조기 구강설 편평상피암종에서 경부 림프절 전이 인자 분석
Analysis of Influencing Factors on Cervical Lymph Node Metastasis in Early Oral Tongue Cancer
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Background and Objectives：The status of cervical lymph node metastasis has a greatinfluence on the prognosis of patients with early oral tongue cancer. We evaluated various clinical, histopathological, lymphangiogenic parameters and their association with cervical lymph node metastasis in early oral squamous cell carcinoma of the tongue. Subjects and Method：Fifty-one patients with squamous cell carcinoma of the early oral tongue were classified as their tumor stage, lymph node metastasis, histopathological grade, tumor depth of invasion and their paraffin-embedded surgical specimens were investigated by immunohistochemical analysis using VEGF and E-cadherin antibody. Results：Cervical lymph node metastases were present in 18 of the 51 cases (35.3%). Regarding tumor cell differentiation, there were 28 (54.9%), 19 (37.3%), and 4 (7.8%) well-, moderate-, and poorly-differentiated cases, respectively. The depth of invasion varied from 1 to 25 mm and averaged 9.69±5.83 mm, and there was a significant correlation between the tumor depth ofinvasion and cervical lymph node metastasis (p<0.001) and primary tumor size (p<0.001). Immunohistochemical analysis showed the expression rates of VEGF, E-cadherin as 46.9% and 52.9%, respectively. There was significant correlation between the expressions of VEGF and lymph node metastasis (p=0.009). Patients who were followed up for more than 12 months had a 5-year overall survival of 82%. Primary tumor size and VEGF expression was associated with the overall survival. Conclusion：The analysis of these clinical, histological, and immunohistochemical parameters may help to identify patients who would benefit from a neck dissection by predicting the likelihood of cervical lymph node metastasis.
Abstract
Background and Objectives：The status of cervical lymph node metastasis has a greatinfluence on the prognosis of patients with early oral tongue cancer. We evaluated various clinical, histopathological, lymphangiogenic parameters and their association with cervical lymph node metastasis in early oral squamous cell carcinoma of the tongue. Subjects and Method：Fifty-one patients with squamous cell carcinoma of the early oral tongue were classified as their tumor stage, lymph node metastasis, histopathological grade, tumor depth of invasion and their paraffin-embedded surgical specimens were investigated by immunohistochemical analysis using VEGF and E-cadherin antibody. Results：Cervical lymph node metastases were present in 18 of the 51 cases (35.3%). Regarding tumor cell differentiation, there were 28 (54.9%), 19 (37.3%), and 4 (7.8%) well-, moderate-, and poorly-differentiated cases, respectively. The depth of invasion varied from 1 to 25 mm and averaged 9.69±5.83 mm, and there was a significant correlation between the tumor depth ofinvasion and cervical lymph node metastasis (p<0.001) and primary tumor size (p<0.001). Immunohistochemical analysis showed the expression rates of VEGF, E-cadherin as 46.9% and 52.9%, respectively. There was significant correlation between the expressions of VEGF and lymph node metastasis (p=0.009). Patients who were followed up for more than 12 months had a 5-year overall survival of 82%. Primary tumor size and VEGF expression was associated with the overall survival. Conclusion：The analysis of these clinical, histological, and immunohistochemical parameters may help to identify patients who would benefit from a neck dissection by predicting the likelihood of cervical lymph node metastasis.
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