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Abstract：
UNASSIGNED: Low-grade salivary gland carcinoma is regularly treated with surgical therapy of the salivary gland without elective neck dissection in T1/2 carcinomas, either alone or with adjuvant radiation therapy. However, occult metastasis and locoregional recurrence influence therapy and outcome. Tumor budding is an emerging prognostic pathological factor in many carcinomas, but has not yet been adequately considered in salivary gland carcinomas.
UNASSIGNED: We conducted a retrospective single-center study of 64 patients diagnosed with low-grade carcinoma of the major salivary glands treated between 2003 and 2017. Pathological risk factors and TNM classification were thoroughly assessed for each case. All hematoxylin and eosin (HE)-stained histological specimens underwent careful examination, and tumor budding was identified following the guidelines set forth by the International Tumor Budding Consensus Conference in 2016.
UNASSIGNED: Tumor budding was not statistically significant concerning 5-year survival rate (5-YSR) (p=0.969) and mean overall survival (log-rank p=0.315). Whereas 5-year disease-free survival rate (5-YDFSR) was 87% in the low tumor budding group and 61.1% in the intermediate and high tumor budding group (p=0.021). Mean disease-free survival accounted for 100.2 months (CI: 88.6;111.9) in the low budding score group and 58.7 months (CI: 42.8;74.6) in the other group (log-rank p=0.032). Notably, pT1/2 showed significantly lower tumor buds than pT3/4 stages (2.43 tumor buds/0.785 mm2 vs. 4.19 tumor buds/0.785 mm2, p=0.034). Similar findings were noted comparing nodal-positive and nodal-negative patients, as well as patients with and without lymphovascular invasion and perineural invasion (each p<0.05).
UNASSIGNED: Tumor budding might be used as an additional prognostic factor for recurrence in low-grade salivary gland carcinoma, seemingly associated with a higher nodal metastasis rate and advanced tumor stages and a worse 5-YDFSR. Consequently, the evaluation of tumor budding in resection specimens of low-grade salivary gland tumor may prove valuable in decision-making for neck dissection and follow-up strategy.
UNASSIGNED: We conducted a retrospective single-center study of 64 patients diagnosed with low-grade carcinoma of the major salivary glands treated between 2003 and 2017. Pathological risk factors and TNM classification were thoroughly assessed for each case. All hematoxylin and eosin (HE)-stained histological specimens underwent careful examination, and tumor budding was identified following the guidelines set forth by the International Tumor Budding Consensus Conference in 2016.
UNASSIGNED: Tumor budding was not statistically significant concerning 5-year survival rate (5-YSR) (p=0.969) and mean overall survival (log-rank p=0.315). Whereas 5-year disease-free survival rate (5-YDFSR) was 87% in the low tumor budding group and 61.1% in the intermediate and high tumor budding group (p=0.021). Mean disease-free survival accounted for 100.2 months (CI: 88.6;111.9) in the low budding score group and 58.7 months (CI: 42.8;74.6) in the other group (log-rank p=0.032). Notably, pT1/2 showed significantly lower tumor buds than pT3/4 stages (2.43 tumor buds/0.785 mm2 vs. 4.19 tumor buds/0.785 mm2, p=0.034). Similar findings were noted comparing nodal-positive and nodal-negative patients, as well as patients with and without lymphovascular invasion and perineural invasion (each p<0.05).
UNASSIGNED: Tumor budding might be used as an additional prognostic factor for recurrence in low-grade salivary gland carcinoma, seemingly associated with a higher nodal metastasis rate and advanced tumor stages and a worse 5-YDFSR. Consequently, the evaluation of tumor budding in resection specimens of low-grade salivary gland tumor may prove valuable in decision-making for neck dissection and follow-up strategy.
摘要：
■在T1/2癌中，低级别唾液腺癌定期接受唾液腺手术治疗，而不进行选择性颈清扫术，单独或辅助放射治疗。然而,隐匿性转移和局部复发影响治疗和结果。肿瘤出芽是许多癌症中新兴的预后病理因素。但尚未在唾液腺癌中得到充分考虑。
■我们对2003年至2017年间治疗的64例诊断为主要唾液腺低度癌的患者进行了回顾性单中心研究。对每个病例的病理危险因素和TNM分类进行了全面评估。所有苏木精和伊红（HE）染色的组织学标本都经过仔细检查，肿瘤出芽是按照2016年国际肿瘤出芽共识会议制定的指导方针确定的.
■肿瘤出芽在5年生存率（5-YSR）（p=0.969）和平均总生存率（log-rankp=0.315）方面无统计学意义。而5年无病生存率（5-YDFSR）在低肿瘤出芽组中为87％，在中，高肿瘤出芽组中为61.1％（p=0.021）。低芽评分组的平均无病生存期为100.2个月（CI：88.6;111.9），另一组为58.7个月（CI：42.8;74.6）（log-rankp=0.032）。值得注意的是,pT1/2显示肿瘤芽明显低于pT3/4阶段（2.43肿瘤芽/0.785mm2vs.4.19肿瘤芽/0.785mm2,p=0.034)。比较淋巴结阳性和淋巴结阴性患者，以及有和没有淋巴管侵犯和神经侵犯的患者（每个p<0.05）。
■肿瘤出芽可作为低级别唾液腺癌复发的额外预后因素，似乎与较高的淋巴结转移率和晚期肿瘤分期以及较差的5-YDFSR有关。因此,低级别涎腺肿瘤切除标本中肿瘤出芽的评估可能被证明对颈部淋巴结清扫的决策和随访策略有价值.
■我们对2003年至2017年间治疗的64例诊断为主要唾液腺低度癌的患者进行了回顾性单中心研究。对每个病例的病理危险因素和TNM分类进行了全面评估。所有苏木精和伊红（HE）染色的组织学标本都经过仔细检查，肿瘤出芽是按照2016年国际肿瘤出芽共识会议制定的指导方针确定的.
■肿瘤出芽在5年生存率（5-YSR）（p=0.969）和平均总生存率（log-rankp=0.315）方面无统计学意义。而5年无病生存率（5-YDFSR）在低肿瘤出芽组中为87％，在中，高肿瘤出芽组中为61.1％（p=0.021）。低芽评分组的平均无病生存期为100.2个月（CI：88.6;111.9），另一组为58.7个月（CI：42.8;74.6）（log-rankp=0.032）。值得注意的是,pT1/2显示肿瘤芽明显低于pT3/4阶段（2.43肿瘤芽/0.785mm2vs.4.19肿瘤芽/0.785mm2,p=0.034)。比较淋巴结阳性和淋巴结阴性患者，以及有和没有淋巴管侵犯和神经侵犯的患者（每个p<0.05）。
■肿瘤出芽可作为低级别唾液腺癌复发的额外预后因素，似乎与较高的淋巴结转移率和晚期肿瘤分期以及较差的5-YDFSR有关。因此,低级别涎腺肿瘤切除标本中肿瘤出芽的评估可能被证明对颈部淋巴结清扫的决策和随访策略有价值.
