Abstract
Simple SummaryThe frequent occurrence of occult cervical lymph node metastasis is still a therapeutic challenge in oral squamous cell carcinoma (OSCC) and represents a limiting factor in terms of survival. The common staging of malignancy is not precise enough to predict the development of lymph node metastases and additional prognostic factors are needed. In this study we show that CD36, a protein related to fatty acid metabolism, is expressed in OSCC and correlates with the occurrence of lymph node metastasis. CD36 may be useful as a specific parameter for lymph node metastasis and as a progression parameter for survival. Therefore, CD36 could be useful for risk stratification regarding lymph node metastasis in OSCC and, beyond that, CD36 could also be a possible therapeutic target in future.Purpose: To investigate the expression pattern of CD36 in a patient population with oral squamous cell carcinoma (OSCC) and to correlate CD36 expression with clinical and histopathological parameters. The hypothesis was that CD36 expression correlates with the occurrence of lymph node metastasis. Methods: To address the study objectives, a retrospective cohort study was conducted. Study variables included demographic, histopathological and survival data. CD36 expression patterns were assessed by immunohistochemistry on tissue microarrays (TMA). Logistic regression analysis, survival analysis and Cox proportional hazards model were performed. Results: High CD36 expression correlated significantly with a higher T-status, grading and occurrence of lymph node metastasis. The logistic regression with binary N status as a dependent variable showed that high CD36 expression increased the chance for lymph node metastasis 45-fold (OR = 44.7, 95% CI: 10.0–316). Patients with high CD36 expression had lower probabilities of progression-free survival. CD36 had a small and non-significant independent influence on progression-free survival. Conclusions: CD36 is expressed in OSCC and correlates with tumor grading, T-status, and especially the occurrence of lymph node metastasis. CD36 may be useful for risk stratification regarding lymph node metastasis in OSCC.
Highlights
Oral squamous cell carcinoma (OSCC) is a common cancer in the head and neck region showing a very heterogeneous course of disease [1,2]
The patient cohort consisted of 83 patients (female n = 33, male n = 50; age 64.1 ± 16.5 (SD) years) with primary diagnosed oral squamous cell carcinoma (OSCC)
Summarizing our results shows that lymph node metastasis, high grading and increased T-status occurred much more frequently in the high CD36 group than for low CD36 status, an indication that CD36 could be associated with a more aggressive disease course
Summary
Oral squamous cell carcinoma (OSCC) is a common cancer in the head and neck region showing a very heterogeneous course of disease [1,2]. A significant proportion of patients suffer from cancer recurrence and lymph node metastasis [1,3,4]. Lymph node metastasis is common and even 30–40% of the patients suffer from occult nodal metastasis [6,7]. The frequent occurrence of occult metastases poses a major therapeutic challenge. Even the common usage of PET-CT did not improve the therapeutic decision making [9]. They are often only revealed in the pathological examination of the removed cervical lymph nodes. Markers that have a high correlation with the presence of lymph node metastases would be able to influence the therapeutic decision
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