Zhang Dong-Kun, Guo Zhu-Ming, Zhang Quan, Chen Wen-Kuan, Li Hao, Wang Shun-Lan, Zhang Jing, Zhang Qin
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China.
Ai Zheng. 2008 Jun;27(6):642-5.
BACKGROUND & OBJECTIVE: Postoperative relapse in tongue squamous cell carcinoma patients with pathologically negative cervical lymph node might be related to micrometastases. This study was to detect the lymph node micrometastases in cN0 tongue cancer patients, and explore its clinical significance.
A total of 523 cervical lymph nodes taken from 49 tongue cancer patients were examined by routine HE staining and immunohistochemistry (IHC) with anti-cytokeratin antibody (CK19) staining. The follow-up period ranged from 9 to 83 (mean 56) months.
Metastases were detected in 7 (1.3%) lymph nodes from 5 patients with HE staining, and in 34 (6.5%) lymph nodes from 19 patients with CK19 staining. Micrometastases were detected in 27 (5.2%) lymph nodes from 14 patients. The difference in detecting lymph node metastases between two methods was significant (P=0.001). HE staining upstaged 3 cases from cN0 to pN1, and 2 cases from cN0 to pN2b; IHC staining upstaged 3 cases from cN0 to pN1, and 16 cases from cN0 to pN2b. Lymph node micrometastases showed no correlation to sex, age, T stage, differentiation, and depth of primary tumor invasion (P>0.05). The 5-year survival rates of the patients with and without micrometastases were 78.5% and 86.7%, respectively (P>0.05).
CK19 staining could increase the detection rate of cervical lymph node metastases and the accuracy of pathologic stage in tongue cancer. The results of our study showed that the presence of lymph node micrometastasis has no correlation to the prognosis. A further study is needed.
病理检查颈部淋巴结阴性的舌鳞状细胞癌患者术后复发可能与微转移有关。本研究旨在检测cN0期舌癌患者的淋巴结微转移情况，并探讨其临床意义。
对49例舌癌患者切除的523枚颈部淋巴结进行常规苏木精-伊红（HE）染色及抗细胞角蛋白抗体（CK19）免疫组织化学（IHC）染色检查。随访时间为9至83个月（平均56个月）。
HE染色在5例患者的7枚（1.3%）淋巴结中检测到转移，CK19染色在19例患者的34枚（6.5%）淋巴结中检测到转移。14例患者的27枚（5.2%）淋巴结中检测到微转移。两种方法检测淋巴结转移的差异有统计学意义（P = 0.001）。HE染色使3例患者从cN0期上调为pN1期，2例从cN0期上调为pN2b期；IHC染色使3例患者从cN0期上调为pN1期，16例从cN0期上调为pN2b期。淋巴结微转移与性别、年龄、T分期、分化程度及原发肿瘤浸润深度无关（P>0.05）。有微转移和无微转移患者的5年生存率分别为78.5%和86.7%（P>0.05）。
CK19染色可提高舌癌颈部淋巴结转移的检出率及病理分期的准确性。本研究结果显示淋巴结微转移的存在与预后无关，尚需进一步研究。
