title: Nerve cell adhesion molecule expression in squamous cell carcinoma of the head and neck: a predictor of propensity toward perineural spread.
abstract: OBJECTIVE
  To evaluate head and neck squamous cell carcinomas (SCCAs) for the expression of nerve cell adhesion molecule (N-CAM). We propose that expression of N-CAM by tumor cells may be associated with perineural invasion in SCCA of the head and neck.
  
  
  METHODS
  Seventy-six archived specimens of histologically proven SCCA were analyzed by immunohistochemistry for the expression of N-CAM. Positive and negative controls were used to assess staining. Two sections of each specimen were reviewed for the presence of perineural invasion. A retrospective chart review was performed for each patient that corresponded to the above specimens.
  
  
  RESULTS
  Perineural invasion was present in 28 (37%) of the 76 patients evaluated for the expression of N-CAM. N-CAM expression was demonstrated in 38 (50%) of the 76 specimens. The incidence of N-CAM expression was significantly associated with perineural invasion (P = .002). There was no significant association between the presence of staining or the presence of perineural invasion and the incidence of locoregional recurrence, distant metastasis, or survival status; however, the mean follow-up was only 13.6 months (range, 1-49 mo).
  
  
  CONCLUSIONS
  There is a positive correlation between the presence of N-CAM expression and perineural invasion in SCCA of the head and neck. The expression of this adhesion molecule by tumor cells may facilitate both homophilic cell-to-cell and heterophilic cell-to-substrate adhesion, thereby enabling the tumor cells to use the perineural tissues or neural cells, or both as a conduit for perineural spread.
authors.affiliation: Head and Neck Cancer Center, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia 19104, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: McLaughlin
authors.forename: K T
authors.initials: KT
authors.lastname: Montone
authors.forename: S J
authors.initials: SJ
authors.lastname: Wall
authors.forename: A A
authors.initials: AA
authors.lastname: Chalian
authors.forename: G S
authors.initials: GS
authors.lastname: Weinstein
authors.forename: S A
authors.initials: SA
authors.lastname: Roberts
authors.forename: P F
authors.initials: PF
authors.lastname: Wolf
authors.forename: R S
authors.initials: RS
authors.lastname: Weber
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology; D015816:Cell Adhesion Molecules, Neuronal / Q000378:metabolism*; D005260:Female; D006258:Head and Neck Neoplasms / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis
chemical_list: D015816:Cell Adhesion Molecules, Neuronal