[Detection and clinical significance of cervical lymph node micrometastases in patients with cN0 tongue squamous cell carcinoma].
OBJECTIVE
Postoperative relapse in tongue squamous cell carcinoma patients with pathologically negative cervical lymph node might be related to micrometastases. This study was to detect the lymph node micrometastases in cN0 tongue cancer patients, and explore its clinical significance.


METHODS
A total of 523 cervical lymph nodes taken from 49 tongue cancer patients were examined by routine HE staining and immunohistochemistry (IHC) with anti-cytokeratin antibody (CK19) staining. The follow-up period ranged from 9 to 83 (mean 56) months.


RESULTS
Metastases were detected in 7 (1.3%) lymph nodes from 5 patients with HE staining, and in 34 (6.5%) lymph nodes from 19 patients with CK19 staining. Micrometastases were detected in 27 (5.2%) lymph nodes from 14 patients. The difference in detecting lymph node metastases between two methods was significant (P=0.001). HE staining upstaged 3 cases from cN0 to pN1, and 2 cases from cN0 to pN2b; IHC staining upstaged 3 cases from cN0 to pN1, and 16 cases from cN0 to pN2b. Lymph node micrometastases showed no correlation to sex, age, T stage, differentiation, and depth of primary tumor invasion (P>0.05). The 5-year survival rates of the patients with and without micrometastases were 78.5% and 86.7%, respectively (P>0.05).


CONCLUSIONS
CK19 staining could increase the detection rate of cervical lymph node metastases and the accuracy of pathologic stage in tongue cancer. The results of our study showed that the presence of lymph node micrometastasis has no correlation to the prognosis. A further study is needed.
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China.
Dong-Kun
DK
Zhang
Zhu-Ming
ZM
Guo
Quan
Q
Zhang
Wen-Kuan
WK
Chen
Hao
H
Li
Shun-Lan
SL
Wang
Jing
J
Zhang
Qin
Q
Zhang
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053539:Keratin-19 / Q000032:analysis; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D014062:Tongue Neoplasms / Q000401:mortality / Q000473:pathology*
D053539:Keratin-19