title: 18F-fluorodeoxyglucose uptake level-based lymph node staging in oropharyngeal squamous cell cancer--role of molecular marker expression on diagnostic outcome.
abstract: BACKGROUND
  A prospective study was performed to assess standard uptake value (SUV)-level based (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) lymph node staging in 33 patients with oropharyngeal squamous cell cancer (OSCC) out of a total of 99 patients with head-and-neck squamous cell cancer (HNSCC) and the role of nodal molecular marker expression in diagnostic outcome prediction.
  
  
  METHODS
  Preoperative nodal PET/CT staging in 123 lymph nodes was correlated with postoperative lymph node histology, which served as gold standard. Tissue samples were prepared for immunohistochemistry of the excised lymph nodes.
  
  
  RESULTS
  The negative and positive predictive values (NPV and PPV) of PET for correct lymph node assessment were 100% and 93%, respectively. There was a significant association between SUVmax and lymph node histology (p < 0.0001) and a significant linear correlation between SUVmax and nodal size (Pearson's correlation coefficient r = 0.61336, p < 0.0001). The molecular marker E-Cadherin was significantly overexpressed in lymph node metastases (p < 0.0001). Benign lymph nodes showed significant 2-fold Bcl2 overexpression (p < 0.0001). However, the molecular marker expression profiles were inhomogeneous and did not allow valuable diagnostic outcome prediction.
  
  
  CONCLUSIONS
  SUV level-based (18)F-FDG-PET/CT lymph node assessment in OSCC still has to be considered as the most established and reliable staging tool. Lymph node molecular marker expression profiles need to be investigated further as they currently do not sufficiently contribute to therapy decision-making.
authors: Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Maliha
authors: M
authors: Sadick
authors: Christel
authors: C
authors: Weiss
authors: Rafael
authors: R
authors: Piniol
authors: Sabine
authors: S
authors: Frey
authors: Karl
authors: K
authors: Hoermann
authors: Stefan O
authors: SO
authors: Schoenberg
authors: Haneen
authors: H
authors: Sadick
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology* / Q000556:secondary*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000378:metabolism* / Q000473:pathology*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18