Parameters In Squamous Cell Carcinoma Research Articles

The Association between Vascular Endothelial Growth Factor (VEGF) Expression and Various Pathological Parameters of Squamous Cell Carcinoma of Uterine Cervix in Sanglah General Hospital

Cervical cancer is the second most common malignancy in women with increasing morbidity and mortality rate. VEGF is known as one of pro-angiogenic factors that induce angiogenesis in various malignancy. VEGF overexpression is associated with poor prognosis and plays an important role in cervical cancer progression. This study aimed to investigate the association between VEGF expression and pathological parameters of squamous cell carcinoma of uterine cervix in Sanglah General Hospital Denpasar. This is a cross-sectional study design. The sampel size was 36 paraffin blocks which were selected by consecutive sampling. Pathological parameter data were divided into 2 categories; tumor size (£4 cm, >4 cm), tumor extension (intra and extra-uterine), lymphatic vascular invasion (positive, negative), vascular density (low, high) and lymph node metastasis (positive, negative). VEGF expressions were examined by imunohistochemical technique and evaluated by Histo-Score method. All variables were analyzed by Chi-square analysis with significance value p <0.05. Chi-square analysis revealed an association between tumor size and VEGF expression (p=0.035). In addition, large tumor size (>4 cm) has 2.17 times probability of causing high VEGF expression. VEGF expression were not associated with tumor extension (p=0.502), lymphatic vascular invasion (p=0.346), vascular density (p=0.364) and lymph node metastasis (p=0.209). This study has proved that tumor size is associated with VEGF expression. Large tumor size has greater risk of causing high VEGF expression therefore anti-VEGF targeted therapy could be proposed in large tumor size. There were no association between VEGF expression and tumor extension, lymphatic vascular invasion, vascular density and lymph node metastasis.
 
 Keywords: VEGF expression, squamous cell carcinoma, uterine cervix.

A proposed Clino-radio-pathological Risk Scoring System (CRiSS) for prediction and management of inguinal lymph-nodes metastasis in squamous cell carcinoma of the penis

ObjectiveTo develop a risk scoring system for prediction of inguinal lymph-node involvement and to suggest a management strategy according to the risk groups based on clinical, radiological and pathological parameters in squamous cell carcinoma (SCC) of penis. Materials and MethodsA retrospective analysis of all patients of SCC penis from 2014 to 2020 at our institute was done. The patients were divided into derivation cohort (2014 to 2019) and validation cohort (2019 to 2020). A total of 10 predictors were analysed in univariate analysis and those found significant were further subjected to multivariate analysis to derive regression coefficient for each. CRiSS scores were assigned based on the coefficients and three groups were created which were correlated with nodal metastasis. The predictive accuracy of the model was assessed by ROC analysis of the derivation cohort and validation cohort. ResultsA total of 102 patients were identified in derivation cohort and 23 patients in validation cohort. Size of the primary >3cm, ulceroinfiltrative growth, involving shaft, ultrasound size of lymph-nodes >1cm, loss of fatty hila, moderate and poor differentiation, and lypmphovascular/perineural invasion were independent predictors of inguinal lymphnode metastasis in multivariate analysis. CRiSS could achieve AUROC of .910 and .887 in derivation and validation cohort respectively. The rate of metastatic lymphadenopathy was 0%, 41.4%, and 89.5% in low, intermediate, and high-risk groups respectively. ConclusionsCRiSS can effectively predict inguinal lymph-node metastasis in SCC penis. We suggest a management strategy based on risk groups that will avoid morbidity of groin dissection in many patients.

Lymph Node Subcapsular Sinus Microenvironment-On-A-ChipModeling Shear Flow Relevant to Lymphatic Metastasis and Immune Cell Homing.

SummaryA lymph node sinus-on-a-chip adhesion microfluidic platform that recapitulates the hydrodynamic microenvironment of the lymph node subcapsular sinus was engineered. This device was used to interrogate the effects of lymph node remodeling on cellular adhesion in fluid flow relevant to lymphatic metastasis. Wall shear stress levels analytically estimated and modeled after quiescent and diseased/inflamed lymph nodes were experimentally recapitulated using a flow-based microfluidic perfusion system to assess the effects of physiological flow fields on human metastatic cancer cell adhesion. Results suggest that both altered fluid flow profiles and presentation of adhesive ligands, which are predicted to manifest within the lymph node subcapsular sinus as a result of inflammation-induced remodeling, and the presence of lymph-borne monocytic cells may synergistically contribute to the dynamic extent of cell adhesion in flow relevant to lymph node invasion by cancer and monocytic immune cells during lymphatic metastasis.

