Peri-neural Invasion in Oral Squamous Cell Carcinoma (OSCC): A Clinico-pathological Marker of OSCC Prognosis and Risk Assessment

Abstract

Aims And Objectives: To assess the incidence of Peri-Neural invasion in oral squamous cell carcinoma (OSCC), and to notify its significance as potent risk factor in OSCC recurrence and metastasis. Study Design and Place of Study: A retrospective in vitro study was conducted at Indira Gandhi Institute of Medical Sciences, Patna, after approval of ethical committee Material and Methods: Clinical, histopathological and follow-up details of 86 cases of oral squamaous cell carcinoma were collected from medical records as secondary data from December 2019 till April 2021. Peri-Neural invasion was assessed in all patients and was associated with, lymph node involvement and with the different histologic grades of OSCC. Location, density and patterns of Peri-Neural invasion was checked along with extracapsular spread and survival. Chi-square test was used for analyzing statistical data. P value of < .05 was considered as significant Results: On statistical analysis it was found that, out of total 86 cases of OSCC, 59 were primary and 27 were recurrent OSCC. Male to female ratio was 3:1 and primary cases were more in age group of 35-44 years where as recurrent OSCC were more in age group of 55-64 years. Out of 59 primary cases of OSCC, Peri-Neural invasion was seen in 27 cases and out of 27 recurrent OSCC 18 had Peri-Neural invasion with a total of 45 cases with Peri-Neural invasion out of 86. Intratumor location was assessed in 22 cases and density of 1-2 nerves per section was seen. “Crescent” pattern was commonly occurring pattern in our study. Conclusion: Our study affirmed that the incidence of Peri-Neural invasion is high in OSCC. It is present in both primary and recurrent tumors, irrespective of tumor’s grading. PNI must be assessed in all cases of OSCC as it gives markable impression on recurrence, metastasis and prognosis, and modulates treatment protocols.