title: Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma.
abstract: BACKGROUND
  We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical lymph node metastasis in oral squamous cell carcinoma.
  
  
  METHODS
  A digital image system was used to measure the mean nuclear area, mean nuclear perimeter, nuclear circular rate, ratio of nuclear length to width (aspect ratio), and nuclear area coefficient of variation (NACV). Relationships between these parameters and nodal status were evaluated by t-test and logistic regression analysis.
  
  
  RESULTS
  Eighty-eight cases of squamous cell carcinoma (52 of the tongue, 25 of the gingiva, 4 of the buccal mucosa, and 7 of the mouth floor) were included: 46 with positive node classification and 42 with negative node classification. Nuclear area and perimeter were significantly larger in node-positive cases than in node-negative cases; however, there were no significant differences in circular rate, aspect ratio, or NACV. We derived two risk models based on the results of multivariate analysis: Model 1, which identified age and mean nuclear area and Model 2, which identified age and mean nuclear perimeter. It should be noted that primary tumor site was not associated the pN-positive status. There were no significant differences in pathological nodal status by aspect ratio, NACV, or primary tumor site.
  
  
  CONCLUSIONS
  Our method of preoperative nuclear morphometry may contribute valuable information to evaluations of the risk for lymph node metastasis in oral squamous cell carcinoma.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Karino
authors.affiliation: Translational Research Informatics Center, Kobe, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Nakatani
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Hideshima
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nariai
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Kohji
authors.initials: K
authors.lastname: Tsunematsu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ohira
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kanno
authors.affiliation: Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Medical Science, Nagasaki, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Asahina
authors.affiliation: Translational Research Informatics Center, Kobe, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kagimura
authors.affiliation: Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Sekine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D011300:Preoperative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000556:secondary*