Expression of P16 biomarker in squamous cell carcinoma of uterine cervix and its association with clinico-pathological parameters: A cross-sectional study

Introduction: Cervical cancer is the most common cancer among females. P16 is the surrogate marker for cervical carcinoma. This study aimed to evaluate the association of P16 marker with clinic-pathological parameters in squamous cell carcinoma of uterine cervix.
 Methods: This was a cross-sectional study. Histological confirmed cases of squamous cell carcinoma (SCC) of cervix were considered. All cases were evaluated for IHC P16 expression as per lower anogenital squamous terminology (LAST) criteria and correlated with clinico-pathological parameters. The data was analyzed by SPSS software version 22.
 Results: Out of 75 cases, P16 biomarker expression was block positive, ambiguous and negative in 67 (89.3%), 5 (6.6%), and 3 (4%) cases, respectively. There was a significant association between P16 expression and age (p = 0.005). All cases between 30-59 years of age showed block positivity. There was no significant association between P16 expression and age at marriage (p = 0.951), age at menopause (p = 0.311), parity (p = 0.554), clinical symptoms/signs, stage of disease (p = 0.28), or histopathological grade (p = 0.877). Maximum expression was seen between 40-44 years. Moreover, all cases having 1 & 2 parity showed block positivity and all stage I cases showed block positivity.
 Conclusion: P16 biomarker was significantly expressed in cervical cancers of the relatively younger age group and those with early stage of disease.

Expression of urokinase-type plasminogen activator and its receptor in squamous cell carcinoma of the oral tongue.

Urokinase-type plasminogen activator (uPA) and its receptor (uPAR) act in the proteolysis of basement membrane and extracellular matrix structures, facilitating tumor invasion. The purpose of this study was to evaluate the relationship between these proteins and clinicopathological parameters in squamous cell carcinoma of the oral tongue (SCCOT). Sixty cases of SCCOT were submitted to immunohistochemistry and analyzed semiquantitatively at the invasion front and in the tumor core. The results were associated with lymph node metastasis, clinical stage, locoregional recurrence, clinical outcome and histological grade of malignancy. A higher expression of uPA was observed in cases of tumors of high-grade versus low-grade malignancy (p = 0.010). Moreover, the cases with the worst pattern of invasion presented an overexpression of uPA (p = 0.011). The presence of locoregional recurrence was associated with uPAR (p = 0.039), and the expression of both biomarkers was much higher at the invasion front than in the tumor core (p < 0.001). The results suggest uPA and uPAR are involved in the progression and aggressiveness of SCCOT, mainly at the tumor-host interface.

The value of quantitative analysis with spectral CT imaging in the diagnosis of non-small cell lung cancer with different pathological types

Objective To explore the value of quantitative parameters of spectral CT imaging in the diagnosis of non-small cell lung cancer (NSCLC) with different pathological types. Methods One hundred and thirty-six patients with NSCLC proved by pathology underwent chest plain and enhanced CT scan with gemstone spectral imaging (GSI) mode by Discovery CT750 HD, including 57 cases of squamous cell carcinoma (SQCC) and 79 cases of adenocarcinoma (ADC). All the cases were divided into two groups of tumor diameter>2 cm (120 cases, including 50 cases of SQCC and 70 cases of ADC) and diameter≤2 cm (16 cases, including 7 cases of SQCC and 9 cases of ADC). The slope between 40 and 65 keV(K40-65 keV) of spectral attenuation curve, effective atomic number (Eff-Z) and calcium concentration in plain scan (PS) and K40-65 keV of spectral attenuation curve, iodine concentration and water concentration in arterial phase (AP) of SQCC and ADC in the two groups were measured and compared respectively. Furthermore, all cases were classified according to the trend of spectral attenuation curve in PS. These quantitative parameters satisfying normal distribution were compared by two independent samples t test, while those parameters not satisfying normal distribution were compared by rank sum test. ROC curves was drawn for these parameters with statistical difference and area under the curve (AUC) was used to measure the differential diagnostic performance of each parameter. Chi square test was used to compare the differences of the trend of spectral attenuation curve in PS between SQCC and ADC. Results In the group of diameter>2 cm: (1) Comparison of quantitative parameters of spectral CT in PS: K40-65 keV, Eff-Z and calcium concentration of ADC were 0.69±0.56, 7.76±0.19, and (4.11±2.93) mg/cm3, respectively. The corresponding parameters of SQCC were 0.19±0.23, 7.59±0.14, and (1.25±1.59) mg/cm3, respectively. These parameters of ADC were significantly higher than SQCC (Z=-7.000, -6.249, t=-6.884, P 0.05). The trend of spectrum attenuation curve in PS of all cases showed type Ⅱ. Conclusions Lung ADC and SQCC have different quantitative parameters in spectral CT imaging. These quantitative parameters are valuable in classifying the pathological type of NSCLC with diameter more than 2 cm. Key words: Carcinoma, non-small-cell lung; Tomography, X-ray computed; Comparative study

