title: Predictive value of cathepsin-D for cervical lymph node metastasis in head and neck squamous cell carcinoma.
abstract: BACKGROUND
  Prognosis of head and neck squamous cell carcinoma (HNSCC) is strongly associated with cervical lymph node metastasis. Cathepsin-D is a lysosomal protease expressed in all cells. Its role in extracellular matrix degradation is postulated to promote tumor invasion and metastasis. Increased cathepsin-D has been demonstrated in cervical lymph node metastasis in HNSCC.
  
  
  METHODS
  Formalin fixed tumor biopsy samples from 34 patients with HNSCC of the oral cavity, oropharynx, or hypopharynx were analyzed for the presence of cathepsin-D by immunohistochemistry (1:8000, Calbiochem, Cambridge, MA). Tumors were considered positive if >50% of cells showed strong cytoplasmic staining.
  
  
  RESULTS
  All patients had T1 or T2 lesions ranging in size from 1-4 cm and 19 (56%) had cervical metastasis. Eight (24%) were well differentiated and 26 (76%) were moderately or poorly differentiated. Thirteen tumors (38%) had high cathepsin-D expression that was strongly associated with cervical lymph node metastasis (p = 0.008). When adjusted for tumor stage and grade, cathepsin-D positivity was nearly twice as likely to be associated with node metastasis (p = 0.011).
  
  
  CONCLUSIONS
  We demonstrated cathepsin-D expression in biopsies from a subset of patients with HNSCC and a strong association between this protease and cervical lymph node metastases. Cathepsin-D is a potential independent predictor of cervical lymph node metastasis in HNSCC and merits additional study.
authors.affiliation: Department of Pathology, University of California Davis, 2315 Stockton Blvd, Sacramento, California, USA.
authors.forename: R
authors.initials: R
authors.lastname: Gandour-Edwards
authors.forename: B
authors.initials: B
authors.lastname: Trock
authors.forename: P J
authors.initials: PJ
authors.lastname: Donald
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000473:pathology*; D002402:Cathepsin D / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D009062:Mouth Neoplasms / Q000737:chemistry / Q000473:pathology*; D009333:Neck; D010610:Pharyngeal Neoplasms / Q000737:chemistry / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D002402:Cathepsin D