 2014. The association between PNI and clinical and histopathological features of cervical cancer and post-operative radiotherapy was evaluated based on univariate and multivariate analyses. PNI of cervical cancer was identified in 33 of 206 (16%) cervical cancer patients. Univariate analysis demonstrated that PNI was associated with clinical stage, tumor grade, tumor size, depth of invasion, lymphovascular space invasion (LVSI), and lymph node metastasis (P<0.05), but not associated with age and histopathological types (P>0.05). Multivariate analysis suggests that LVSI and lymph node metastasis were associated with PNI of cervical cancer (P<0.05). In addition, post-operative radiotherapy was significantly more recommended for patients with PNI than those without PNI (P<0.001). In conclusion, PNI of cervical cancer is associated with LVSI and lymph node metastasis and can be used as an index for the determination of post-operative radiotherapy for cervical cancer patients.

Relationship between lymphovascular invasion and clinicopathological features of papillary thyroid carcinoma

“…or the presence of thrombus adherent to intravascular tumor. Although LVI is a poor prognostic factor in different cancers, it is not included into the staging systems for PTC [14][15][16][17][18][19][20].…”

“…Among the most frequently used staging systems for estimating the prognosis and risk of recurrence in thyroid carcinomas are those developed by the Union for International Cancer Control (UICC) and American Joint systems consistently include clinicopathological parameters, however, factors such as age, gender, tumor type and size, extracapsular extension, lymph nodes, lymphovascular invasion (LVI), and distant metastasis are not all covered by a single staging system [7][8][9][10][11][12][13]. Although LVI is a poor prognostic factor for numerous cancers, including laryngeal, uterine, endometrial, colorectal, cervical, bile duct, and vulvar cancer, none of the staging systems include LVI in staging of thyroid carcinomas [14][15][16][17][18][19][20]. In a clinical series conducted by Ieni et al [21], 295 PTC patients (8 of them with a newly described entity -micropapillary/hobnail variant [MPHC]) were evaluated and the authors concluded that the prognosis of MPHC-PTC tumors was better compared to the other groups, possibly due to a lower rate of vascular invasion in this group [21].…”

‘Trident sign’ in pelvis: sinister sign with poor prognosis

“…Zhang et al reported that perineural spread of cervical cancer is associated with depth of stromal invasion, tumour size, invasion of the parametrium and lymphovascular space and lymph node metastasis 6. Wei et al have shown that the perineural spread in cervical cancer is associated with lymphovascular space invasion and lymph node metastasis 7. The perineural spread in the lumbosacral plexus leads to the diffuse thickening of the nerve plexus, giving appearance of ‘trident’ on the CT scan.…”

Effects of Nerve Growth Factor Expression on Perineural Invasion and Worse Prognosis in Early-Stage Cervical Cancer

“…Our previous study has shown that PNI in cervical cancer is associated with other pathology risk features, and other studies have shown that it is a predictor of poor prognosis. [ 1 2 3 ] These findings highlight the importance of clarifying the molecular mechanism of PNI.…”