Tumor-associated macrophages (TAMs): clinical-pathological parameters in squamous cell carcinomas of the lower lip.

The objective of this study was to analyze the presence of tumor-associated macrophage (TAM) subpopulations M1 and M2 in squamous cell carcinoma of the lower lip (SCCLL) by immunohistochemitry, and to evaluate the possible role of these subtypes in the development of regional lymph node metastasis and their association with clinical and pathological parameters. Forty-two cases of SCCLL were divided into two groups (21 with and 21 without regional lymph node metastasis). The histopathological grade of malignancy was determined and the material was submitted to double staining with anti-CD68/anti-CD163 and anti-CD68/anti-HLA-DR monoclonal antibodies. The results were analyzed statistically using the Wilcoxon signed-rank and Spearman correlation tests. The M1 and M2 subpopulations were observed in all cases studied. No significant difference was observed between the quantities of M1 and M2 TAMs regarding tumor size (p > 0.05). A significantly larger number of M2 compared to M1 TAMs was observed in tumors without regional lymph node metastasis, tumors in early stages, and low-grade tumors (p < 0.05). No significant difference between the numbers of M1 and M2 TAMs was observed in tumors with regional lymph node metastasis, tumors in advanced stages, and high-grade tumors (p > 0.05). There was a positive weak correlation between M1 and M2 TAMs (r = 0.361; p = 0.019). The results suggest a more important role of M2 TAMs in early stages than advanced stages of lip carcinogenesis. The progression of SCCLL does not seem to be related to an imbalance of macrophage polarization in the microenvironment of these tumors.

Expression of Na+-K+-2Cl- cotransporter isoform 1 (NKCC1) predicts poor prognosis in lung adenocarcinoma and EGFR-mutated adenocarcinoma patients.

Sodium-potassium-chloride cotransporter isoform 1 (NKCC1) is an active ions cotransporter and modulates cellular volume and migration. NKCC1 blockers can inhibit cancer cell growth. We aimed to elucidate the expression and prognostic significance of NKCC1 in non-small cell lung cancer (NSCLC). We retrospectively analyzed 788 NSCLC patients with either adenocarcinoma (n = 503) or squamous cell carcinoma (n = 285) by immunohistochemistry to correlate NKCC1 expression with clinicopathologic and survival outcomes. In adenocarcinoma, high NKCC1 expression was associated with larger tumor size (P = 0.013), vascular invasion (P < 0.001), lymphatic invasion (P < 0.001), perineural invasion (P = 0.019) and advanced pathologic stage (P < 0.001), but there are no significant correlations between NKCC1 expression and clinicopathological parameters in squamous cell carcinoma. Patients with high NKCC1 expression had significantly shorter disease-free survival (DFS;P < 0.001) and shorter overall survival (OS;P < 0.001) than those with low NKCC1 expression in adenocarcinoma. In squamous cell carcinoma, NKCC1 expression was not associated with prognosis. Multivariate analysis revealed that high NKCC1 expression was an independent prognostic factor for DFS in lung adenocarcinomas (HR, 1.709; 95% CI 1.029-2.130;P = 0.033) and for OS inEGFR-mutated adenocarcinoma patients (HR, 3.165; 95% CI 1.424-7.035;P = 0.005). NKCC1 high expression predicted a bad clinical outcome for lung adenocarcinoma patients andEGFR-mutated subgroup. Therefore, NKCC1 may play a role in lung adenocarcinoma and novel therapeutic tactics could be developed by targeting NKCC1 protein.

