Clinical value of genetically diagnosed lymph node micrometastasis for patients with oral squamous cell carcinoma.
BACKGROUND
The purpose of this study was to investigate the incidence and clinical significance of genetically diagnosed lymph node micrometastasis for patients with oral squamous cell carcinoma (SCC).


METHODS
A total of 495 lymph nodes obtained from 21 patients with primary oral SCCs that had p53 mutations were examined for corresponding p53 mutations in lymph nodes using mutant allele-specific amplification (MASA).


RESULTS
Among 476 histologically negative nodes, 44 were scored as positive for metastasis by MASA. All 19 histologically positive lymph nodes were genetically positive. Four of the 10 pN0 cases and nine of the 11 pN-positive cases had genetically positive micrometastases. Four patients who had five or more genetically positive lymph nodes located in three or more levels, three with disease staged as pN0 or pN1, died of cancer.


CONCLUSIONS
These results indicate that a high rate of micrometastasis in cervical lymph nodes of oral SCCs and patients with multiple or lower neck spread of micrometastases have a poor prognosis; they should be treated with postoperative adjuvant therapy.
Yamazaki
Yutaka
Y
Oral Diagnosis and Medicine, Graduate School of Dental Medicine, Hokkaido University, Kita-13 Nishi-7, Sapporo, 060-8586, Japan. yutaka8@den.hokudai.ac.jp
Chiba
Itsuo
I
Hirai
Atsuko
A
Satoh
Chiharu
C
Sakakibara
Noriyuki
N
Notani
Ken-ichi
K
Iizuka
Tadashi
T
Totsuka
Yasunori
Y
D000328:Adult; D000368:Aged; D001483:Base Sequence; D014408:Biomarkers, Tumor; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000235:genetics* / Q000556:secondary; D004252:DNA Mutational Analysis; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D016158:Genes, p53 / Q000235:genetics*; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D009154:Mutation; D009367:Neoplasm Staging; D021141:Nucleic Acid Amplification Techniques; D020133:Reverse Transcriptase Polymerase Chain Reaction
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm