Angiogenesis and CD34 expression as a predictor of recurrence in oral squamous cell carcinoma.
OBJECTIVE
To assess immunohistologic features of angiogenesis of T1N0M0 oral squamous cell carcinoma (OSCC), and to identify predictors of regional recurrence. The identification of prognostic markers of early lymph node involvement in OSCC could allow for the use of more targeted biologic therapies for patients with early-stage tumors.


METHODS
The study included patients treated for T1N0M0 OSCC at the Mayo Clinic from 1986 to 2001. All patients had initial surgical resection without neck dissection, and all had adequate follow-up with histologic specimens for review. Patients with lip, pharyngeal, or salivary gland tumors were excluded. Patient specimens were regraded and assessed for the histologic markers p53 and CD34 (penetrating and circumscribing patterns). The Kaplan-Meier method was used to estimate patient survival and survival free of regional recurrence.


RESULTS
The study included 175 patients. The overall 5-year survival was 75%, and 5-year survival free of regional recurrence was 80.3%. Twenty-eight patients had regional recurrence. High-grade tumors (P = .03) and the penetrating pattern of CD34 (P = .02) were significantly associated with early regional metastasis from early-stage OSCC. The presence of p53 was not independently associated as a marker for regional metastasis.


CONCLUSIONS
Early-stage T1 OSCC with high-grade lesions and a penetrating pattern of CD34 was associated with a statistically significant risk of cervical lymph node metastasis, compared with a circumscribing pattern of CD34.
Kademani
Deepak
D
Mayo Clinic, College of Medicine, Rochester, MN 55905, USA. kadem001@umn.edu
Lewis
Jason T
JT
Lamb
Derek H
DH
Rallis
David J
DJ
Harrington
Jeffrey R
JR
D018952:Antigens, CD34 / Q000096:biosynthesis*; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000096:biosynthesis; D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000098:blood supply* / Q000378:metabolism; D009364:Neoplasm Recurrence, Local / Q000098:blood supply / Q000378:metabolism*; D009389:Neovascularization, Pathologic / Q000503:physiopathology; D011379:Prognosis; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis
D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D016159:Tumor Suppressor Protein p53