The expression of EGFR, cerbB2, p16, and p53 and their relationship with conventional parameters in squamous cell carcinoma of the larynx*

To investigate the expression of epidermal growth factor receptor-HER1 (EGFR), cerbB2 (HER2), p16, and p53, as well as the relationship of the expression of these genes with conventional parameters in squamous cell carcinoma (SCC) of the larynx. Samples from 92 cases of diagnosed laryngeal SCC between 2001 and 2011 from the Pathology Department of Ministry of Health Ankara D1şkapi Yildirinm Beyazit Teaching & Research Hospital were studied by immunohistochemistry using EGFR, cerbB2, p16, and p53 antibodies. An increase in the TNM stage and pathological tumor size status correlated with an increase in EGFR and cerbB2 expression. In the cases with lymphovascular invasion, the expression was detected at a higher ratio. Cases in which high levels ofpl6 and p53 expression were observed did not show any lymphovascular invasions. Expressions of p53 and p16 were considered to be most effective in early carcinogenesis stages of laryngeal SCC. In comparison with p53 and p16 expression levels, EGFR and cerbB2 expression levels were observed to be associated with poor prognostic parameters and were higher at later stages of laryngeal carcinogenesis development.

Survivin expression is an independent poor prognostic marker in lung adenocarcinoma but not in squamous cell carcinoma

Survivin is a member of the inhibitors of apoptosis and frequently overexpressed in various cancer cells. Overexpression of survivin in lung cancer cells attenuates antitumor effect of tyrosine kinase inhibitors. However, data from the previous studies on the clinicopathologic implication of survivin in non-small-cell lung carcinoma (NSCLC) are inconsistent. We investigated the expression of survivin in 373 cases of surgically resected NSCLC. Correlations between the expression of survivin and clinicopathologic, molecular features and prognostic significance were analyzed. In adenocarcinoma, the increased expression of survivin was associated with the presence of vascular invasion, lymph node metastasis, and tumor recurrences, but we didn't find any correlation with survivin expression and clinicopathological parameters in squamous cell carcinoma. Patients with high survivin expression had significantly shorter disease-free survival (DFS; 42.2 vs. 58.8 months; p = 0.001) and shorter overall survival (OS; 60.8 vs. 71.5 months; p = 0.009) than those with low survivin expression group in adenocarcinoma. In squamous cell carcinoma, the expression of survivin was not associated with prognosis of the patients (DFS; 48.9 vs. 48.7 months; p = 0.837, OS; 61.0 vs. 62.4 months; p = 0.771). Multivariate analysis confirmed that survivin was an independent poor prognostic factor in adenocarcinoma (DFS: hazard ratio (HR), 1.687; 95 % confidence interval (CI), 1.123-2.532; p = 0.012; OS: HR, 1.965; 95 % CI, 1.108-3.486; p = 0.021). There was no statistically significant difference in the expression of survivin among different molecular subgroups (p > 0.05). Our results suggest that survivin is an independent negative prognostic factor in adenocarcinoma, but not in squamous cell carcinoma. The different prognostic roles played by survivin in adenocarcinoma and squamous cell carcinoma highlights the biological differences between these two histologic types.

Poor prognostic clinicopathologic features correlate with VEGF expression but not with PTEN expression in squamous cell carcinoma of the larynx

BackgroundThe aim of this study was to assess the relationship between expression of vascular endothelial growth factor (VEGF) and phosphatase and tensin homolog deleted in chromosome ten (PTEN), angiogenesis and clinicopathological parameters of squamous cell carcinoma of the larynx.MethodsWe examined immunohistochemical expression of VEGF and PTEN and CD34 for microvessel density (MVD) in sections of formalin-fixed, paraffin embedded tissue blocks of 140 patients with squamous cell carcinoma of the larynx. The intensity of VEGF and PTEN staining and the proportion of cells staining were scored.ResultsThe tumor grade was not significantly related to PTEN expression, but it was to VEGF expression (p = 0.400; p = 0.015, respectively). While there was no significant relationship between PTEN expression and tumor size and cartilage invasion (p = 0.311, p = 0.128), there was a significant relationship between the severity of VEGF expression and tumor size (p = 0.006) and lymph node metastasis (p = 0.048) but not cartilage invasion (p = 0.129). MVD was significantly higher in high-grade tumors (p = 0.003) but had no significant relationship between MVD, lymph node metastasis, and cartilage invasion (p = 0.815, p = 0.204). There was also no significant relationship between PTEN and VEGF expression (p = 0.161) and between PTEN and VEGF expression and the MVD (p = 0.120 and p = 0.175, respectively).ConclusionsIncreased VEGF expression may play an important role in the outcome of squamous cell carcinoma of the larynx. PTEN expression was not related to VEGF expression and clinicopathological features of squamous cell carcinoma of the larynx.

