Clinicopathological correlations of perineural invasion in resected non-small cell lung cancer.

BACKGROUND: The complex forms of the neural tumor microenvironment are involved in cancer progression and constitute the area of cancer neuroscience research. Perineural invasion (PNI), as one of the nerve-neoplastic interactions, is a well-known histopathological feature found in many solid malignancies, carrying potential prognostic significance. PNI frequency and prognostic significance in non-small cell lung cancer (NSCLC) remain poorly analyzed. OBJECTIVE: This study aimed to evaluate the incidence of PNI in a cohort of NSCLC patients and its relationship with clinicopathological features and overall survival (OS). MATERIAL AND METHODS: The study population consisted of 124 archival, surgically resected NSCLC cases. Standard hematoxylin and eosin-stained tumor sections were assessed for the presence of PNI. Associations between PNI and clinicopathological parameters were analyzed, and its prognostic significance was evaluated in relation to overall survival (OS). RESULTS: PNI was identified in 13.7% of cases, occurring more frequently in squamous cell carcinomas (21.0%) compared to adenocarcinomas (7.5%). It was significantly associated with hilar localization (p = 0.0005), squamous histology (p = 0.037), vascular invasion (p = 0.040), and lymph node metastases (p = 0.002). However, no significant association was found between PNI and overall survival (p = 0.216). CONCLUSION: PNI in NSCLC is an infrequent phenomenon. It shows a significant association with high-risk pathological features, including lymph node metastases and vascular invasion, suggesting a potential role in tumor progression. However, PNI was not significantly correlated with overall survival in this cohort of patients.