{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:17:32Z","timestamp":1788239852040,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Building on our recent characterization of a layer-specific neurovascular microenvironment in the normal human vocal fold, we examined how that unit behaves in laryngo-hypopharyngeal carcinoma, where lymphatic and venous involvement are conventionally reported together. Methods: We retrospectively analyzed 48 laryngo-hypopharyngeal squamous cell carcinomas (2017\u20132025) with complete TNM vascular reporting, confirmed by CD31 and neuron-specific enolase (NSE) immunohistochemistry. Lymphatic (L) versus venous (V) assignment rested on morphological criteria, since CD31 cannot discriminate lymphatic from blood vessels and D2-40 was unavailable. L, V and perineural (Pn) status were related to pT stage and topography and combined into a composite score (NV = L + V + Pn), reassessed after adjustment for pT. Results: Concordant patterns predominated (L0V0 60.4%, L1V1 27.1%); 12.5% were dissociated. Vascular invasion correlated with pT (\u03c1 = 0.393, p = 0.006) and, unadjusted, with Pn, but not after adjustment for pT. NV tracked pT more strongly than any single axis (KR-20 = 0.725; \u03c1 = 0.534, p &lt; 0.001). Glottic-only carcinoma showed the lowest involvement on all axes. Conclusions: Reporting L, V and Pn separately\u2014parameters already in routine TNM notation\u2014may capture tumor aggressiveness more completely than LVI as a single entity. This series cannot establish stage-independent co-variation in these axes, validate the L\/V distinction molecularly, or, lacking follow-up, demonstrate prognostic value.<\/jats:p>","DOI":"10.3390\/medsci14050527","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:55:56Z","timestamp":1788155756000},"page":"527","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Lymphovascular Invasion: Site-Dependent Patterns of Lymphatic, Venous and Perineural Involvement in Laryngo-Hypopharyngeal Carcinoma"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1130-3629","authenticated-orcid":false,"given":"Roxana-Andreea","family":"Popa","sequence":"first","affiliation":[{"name":"Department of Morpho-Functional Sciences I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"software","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7124-3179","authenticated-orcid":false,"given":"Cosmin-Gabriel","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Morpho-Functional Sciences I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9856-6496","authenticated-orcid":false,"given":"Delia","family":"H\u00eenganu","sequence":"additional","affiliation":[{"name":"Department of Morpho-Functional Sciences I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Marius Valeriu","family":"H\u00eenganu","sequence":"additional","affiliation":[{"name":"Department of Morpho-Functional Sciences I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Cristinel Ionel","family":"Stan","sequence":"additional","affiliation":[{"name":"Department of Morpho-Functional Sciences I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5182-3967","authenticated-orcid":false,"given":"Rares-Vasile","family":"Tracicaru","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otilia","family":"Boi\u0219teanu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"254","DOI":"10.3109\/00016489109135003","article-title":"Microvascular structure of the larynx: A scanning electron microscopic study of microcorrosion casts","volume":"111","author":"Nakai","year":"1991","journal-title":"Acta Oto-Laryngol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Sato, K. (2018). Functional Histoanatomy of the Human Larynx, Springer.","DOI":"10.1007\/978-981-10-5586-7"},{"key":"ref_3","first-page":"1365","article-title":"The morphometry of the laryngeal phonatory system\u2014Basis for the anatomical study of voice aptitudes","volume":"58","author":"Cozma","year":"2017","journal-title":"Rom. J. Morphol. 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