Tracer kinetics analysis of dynamic contrast‐enhanced CT and MR data in patients with squamous cell carcinoma of the upper aerodigestive tract: comparison of the results

(i) To evaluate the feasibility of tracer kinetics analysis of dynamic contrast-enhanced (DCE) CT and T2-weighted MR data of squamous cell carcinoma (SCCA) of the upper aerodigestive tract. (ii) To compare functional parameters derived by both modalities and examine the interchangeability of them as well as the intra- and inter-rater agreement. Dynamic contrast-enhanced-CT and MR images of 23 patients with SCCA were postprocessed using a distributed-parameter (DP) tracer kinetic model. The evaluated parameters included blood flow (F), intravascular blood volume (v(1)), extravascular extracellular blood volume (v(2)), intravascular mean transit time (t(1)), lag time (t(0)), permeability surface area product (PS) and extraction ratio (E). Mean perfusion values, based on region-of-interest analysis, of the tumors and the healthy muscle tissue were compared and correlated. Inter-rater and intra-rater variability were assessed. Interchangeability of the tumor functional parameters was tested using Pearson's correlation coeficients and Bland-Altman plots. The mean values in tumor and healthy muscle tissues were significantly different for each modality (0.0001< or =P< or =0.03). The mean values of all tumor perfusion parameters apart from v(2) and E were significantly different (0.001< or =P< or =0.009) between the two modalities. The intra-rater variability was good to very good for all parameters. The inter-rater variability was moderate to good. Bland-Altman plots of F, t(1), t(0), and v(2) showed moderate interchangeability. There was a proportionality error in v(1) and PS graphs. The estimation of functional parameters in SCCA is feasible using DCE-CT and -MR with a DP model. The parameters are mostly significantly different and the interchangeability of them is limited.

Proliferating cell nuclear antigen (PCNA) overexpression and microvessel density predict survival in the urinary bladder carcinoma

To study proliferating cell nuclear antigen (PCNA) over expression and angiogenesis with their relationship to tumor parameters in squamous cell carcinoma of the urinary bladder in patients who underwent radical cystectomy. The mean age of the patients was 53.53 years (range; 29-70 years) and the males were 98 of 154. Sections from paraffin embedded tissues were retrieved and stained with antibodies against PCNA for proliferation and CD34 for angiogenesis using immunohistochemical technique. Fisher's exact test was used to evaluate the relationship between categorical variables and the Kaplan-Meier procedure was used to assess survival outcomes. The Cox regression model was used for multivariate analysis. The median follow up period was 65 months. microvessel density (MVD), PCNA, tumor grade, P-stage, DNA ploidy, lymph node status had a significant impact on the 5-year survival of patients in univariate analysis. In Cox proportional hazard model, MVD, PCNA, DNA ploidy and stage sustained their significant impact on survival of the patients. MVD, PCNA, DNA ploidy and stage are independent prognostic factors in patients with squamous cell carcinoma of the urinary bladder.

Correlation between reduction of syndecan-1 expression and clinico-pathological parameters in squamous cell carcinoma of tongue

We examined expression of syndecan-1 in squamous cell carcinoma (SCC) of tongue using immunohistochemistry. Forty-three cases of SCC arising in lateral border of tongue were investigated. From the immunohistochemical staining pattern, the cases were divided into two groups based on expression of syndecan-1 at the supra-peripheral cells of the tumor nest: Group A, completely or mainly positive; Group B, sporadically positive or negative. Most poorly differentiated SCC cases were classified into Group B (81.8%). The number of Group B cases in T1–2 was different from that in T3–4. The number of cases where syndecan-1 expression was reduced was much greater in T3–4, and represented the majority of Group B (86.7%). More than 80% of Grade 4D cases were in Group B (83.3%) based on the Yamamoto–Kohama criteria. These results indicate that reduction of syndecan-1 correlates to histological grade, tumor size and mode of invasion in tongue SCC.

