Abstract
Problem To report our experience in analysis of immunohistochemical markers for detection of micrometastasis in patients with oral cavity squamous cell carcinoma (OCSCCA)who have undergone lymphoscintigraphy and sentinel lymph node biopsy(SLNB). Staining results and analysis for CD-44, MT1-MMP, FAK and E-cadherin will be presented. Methods Paraffin embedded specimens (N=30) were retrospectively studied by immunohistochemical analysis. Applied monoclonal antibodies were anti-CD-44(Bender Med-Systems Inc., Burlingame, CA), anti-MT1-MMP(Calbiochem, San Diego, CA), anti-FAK (Upstate Biotechnology Inc, Lake Placid, NY) and anti-E-cadherin (Transduction Laboratories, Lexington, Ky). Staining patterns were analyzed by 2 independent pathologists. Differences between groups for each staining pattern were analyzed by the Fisher exact method. Results 2 groups were identified based on results of SLNB: patients with negative sentinel lymph node biopsies who represented true N0 necks (N = 19; group I) and those with evidence of occult lymph node metastasis (N =11; group II). There was no significant difference in staining patterns between groups for CD-44, although three distinct staining patterns were identified. For MT1-MMP there was a striking difference in staining between groups I (20%) and II (67%) that did not reach statistical significance (p=0.13). Specimens are currently undergoing staining for FAK and E-cadherin as described. Staining results for these markers will be analyzed and compared to those for CD-44 and MT1-MMP. Conclusion Lymphoscintigraphy followed by SLNB has been established as a sensitive tool to detect early tumor metastasis to proximal nodal basins. By comparing sentinel node status with molecular events at the primary tumor site we hope to identify a molecular marker for metastasis. We will report results of immunohistochemical analysis for CD-44, MT1-MMP, FAK and E-cadherin in this manuscript. Significance By studying this unique subset of patients we hope to identify a reliable molecular marker for metastasis, which may ultimately change the way we manage the neck for early oral cavity cancer. Support Resident research stipend.
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