本研究的目的是评估肌肉浸润（MI）在肿瘤侵袭性关键组织病理特征的预后价值，并构建一个结合当前TNM分期系统的优越预后预测模型。对301例原发性鳞状上皮口腔黏膜癌（BMSCC）患者的整张切片图像进行了MI分析。通过Kaplan-Meier分析评估了带有/不带有MI的患者的生存时间。进一步结合TNM分期系统探索MI对预后的预测价值。此外，还纳入了TCGA数据库中的204例头颈癌病例。BMSCC患者中的MI阳性率达到76%（229/301）。MI与总生存期（p = 0.012）和无病生存期（p = 0.022）呈负相关。新的系统（TNM分期结合MI）显示出强大的预测性能，曲线下面积最大（OS：p < 0.001，DFS：p < 0.004）。MI和已建立的分类系统在TCGA队列中也具有很好的预测能力。MI是BMSCC恶预后的独立预测因子。将MI纳入预测系统可以增强口腔鳞状细胞癌患者的风险分层，并可能协助临床决策过程。 © 2023 The Authors. 此文章由Wiley Periodicals LLC发布的《口腔疾病》出版物提供。

The objective of the study was to assess the prognostic value of muscle invasion (MI), a key histopathological feature of tumor aggressiveness, and construct a superior prognostic prediction model combining the current TNM staging system.MI was analyzed in the whole-slide images from a total of 301 patients with primary buccal mucosa squamous cell carcinoma (BMSCC). Survival times of patients with/without MI were evaluated by Kaplan-Meier analysis. MI was further combined with the TNM staging system to explore its predictive value for prognosis. Moreover, 204 cases of head and neck carcinoma from the TCGA database were included.MI positive rate reached to 76% (229/301) in patients with BMSCC. MI was associated with poor overall survival (p = 0.012) and disease-free survival (p = 0.022). The novel system (TNM staging combined with MI) revealed strong predictive performance, with the largest area under the curve (OS: p < 0.001, DFS: p < 0.004). MI and the established classification system were also had good predictive ability in the TCGA cohort.MI is an independent predictor of poor prognosis of BMSCC. The inclusion of MI in prediction system can augment the risk stratification of patients with oral squamous cell carcinoma and may assist in the clinical decision-making process.© 2023 The Authors. Oral Diseases published by Wiley Periodicals LLC.