Identification of Prognostic Pathologic Parameters in Squamous Cell Carcinoma of the Penis

Abstract: Penile carcinomas are infrequent in the USA and Europe, but fairly frequent in some geographical regions of Asia, Africa, and Latin America. The vast majority of tumors are squamous cell carcinoma, which disseminate in a loco regional manner to intrapenile anatomical structures: lamina propria, corpus spongiosum, and corpus cavernosum in the glans and lamina propria, dartos, and outer skin in the prepuce. Nodal spread is in the sentinel, superficial, and deep groin nodes, and then to pelvic or iliac lymph nodes. Widespread dissemination occurs in a third of the cases, usually in locally advanced disease. Pathologic factors important to predict regional metastasis and patient's outcome are: site and size of the primary tumor, growth pattern, histologic grade, subtype of squamous cell carcinoma, tumor depth of invasion, and the prognostic index. Tumors in the foreskin have a better prognosis because they are of lower grade and more superficial than those of the glans. Neoplasms with superficially spreading, multicentric, or verruciform patterns of growth carry a better prognosis than those of a vertical growth. There is a correlation between high histologic grade, deep intrapenile invasion, and nodal metastasis in penile squamous cell carcinomas. Superficially invasive tumors in the lamina propria, corpus spongiosum, or dartos tend not to be associated with metastasis whereas those deeply invasive in the corpus cavernosum, in the glans, or skin of the foreskin are associated with a high risk of metastasis. Considering the variability in the gross presentation of penile neoplasms, which make the use of a single measurement system difficult, we describe 3 methods to evaluate the depth of invasion: tumor depth (for smaller tumors—measured from the basement membrane of the adjacent uninvolved epithelium to the deepest point of tumor invasion), tumor thickness (for bulky or verruciform tumors—measured from the granular layer of the tumor to the deepest point), and anatomical levels of invasion (for all tumors. In the glans, the levels are lamina propria, corpus spongiosum, and corpus cavernosum; in the foreskin, the levels are lamina propria, dartos, and skin). The histologic subtype of squamous cell carcinoma associated with almost no risk of metastasis is the pure verrucous carcinoma. A mixed component should be ruled out by submitting multiple sections of the tumor. Low risk for metastasis is found in papillary NOS (not otherwise specified) and warty (condylomatous) carcinomas. Basaloid and sarcomatoid carcinomas are associated with higher risk of nodal metastasis. Vascular invasion is a more important predictor of metastasis than perineural invasion. The prognostic index is a system we use in our practice to predict metastasis and survival. It is represented by numbers 1 to 6, arrived at by adding numerical values given to histologic grades (1-3) and to anatomical levels of invasion (1-3) in the glans and foreskin. Low indexes (1-4) are associated with low metastatic rate. The use of prognostic molecular markers is not yet a common practice in the pathologic and clinical management of penile cancer.

Genomic gain of the epidermal growth factor receptor harboring band 7p12 is part of a complex pattern of genomic imbalances in oral squamous cell carcinomas

To determine the association between changes of genomic gene dose and clinical parameters in squamous cell carcinomas of the oral cavity, comparative genomic hybridization seemed suited not only to detect genomic imbalances in these tumors, but also particularly to examine the role of gain of 7p12, the band harboring the epidermal growth factor receptor (EGFR) in this context. Total genomic DNA obtained from 35 oral squamous cell carcinomas was subjected to comparative genomic hybridization (CGH) and detected patterns of genomic imbalances were associated with various clinical parameters. The examined tumors exhibited five and up to 47 DNA copy number alterations (CNAs). Nineteen of these showed a gain of chromosome band 7p12. A highly complex but strikingly consistent pattern of genomic imbalances (average, 32 CNAs per tumor) was associated with this alteration, among which gains clearly dominated over losses of genomic material. Comparable patterns, however, could also be found in a few tumors with a high number of CNAs (average, 26) but without the 7p gain. Low numbers of imbalances always were accompanied by low consistency of CNA patterns and none of these cases showed enh(7p12). No significant differences with respect to pT class or grade of tumors were found between enh(7p)-positive and -negative tumors. Stage IV and lymph node affection were slightly more frequent among enh(7p12)-positive than in -negative cases. Relapse occurred in 63% in 7p12-positive vs. 25% in the negative group. Average disease-free survival of tumors without 7p gain clearly exceeded that of tumors with gain of 7p (36.8 vs. 21.3). However, some of these associations could also be found if comparison was based on number of CNAs. By means of hierarchical cluster analysis, we were able to show that different patterns of CNAs can be separated from each other in tumors with or without 7p alterations, and that these patterns predict short- or long-term survival of patients. Previously described associations of gains of 7p12, the chromosomal band harboring the EGFR gene with clinical parameters can reasonably be estimated only within the context of the pattern and complexity of the genomic imbalances accompanying this chromosomal loss in examined tumors.

