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.
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.