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Poor Correlation of Histologic Parameters Between Biopsy and Resection Specimen in Early Stage Oral Squamous Cell Carcinoma.

Author(s): Dik EA, Ipenburg NA, Adriaansens SO, Kessler PA, van Es RJ, Willems SM

Publication: Am J Clin Pathol, 2015, Vol. 144, Page 659-66

PubMed ID: 26386088 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to determine if histological parameters in OSCC biopsy specimens correlate with those in matched surgical resections and to determine if the correlation was dependent on specimen diameter. H&E staining was compared in matched archival specimens procured by biopsy and surgical excision from 149 patients diagnosed with pT1-2cN0 OSCC. Specimens were collected between 2004 and 2010. No additional details of specimen processing were included. Node status (N) was determined by pathological examination immediately following neck dissection, and based on evidence of metastasis within three years after the procedure.. PG was defined by the presence of malignant cells along the nerve. VG was defined by the presence of malignant cell aggregates within the endothelial-lined channels or by invasion of the media of a vessel. IG was defined by the presence of non-cohesive tumor cells with a poorly defined edge and with strand formation. The effect of specimen diameter was examined in 68 cases.

   Summary of Findings:

   In surgically resected specimens PG, VG and IG were more prevalent in node positive patients than node negative patients. However, in biopsy specimens the number of growth parameters (PG, VG or IG)  was not an indicator of node status (N), overall survival or disease-specific survival. Comparable PG, VG and IG statuses were observed in surgically resected and biopsy specimens, occurring in77%, 90% and 71% of cases, respectively. For all three growth parameters, discordance was most often due to false negatives in the biopsy specimen (23% for PG, 9% for VG, and 18% for IG). The positive predictive value of a biopsy assessed by agreement with the matched surgically resected specimen was 83%, 50% and 80% for PG, VG and IG, respectively, while the negative predictive value of a biopsy was 76%, 90% and 61%, respectively. Importantly, when the biopsy diameter was greater than 50% of the tumor diameter its growth characteristics were more likely to agree with those of the surgically resected specimen than when the biopsy diameter was smaller than 50%(52% versus 26%, p=0.03).

   Biospecimens

   • Tissue - Oral Cavity

   Preservative Types

   • Formalin

   Diagnoses:

   • Neoplastic - Carcinoma

   Platform:

   Analyte	Technology Platform
   Morphology	H-and-E microscopy

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Aliquots and Components	Aliquot size/volume	Biopsy diameter >50% surgical excision diameter Biopsy diameter <50% surgical excision diameter
   Biospecimen Acquisition	Method of tissue acquisition	Biopsy Surgical resection

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