Biomarkers predictive of lymph node metastases in oral squamous cell carcinoma.
OBJECTIVE
The ability of oral squamous cell carcinoma to metastasize to lymph nodes does not always show a relationship with clinical staging. The aim of this study was to attempt to define a trend for predictive histopathologic and/or molecular biomarkers in the development of nodal metastasis by analyzing 2 clinically extreme groups.


METHODS
Patients with small primary tumors (T1, T2) with lymph node metastasis and patients with large primary tumors (T3, T4) without metastatic disease were identified among 315 consecutive cases of primary oral squamous cell carcinoma. Group comparisons were made with use of a Mann-Whitney test, and associations among the variables were assessed with nonparametric and parametric correlational analyses.


RESULTS
The degree of keratinization was significantly less in primary tumors with lymph node metastasis (P < or = .01). The degree of keratinization was significantly associated with nuclear pleomorphism (P =.02), number of mitoses (P =.02), stage of invasion (P =.002), and p53 expression (P =.04), independent of clinical stage of the tumor. Other microscopic features and immunohistochemical markers did not differ significantly between the groups (P >.05).


CONCLUSIONS
These data indicate that there still is no single predictive parameter superior to the degree of keratinization to identify patients at risk for the development of regional metastasis.
Lopes
Márcio Ajudarte
MA
Oral Diagnosis, Faculty of Odontology of Piracicaba, UNICAMP, Sāo Paulo, Brazil. malopes@fop.unicamp.br
Nikitakis
Nikolaos G
NG
Reynolds
Mark A
MA
Ord
Robert A
RA
Sauk
John
J
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary*; D002467:Cell Nucleus / Q000648:ultrastructure; D005260:Female; D005544:Forecasting; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008938:Mitosis; D009062:Mouth Neoplasms / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D012307:Risk Factors; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D015415:Biomarkers; D007633:Keratins; D018809:Proliferating Cell Nuclear Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53