title: Impact of podoplanin expression in oral squamous cell  carcinoma: clinical and histopathologic correlations.
abstract: Cervical lymph node metastases reduce the overall survival of patients with oral squamous cell carcinoma (OSCC) and require a neck dissection. However, elective management of a clinical N0 neck remains a controversial topic, as there are no reliable factors available predicting cervical lymph node metastases. Recent studies suggest an impact of podoplanin expression on metastatic spread to the cervical lymph nodes. Our aim was to investigate the influence of podoplanin expression on prognosis and metastatic lymphatic spread. In our retrospective study, podoplanin expression was examined in a set of 80 patients with OSCC by immunohistochemistry. We analysed associations between the level of podoplanin expression and various clinicopathologic parameters. In 67 patients (84%), podoplanin was expressed on the tumour cells. Nineteen patients (24%) showed high levels of expression. The 5-year overall survival (31%) for patients with high levels of podoplanin expression was significantly lower (p < 0.001) than for patients with low and moderate expression of podoplanin (93% and 65%, respectively). There was an association between podoplanin expression and the frequency of cervical lymph node metastases. Cervical lymph node metastases were found in 79% of the patients with high podoplanin expression, while patients with weak podoplanin expression had metastases in only 22% (p < 0.001). None of the 13 patients without podoplanin expression had cervical lymph node metastases. We concluded that podoplanin is expressed frequently in OSCC and that podoplanin expression correlates with cervical lymph node metastases and clinical outcome.
authors.affiliation: Department for Oral and Cranio-maxillo and Facial Plastic Surgery, University of Cologne, Kerpener Strasse 62, Cologne, Germany. mattheskreppel@yahoo.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Kreppel
authors.forename: Martin
authors.initials: M
authors.lastname: Scheer
authors.forename: Uta
authors.initials: U
authors.lastname: Drebber
authors.forename: Lutz
authors.initials: L
authors.lastname: Ritter
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Zöller
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008562:Membrane Glycoproteins / Q000096:biosynthesis*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D037981:Neck Dissection; D011379:Prognosis; D012189:Retrospective Studies; D000098853:Podoplanin
chemical_list: D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin
references.citation: Anticancer Res. 2008 Sep-Oct;28(5B):2997-3006
references.pmid: 19031946
references.citation: Head Neck. 2007 Jan;29(1):3-11
references.pmid: 17103411
references.citation: Cancer. 2006 Aug 1;107(3):563-9
references.pmid: 16804930
references.citation: Acta Neuropathol. 2006 May;111(5):483-8
references.pmid: 16596424
references.citation: Head Neck. 2009 Jun;31(6):765-72
references.pmid: 19408291
references.citation: Virchows Arch. 2007 Nov;451(5):959-66
references.pmid: 17846785
references.citation: Oral Oncol. 2009 Apr-May;45(4-5):394-401
references.pmid: 18674952
references.citation: Mund Kiefer Gesichtschir. 2005 Sep;9(5):282-9
references.pmid: 16133281
references.citation: Lab Invest. 2002 Sep;82(9):1255-7
references.pmid: 12218087
references.citation: Cancer Metastasis Rev. 2006 Dec;25(4):677-94
references.pmid: 17160713
references.citation: Oral Oncol. 2008 Dec;44(12):1134-8
references.pmid: 18486527
references.citation: Mod Pathol. 2006 May;19(5):708-16
references.pmid: 16528371
references.citation: Int J Cancer. 2005 Mar 1;113(6):899-910
references.pmid: 15515019