Risk factors for late cervical lymph node metastases in patients with stage I or II carcinoma of the tongue.

Many histopathologic parameters in squamous cell carcinoma of the tongue have been identified as predictive factors for cervical lymph metastasis. However, predictive factors for occult cervical lymph node metastases and the criterion for elective therapy remain inconclusive. This study analyzed the clinicopathologic factors associated with late cervical lymph node metastases in patients with carcinoma of the tongue. The clinicopathologic features of 50 consecutive patients seen between January 1985-December 1996 with previously untreated stage I or II squamous cell carcinoma of the tongue were reviewed. All patients were treated with partial glossectomy without elective neck dissection. Their mean age was 54.5 y (range, 23-90 y) and the male-female ratio was 1.2:1 (27 men and 23 women); 30 cases were stage I, and 20 cases were stage II. Clinicopathologic factors were analyzed to determine factors predicting late cervical lymph node metastasis. The overall cervical lymph node metastasis rate was 14.0% (7 of 50). Clinicopathologic factors significantly associated with the development of cervical lymph node metastasis were tumor size (> or =30 mm), tumor depth (> or =4 mm), differentiation, mode of invasion, microvascular invasion, and histologic grade of malignancy. In a multivariate logistic regression analysis, moderately differentiated squamous cell carcinoma of the tongue with tumor depth > or =4 mm had predictive value for late cervical lymph node metastasis and diminished overall survival (odds ratio, 10.0; p =.02; hazards ratio, 7.0; p =.039). The findings of this study demonstrate tumor depth > or =4 mm moderately differentiated squamous cell carcinoma of the tongue have a substantially higher rate of late cervical metastases. In the basis of these data, it is our recommendation that this be used in the decision to electively treat the neck.

Relation between lymphatic vessel diameter and clinicopathologic parameters in squamous cell carcinomas of the oral region

In an attempt to determine the mechanism of cervical lymph node metastases, the authors studied the relation between lymphatic vessels in or around tumour tissue and lymph node metastases in patients with primary squamous cell carcinoma (SCC) of the oral region by enzyme histochemistry using 5′ nucleotidase-alkaline phosphatase. The subjects consisted of 23 patients, who had biopsy proven oral SCC. After enzyme histochemical staining, the cross-sectional dimensions of the lymphatic vessels were measured and analysed in relation to the T classification of the tumour, degree of tumour differentiation and mode of invasion. The average diameter of the lymphatic vessels in or around tumour tissue was significantly greater than that in tumour-free tissue (P<0.01). The mode of invasion correlated significantly with the lymphatic vessel diameter (P<0.01). The diameter did not correlate significantly with the T classification (P range, 0.135–0.254) or tumour differentiation (P=0.274). The following relation was found between the incidence of cervical lymph node metastases and the mode of invasion: 40.0% of Grade 2 tumours were positive for metastases, 71.4% of Grade 3 tumours were positive, and 75.0% of Grade 4 tumours were positive (grading was according to Jakobsson’s classification). Of the factors evaluated in this study, only the mode of invasion correlated significantly with the diameter of the lymphatic vessels. Although other studies have shown that tumour thickness and perhaps even perineural and blood vessel invasion may be equally important, the findings of the current study suggest that both lymphatic vessel diameter and the mode of invasion may be important factors in the prediction of cervical lymph node metastases. Henk Tideman

Relation between lymphatic vessel diameter and clinicopathologic parameters in squamous cell carcinomas of the oral region

Relation between lymphatic vessel diameter and clinicopathologic parameters in squamous cell carcinomas of the oral region

Relation between lymphatic vessel diameter and clinicopathologic parameters in squamous cell carcinomas of the oral region: Nakayama A, Ogawa A, Fukuta Y, et al. Cancer 86:200, 1999

Relation between lymphatic vessel diameter and clinicopathologic parameters in squamous cell carcinomas of the oral region: Nakayama A, Ogawa A, Fukuta Y, et al. Cancer 86:200, 1999