The study determines morphological features that are associated with perineural invasion (PNI) in patients with cervical carcinoma (CX). Histological slides from 194 patients from surgically treated squamous cell carcinoma were re-examined for PNI and correlated to morphological factors of tumor growth. Material from 68 patients (35.1%) represented PNI. PNI was significantly correlated with advanced tumor stage (P < .001). Patients with deep cervical stromal invasion (>66%) showed more PNI than those with more superficial invasion (41% vs 16.9%; P = .001). Tumors with spray-like PI showed significantly more PNI (48.4%) when compared with finger-like PI (26.7%) and those with pushing borders (18.8%; P = .007). Strong peritumoral desmoplastic stromal reaction and absence of peritumoral inflammation were associated with a higher frequency of PNI (P < .001). PNI is associated with advanced tumor stage, deep cervical stromal invasion (>66%), high grade of tumor cell dissociation (ie, spray-like pattern of invasion), strong peritumoral desmoplastic stromal reaction, and reduced peritumoral inflammation.
Batsakis JGNerves and neurotropic carcinomas. Ann Otol Rhinol Laryngol . 1985;94:426-427.
2.
Baisden BL, Kahane H., Epstein JIPerineural invasion, mucinous fibroplasia, and glomerulations: diagnostic features of limited cancer on prostate needle biopsy. Am J Surg Pathol. 1999;23:918-924.
3.
Liebig C., Ayala G., Wilks JA, Berger DH, Albo D.Perineural invasion in cancer: a review of the literature. Cancer. 2009;115:3379-3391.
4.
Gil Z., Carlson DL, Gupta A., et al. Patterns and incidence of neural invasion in patients with cancers of the paranasal sinuses. Arch Otolaryngol Head Neck Surg . 2009;135:173-179.
5.
Sudo T., Murakami Y., Uemura K., et al. Prognostic impact of perineural invasion following pancreatoduodenectomy with lymphadenectomy for ampullary carcinoma. Dig Dis Sci . 2008;53:2281-2286.
6.
Harnden P., Shelley MD, Clements H., et al. The prognostic significance of perineural invasion in prostatic cancer biopsies: a systematic review. Cancer. 2007;109:13-24.
7.
Lee IH, Roberts R., Shah RB, Wojno KJ, Wei JT, Sandler HMPerineural invasion is a marker for pathologically advanced disease in localized prostate cancer. Int J Radiat Oncol Biol Phys. 2007;68:1059-1064.
8.
Beitler JJ, Anderson PS, Wadler S., et al. Pelvic exenteration for cervix cancer: would additional intraoperative interstitial brachytherapy improve survival? Int J Radiat Oncol Biol Phys. 1997;38:143-148.
9.
Ohtani H.Stromal reaction in cancer tissue: pathophysiologic significance of the expression of matrix-degrading enzymes in relation to matrix turnover and immune/inflammatory reactions. Pathol Int. 1998;48:1-9.
10.
Borg TKIt’s the matrix! ECM, proteases, and cancer. Am J Pathol . 2004;164:1141-1142.
11.
Suzuki C., Matsumoto T., Sonoue H., Arakawa A., Furugen Y., Kinoshita K.Prognostic significance of the infiltrative pattern invasion in endometrioid adenocarcinoma of the endometrium. Pathol Int. 2003;53:495-500.
12.
Kristensen GB, Abeler VM, Risberg B., Trop C., Bryne M.Tumor size, depth of invasion, and grading of the invasive tumor front are the main prognostic factors in early squamous cell cervical carcinoma. Gynecol Oncol. 1999 ;74:245-251.
13.
Horn LC, Fischer U., Raptis G., et al. Pattern of invasion is of prognostic value in surgically treated cervical cancer patients. Gynecol Oncol. 2006 ;103:906-911.
14.
Breuninger H., Schaumburg-Lever G., Holzschuh J., Horny HPDesmoplastic squamous cell carcinoma of skin and vermilion surface: a highly malignant subtype of skin cancer. Cancer. 1997;79:915-919.
15.
Horn LC, Richter CE, Hentschel B., et al. Juxtatumoral desmoplastic stromal reaction is associated with high tumor cell dissociation in squamous cell carcinomas of the uterine cervix . Ann Diagn Pathol. 2006;10:253-256.
16.
Ayala GE, Wheeler TM, Shine HD, et al. In vitro dorsal root ganglia and human prostate cell line interaction: redefining perineural invasion in prostate cancer. Prostate . 2001;49:213-223.
17.
Cornell RJ, Rowley D., Wheeler T., Ali N., Ayala G.Neuro-epithelial interactions in prostate cancer are enhanced in the presence of prostatic stroma. Urology. 2003;61:870-875.
18.
Horn LC, Meinel A., Fischer U., Bilek K., Hentschel B.Perineural invasion (PNI) in carcinoma of the cervix uteri: prognostic impact . J Cancer Res Clin Oncol. 2010; 136:1557-1562.
19.
Horn LC, Einenkel J., Hockel M., et al. Pathoanatomical preparation and reporting for dysplasias and cancers of the cervix uteri: cervical biopsy, conization, radical hysterectomy and exenteration. Pathologe. 2007;28:249-260.
20.
Kurman RJ, Amin MB; Members of the Cancer Committee, College of American Pathologists. Protocol for the examination of specimens from patients with carcinomas of the cervix: a basis for checklists. Arch Pathol Lab Med. 1999;123:55-61.
21.
Eggen T., Arnes M., Moe B., Straume B., Orbo A.Prognosis of early cervical cancer (FIGO Stages IA2, IB, and IIA) in northern Norway predicted by malignancy grading score and objective morphometric image analysis. Int J Gynecol Pathol. 2007;26:447-456.
22.
Wells M., Östör AG, Crum CP, et al. Epithelial tumors of the uterine cervix. In: Tavassoli FA, Devilee P, eds. Pathology and Genetics of Tumours of the Breast and Female Genital Organs. World Health Organization Classification of Tumours . Lyon, France: IARC Press; 2003:259-279.
23.
Dalal R., Djakiew D.Molecular characterization of neurotrophin expression and the corresponding tropomyosin receptor kinases (trks) in epithelial and stromal cells of the human prostate. Mol Cell Endocrinol. 1997;134:15-22.
24.
Ketterer K. , Rao S., Friess H., Weiss J., Büchler MW, Korc M.Reverse transcription-PCR analysis of laser-captured cells points to potential paracrine and autocrine actions of neurotrophins in pancreatic cancer. Clin Cancer Res. 2003 ;9:5127-5136.
25.
Spiro RH, Guillamondegui O. Jr , Paulino AF, Huvos AGPattern of invasion and margin assessment in patients with oral tongue cancer. Head Neck. 1999;21:408-413.
26.
Kurtz KA, Hoffman HT, Zimmerman MB, Robinson RAPerineural and vascular invasion in oral cavity squamous carcinoma: increased incidence on re-review of slides and by using immunohistochemical enhancement . Arch Pathol Lab Med. 2005;129:354-359.
Tavares MB, Sousa RB, Oliveira e Silva T., et al. Prevalence of prognostic factors for cancer of the uterine cervix after radical hysterectomy. Sao Paulo Med J. 2009;127: 145-149.
29.
Memarzadeh S., Natarajan S., Dandade DP, et al. Lymphovascular and perineural invasion in the parametria: a prognostic factor for early-stage cervical cancer. Obstet Gynecol. 2003;102:612-619.
30.
Horn LC, Fischer U., Raptis G., Bilek K., Hentschel B.Tumor size is of prognostic value in surgically treated FIGO stage II cervical cancer. Gynecol Oncol. 2007;107:310-315.
