Akademik Veri Yönetim Sistemi
37. Congress of Pathology, Vienna, Avusturya, 6 - 10 Eylül 2025, ss.404-405, (Özet Bildiri)
Beyond HPV: the role of invasion pattern and stromal signals in oral cavity squamous cell carsinoma
Background & Objectives: The Worst Pattern of Invasion (WPOI) has emerged as a critical histopathological parameter in oral cavity squamous cell carcinomas (OCSCC), with significant prognostic and therapeutic implications. This study evaluated the relationship between WPOI and various clinicopathological and microenvironmental features in patients with oropharyngeal carcinoma. Methods: A retrospective cohort of 53 patients diagnosed with OCSCC was analysed. WPOI was classified into low-risk (types 1–3) and highrisk (types 4–5) categories. Associations between WPOI and key variables—including p16 status (as a surrogate for HPV association), perineural invasion (PNI), lymphovascular invasion (LVI), tumour budding, tumour-infiltrating lymphocytes (TILs), stroma-tumour ratio (STR), depth of invasion (DOI), tumour differentiation, nodal metastasis, and recurrence were evaluated using Pearson’s chi-square test. Survival outcomes were assessed via Kaplan-Meier analysis with log-rank tests for statistical significance. Histopathologic parameters were evaluated in haematoxylin and eosin-stained sections. Results: The cohort included 53 patients (26 male, 27 female) with a median age of 63.84 years (range: 41-86). High-grade WPOI showed statistically significant correlations with several adverse pathological features: perineural invasion (p = 0.0002), lymphovascular invasion (p = 0.0020), high tumour budding grade (p <0.0001), stromal predominance (>50% stroma; p = 0.0006), poor differentiation (p = 0.0404), and cervical lymph node metastasis (p = 0.0068). However, no significant associations were found between WPOI and p16 status (p = 0.452), TIL density (20% cutoff; p = 0.317), or anatomical subsite (p = 0.189). Survival analysis demonstrated significantly worse outcomes for high-WPOI cases (log-rank p = 0.0039), while higher tumour budding showed a trend toward increased nodal metastasis (p = 0.0166). Conclusion: WPOI strongly correlates with adverse features (PNI, LVI, stromal response, tumour budding) and poor survival in OCSCC, reflecting critical tumour-host interactions. These findings support integrating WPOI into routine pathology reporting and risk stratification, offering valuable HPV-independent prognostic information.