Abstract：
OBJECTIVE: Perineural invasion (PNI), classified according to its presence or absence in tumor specimens, is recognized as a poor prognostic factor in pancreatic ductal adenocarcinoma (PDAC) patients. Herein, we identified five histological features of PNI and investigated their impact on survival outcomes of PDAC resected patients.
METHODS: Five histopathological features of PNI (diameter, number, site, sheath involvement, and mitotic figures within perineural invasion) were combined in an additional final score (ranging from 0 to 8), and clinical data of PDAC patients were retrospectively analyzed. PNI + patients were stratified in two categories according to the median score value (<6 and ≥ 6, respectively). Impact of PNI on disease-free survival (DFS) and overall survival (OS) were analyzed.
RESULTS: Forty-five patients were enrolled, of whom 34 with PNI (PNI+) and 11 without PNI (PNI-). The DFS was 11 months vs. not reached (NR) (p = 0.258), while the OS was 19 months vs. NR (p = 0.040) in PNI+ and PNI- patients, respectively. A ≥6 PNI was identified as an independent predictor of worse OS vs. <6 PNI + patients (29 vs. 11 months, p < 0.001) and <6 PNI+ and PNI- patients (43 vs. 11 months, p < 0.001). PNI ≥6 was an independent negative prognostic factor of DFS vs. <6 PNI+ and PNI- patients (13 vs. 6 months, p = 0.022).
CONCLUSIONS: We report a PNI scoring system that stratifies surgically-treated PDAC patients in a graded manner that correlates with patient prognosis better than the current dichotomous (presence/absence) definition. However, further and larger studies are needed to support this PNI scoring system.
METHODS: Five histopathological features of PNI (diameter, number, site, sheath involvement, and mitotic figures within perineural invasion) were combined in an additional final score (ranging from 0 to 8), and clinical data of PDAC patients were retrospectively analyzed. PNI + patients were stratified in two categories according to the median score value (<6 and ≥ 6, respectively). Impact of PNI on disease-free survival (DFS) and overall survival (OS) were analyzed.
RESULTS: Forty-five patients were enrolled, of whom 34 with PNI (PNI+) and 11 without PNI (PNI-). The DFS was 11 months vs. not reached (NR) (p = 0.258), while the OS was 19 months vs. NR (p = 0.040) in PNI+ and PNI- patients, respectively. A ≥6 PNI was identified as an independent predictor of worse OS vs. <6 PNI + patients (29 vs. 11 months, p < 0.001) and <6 PNI+ and PNI- patients (43 vs. 11 months, p < 0.001). PNI ≥6 was an independent negative prognostic factor of DFS vs. <6 PNI+ and PNI- patients (13 vs. 6 months, p = 0.022).
CONCLUSIONS: We report a PNI scoring system that stratifies surgically-treated PDAC patients in a graded manner that correlates with patient prognosis better than the current dichotomous (presence/absence) definition. However, further and larger studies are needed to support this PNI scoring system.
摘要：
目标：神经周浸润（PNI），根据其在肿瘤标本中的存在或不存在进行分类，被认为是胰腺导管腺癌（PDAC）患者的不良预后因素。在这里，我们确定了PNI的5个组织学特征,并研究了它们对PDAC切除患者生存结局的影响.
方法：PNI的五个组织病理学特征（直径，number,site,鞘受累,和神经周浸润内的有丝分裂图）合并为额外的最终评分（范围从0到8），并对PDAC患者的临床资料进行回顾性分析。PNI+患者根据中位数评分（分别<6和≥6）分为两类。分析PNI对无病生存期(DFS)和总生存期(OS)的影响。
结果：纳入45例患者，其中34人具有PNI(PNI+)，11人没有PNI(PNI-)。DFS是11个月，而不是未达到(NR)(p=0.258)，而操作系统是19个月与PNI+和PNI-患者的NR（p=0.040），分别。≥6PNI被确定为OS较差与OS较差的独立预测因子。<6PNI+患者（29例vs.11个月,p<0.001）和<6PNI+和PNI-患者（43vs.11个月,p<0.001)。PNI≥6是DFS与DFS的独立阴性预后因素。<6名PNI+和PNI-患者（13名vs.6个月,p=0.022)。
结论：我们报告了一个PNI评分系统，该系统以分级方式对手术治疗的PDAC患者进行分层，与患者预后相关程度优于目前的二分法（存在/不存在）定义。然而,需要进一步和更大的研究来支持PNI评分系统.
方法：PNI的五个组织病理学特征（直径，number,site,鞘受累,和神经周浸润内的有丝分裂图）合并为额外的最终评分（范围从0到8），并对PDAC患者的临床资料进行回顾性分析。PNI+患者根据中位数评分（分别<6和≥6）分为两类。分析PNI对无病生存期(DFS)和总生存期(OS)的影响。
结果：纳入45例患者，其中34人具有PNI(PNI+)，11人没有PNI(PNI-)。DFS是11个月，而不是未达到(NR)(p=0.258)，而操作系统是19个月与PNI+和PNI-患者的NR（p=0.040），分别。≥6PNI被确定为OS较差与OS较差的独立预测因子。<6PNI+患者（29例vs.11个月,p<0.001）和<6PNI+和PNI-患者（43vs.11个月,p<0.001)。PNI≥6是DFS与DFS的独立阴性预后因素。<6名PNI+和PNI-患者（13名vs.6个月,p=0.022)。
结论：我们报告了一个PNI评分系统，该系统以分级方式对手术治疗的PDAC患者进行分层，与患者预后相关程度优于目前的二分法（存在/不存在）定义。然而,需要进一步和更大的研究来支持PNI评分系统.
