大多数皮肤鳞状细胞癌（cSCC）预后良好。然而，一部分病例表现为进展迅速的疾病过程，可能导致转移和死亡。几个组织病理学参数与不良预后相关，但淋巴血管侵犯（LVI）尚未得到充分研究。本研究的目的是评估LVI在cSCC中的预后意义，并确定LVI与cSCC之间的关联。通过对来自一家单一中心的连续486例cSCC病例进行5年期回顾性研究，将病例分为存在或不存在LVI两组。使用Logistic回归和多变量生存分析来确定LVI的相关性和LVI的预后意义。结果显示，41例病例（9.2%）存在LVI。LVI与侵袭深度增加、微观肿瘤位置（皮下组织与真皮组织）和肿瘤尺寸显著相关（P<0.05）。单变量生存分析显示，存在LVI的患者2年总生存率（37.1%）明显低于无LVI的患者（66.6%）（95% CI=60.6-73.3，P<0.001）。多变量分析显示，LVI是不良特异性生存（HR=0.232，95% CI=0.090-0.600，P=0.003）、整体生存（HR=0.338，95% CI=0.184-0.623，P<0.001）和无病生存（HR=0.461，95% CI=0.230-0.923，P=0.029）的独立标志物。本研究证实LVI是cSCC中独立的不良预后指标，2年生存率显著较差。未来的cSCC风险分层系统应包括对LVI的考虑。© 2023 Royal Australasian College of Surgeons.

The majority of cutaneous squamous cell carcinomas (cSCC) have a favourable prognosis. However, a subset of cases follow an aggressive disease course with progression to metastasis and death. Several histopathological parameters are associated with poor outcomes, but lymphovascular invasion (LVI) has not been well studied.To assess the prognostic significance of LVI in cSCC and determine associations between LVI and cSCC.A retrospective review of 486 consecutive cases of cSCC over a 5-year period from a single centre was stratified by the presence or absence of LVI. Logistic regression and multivariate survival analysis were used to determine associations of LVI and prognostic significance of LVI, respectively.LVI was present in 41 cases (9.2%). LVI was significantly associated with increasing depth of invasion, microanatomical tumour location (subcutis vs. dermis), and tumour dimensions (P < 0.05). Univariate survival analysis revealed significantly lower 2-year overall survival rates for patients with LVI (37.1%) compared with those without (66.6%) (95% CI = 60.6-73.3, P < 0.001). LVI was also found to be an independent marker of poor disease-specific survival (HR = 0.232 (95% CI = 0.090-0.600), P = 0.003), poor overall survival (HR 0.338 (95% CI = 0.184-0.623), P < 0.001) and poor disease-free survival (HR 0.461 (95% CI = 0.230-0.923), P = 0.029) through multivariate analysis.This study confirms that LVI is an independent poor prognosticator in cSCC, with significantly worse survival indices at 2 years. Future systems of risk stratification for cSCC should incorporate LVI.© 2023 Royal Australasian College of Surgeons.