title: Evaluation of histomorphological and immunohistochemical parameters as biomarkers of cervical lymph node metastasis in squamous cell carcinoma of oral cavity: A retrospective study.
abstract: BACKGROUND
  Oral squamous cell carcinoma (OSCC) is seen worldwide but is more common in India. Lymph node (LN) metastasis has been shown to be the strongest prognostic factor in OSCC. Many histopathological and immunohistochemical markers have been studied to predict the LN metastasis.
  
  
  OBJECTIVE
  To identify clinicopathological factors and immunohistochemical (IHC) biomarkers which predict cervical metastasis in OSCC patients.
  
  
  METHODS
  A total of 105 cases of OSCC were taken up for our study. Histopathological parameters such as tumor thickness, depth, degree of differentiation, pattern of invasion (POI), lymphovascular and neural invasion were assessed. IHC was done on all cases using antibodies against Ki-67, cyclin D, E-cadherin, p53, CD31 and each antibody was assessed according to the standard protocol.
  
  
  METHODS
  To calculate the relation between clinical, histopathological parameter, IHC marker and the occurrence of LN metastasis, chi-square test was used. Variables were tested using multivariate logistic regression method to assess the predictive significance.
  
  
  RESULTS
  Out of 105 cases studied, 29 cases showed LN metastasis. Maximum numbers of cases affected were females with involvement of buccal mucosa. We found significant association of cervical LN metastasis with high grade of differentiation, lack of E-cadherin expression, high Ki-67 and cyclin D1 expression. In our study; tumor depth, thickness, extent of peritumoral lympho-plasmacytic infiltration, presence of eosinophils, tumor nest type, p53 and microvessel density (MVD) showed no significant correlation.
  
  
  CONCLUSIONS
  Significant association of cervical LN metastasis with high grade of differentiation, lack of E-cadherin expression, high Ki-67 and cyclin D1 expression was seen.
authors.affiliation: Department of Pathology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research Center, Kolar, Karnataka, India.
authors.forename: T N
authors.initials: TN
authors.lastname: Suresh
authors.affiliation: Department of Pathology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research Center, Kolar, Karnataka, India.
authors.forename: A
authors.initials: A
authors.lastname: Hemalatha
authors.affiliation: Department of Pathology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research Center, Kolar, Karnataka, India.
authors.forename: M L
authors.initials: ML
authors.lastname: Harendra Kumar
authors.affiliation: Department of Pathology, Ear, Nose and Throat, Head and Neck Surgery, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research Center, Kolar, Karnataka, India.
authors.forename: S M
authors.initials: SM
authors.lastname: Azeem Mohiyuddin
keywords: Cyclin D1; E-cadherin; Ki-67; grade of differentiation of OSCC; lymph node metastasis