Abstract
BackgroundPrognostic factors in predicting occult lymph node metastasis in patients with head and neck squamous-cell carcinoma (HNSCC) are necessary to improve the results of the sentinel lymph node procedure in this tumour type. The E-Cadherin glycoprotein is an intercellular adhesion molecule in epithelial cells, which plays an important role in establishing and maintaining intercellular connections.ObjectivesTo determine the value of the molecular marker E-Cadherin in predicting regional metastatic disease.MethodsE-Cadherin expression in tumour tissue of 120 patients with HNSCC of the oral cavity and oropharynx were evaluated using the tissue microarray technique. 110 tumours were located in the oral cavity (91.7%; mostly tongue), 10 tumours in the oropharynx (8.3%). Intensity of E-Cadherin expression was quantified by the Intensity Reactivity Score (IRS). These results were correlated with the lymph node status of biopsied sentinel lymph nodes. Univariate and multivariate analysis was used to determine statistical significance.ResultspT-stage, gender, tumour side and location did not correlate with lymph node metastasis. Differentiation grade (p = 0.018) and down regulation of E-Cadherin expression significantly correlate with positive lymph node status (p = 0.005) in univariate and multivariate analysis.ConclusionThese data suggest that loss of E-cadherin expression is associated with increased lymhogeneous metastasis of HNSCC. E-cadherin immunohistochemistry may be used as a predictor for lymph node metastasis in squamous cell carcinoma of the oral cavity and oropharynx.Level of evidence: 2b
Highlights
Prognostic factors in predicting occult lymph node metastasis in patients with head and neck squamous-cell carcinoma (HNSCC) are necessary to improve the results of the sentinel lymph node procedure in this tumour type
These data suggest that loss of E-cadherin expression is associated with increased lymhogeneous metastasis of HNSCC
E-cadherin immunohistochemistry may be used as a predictor for lymph node metastasis in squamous cell carcinoma of the oral cavity and oropharynx
Summary
Prognostic factors in predicting occult lymph node metastasis in patients with head and neck squamous-cell carcinoma (HNSCC) are necessary to improve the results of the sentinel lymph node procedure in this tumour type. Head and neck squamous cell carcinoma (HNSCC) is the fifth most common malignancy worldwide. In 1999, in the US, approximately 29’800 patients suffered from a squamous cell carcinoma of the oropharynx and the oral cavity and more than 8000 died of it [1]. A chief feature of malignant behavior is the capability of tumour cells to metastasize. Metastatic spread is an extremely bad prognostic factor and responsible for cause of death in ~90% of all cancer patients [3]. The “tumour cell-to-tumour cell” and “tumour cell-to-stromal environment” cross talk is recognized as an important condition for invasion and metastasis
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