references.citation: Histol Histopathol. 2009 Aug;24(8):1021-7
references.pmid: 19554509
references.citation: Head Neck. 2006 Nov;28(11):1018-27
references.pmid: 16783828
references.citation: Am J Surg Pathol. 2008 Jan;32(1):123-7
references.pmid: 18162779
references.citation: Br J Oral Maxillofac Surg. 2009 Jan;47(1):5-9
references.pmid: 19121878
references.citation: Biochem Biophys Res Commun. 2008 Aug 15;373(1):36-41
references.pmid: 18539139
references.citation: Mod Pathol. 2003 Oct;16(10):1028-34
references.pmid: 14559986
references.citation: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references.pmid: 19474385
references.citation: Cancer. 2003 Aug 1;98(3):508-15
references.pmid: 12879467
references.citation: Cancer Res. 2008 Sep 1;68(17):6877-83
references.pmid: 18757399
references.citation: J Cell Sci. 2006 Nov 1;119(Pt 21):4541-53
references.pmid: 17046996
references.citation: Cancer. 2007 Sep 15;110(6):1287-94
references.pmid: 17674352
references.citation: Cancer Sci. 2009 Nov;100(11):2054-9
references.pmid: 19681903
references.citation: Int J Radiat Oncol Biol Phys. 2009 Mar 1;73(3):913-8
references.pmid: 19215825
references.citation: Cancer. 1999 Feb 15;85(4):757-62
references.pmid: 10091751
references.citation: Am J Pathol. 2005 Mar;166(3):913-21
references.pmid: 15743802
references.citation: Head Neck. 2010 Apr;32(4):445-51
references.pmid: 19672869
references.citation: J Clin Oncol. 2008 Jan 20;26(3):354-60
references.pmid: 18202409
references.citation: Head Neck. 2009 Dec;31(12):1544-56
references.pmid: 19424974
references.citation: Head Neck. 2008 Feb;30(2):230-4
references.pmid: 17764091
references.citation: Head Neck. 2009 May;31(5):618-24
references.pmid: 19132717
references.citation: Semin Surg Oncol. 2003;21(1):30-42
references.pmid: 12923914
references.citation: Future Oncol. 2009 Feb;5(1):51-61
references.pmid: 19243298
references.citation: CA Cancer J Clin. 2002 Jul-Aug;52(4):195-215
references.pmid: 12139232
references.citation: Int J Oral Maxillofac Surg. 2005 May;34(3):262-7
references.pmid: 15741034
references.citation: Oral Oncol. 2003 Apr;39(3):213-21
references.pmid: 12618193
references.citation: Virchows Arch. 2006 May;448(5):570-5
references.pmid: 16496172
references.citation: J Oral Maxillofac Surg. 2008 Aug;66(8):1570-9
references.pmid: 18634942
references.citation: World J Surg Oncol. 2009 Mar 04;7:25
references.pmid: 19261178
references.citation: Virchows Arch. 2002 Jun;440(6):594-7
references.pmid: 12070598
references.citation: Cancer. 2004 Sep 1;101(5):973-8
references.pmid: 15329906
references.citation: J Oral Pathol Med. 2003 Sep;32(8):455-60
references.pmid: 12901726
references.citation: Semin Radiat Oncol. 2009 Jan;19(1):3-10
references.pmid: 19028339
references.citation: Am J Pathol. 1999 Feb;154(2):385-94
references.pmid: 10027397
references.citation: J Pathol. 2005 Jun;206(2):170-7
references.pmid: 15846845
references.citation: Virchows Arch. 2006 Apr;448(4):493-9
references.pmid: 16411134
references.citation: Int J Radiat Oncol Biol Phys. 2007 Feb 1;67(2):453-61
references.pmid: 17236967
references.citation: Cancer Cell. 2006 Apr;9(4):261-72
references.pmid: 16616332
references.citation: Crit Rev Oral Biol Med. 2001;12(1):55-63
references.pmid: 11349962
references.citation: Am J Surg. 2003 Mar;185(3):278-84
references.pmid: 12620571
references.citation: N Engl J Med. 2004 May 6;350(19):1945-52
references.pmid: 15128894
references.citation: Ann Surg Oncol. 2010 May;17(5):1311-23
references.pmid: 20066519
references.citation: World J Surg Oncol. 2007 Dec 11;5:140
references.pmid: 18072963
references.citation: Strahlenther Onkol. 2008 Jan;184(1):23-9
references.pmid: 18188519