Yadav Satish T, Madhu Shankari G S, Chatura K, Dhanuja Rani J, Rashmi M
Department of Oral Pathology, Government Dental College and Research Institute, VIMS Campus, Cantonment, Bellary, India.
Indian J Dent Res. 2012 Jan-Feb;23(1):121-2. doi: 10.4103/0970-9290.99059.
Oral squamous cell carcinoma is the most common neoplasm and comprises of approximately 80% of the cancers occurring in the oral cavity. The role of the host response to this neoplasm has been recognized, and for many years the regional lymph node in tumor-bearing hosts has been considered as an anatomic barrier to the systematic dissemination of tumor cells. Morphological evaluation of the regional nodes has aided in understanding the immune response.
The current study was carried out to observe the morphological changes occurring in the regional lymph nodes and to evaluate whether these features could be helpful in assessing the immunological status of the patient, and thereby, the prognosis of the patient.
The study was based on lymph nodes from 63 patients with oral squamous cell carcinoma, who underwent radical neck dissection or modified neck dissection. In the lymph node, four morphological patterns were observed that included lymphocyte predominance, germinal center predominance, mixed pattern (sinus Histiocytosis), and an unstimulated pattern. The cases were then divided into four groups according to the predominant immunoreactivity pattern based on the World Health Organization (WHO) standardized system for reporting human lymph node morphology.
Revealed that risk of metastases to cervical lymph nodes in patients with lymphocyte predominance was less (28.6%) when compared to the high risk of metastases with germinal center predominance (68%), and these results were statistically significant (P < 0.05). Patients with a mixed pattern showed less risk of metastases (45.4%), while those with an unstimulated pattern had increased risk of metastases (66.6%), but the results were not statistically significant. It was also found that in the positive nodes, germinal center hyperplasia (50.2%) was the predominant pattern.
The present study revealed that patients with lymphocyte predominance had less risk of metastases and patients with germinal center predominance had a high risk of metastases to the lymph node.
口腔鳞状细胞癌是最常见的肿瘤，约占口腔发生癌症的80%。宿主对这种肿瘤的反应作用已得到认可，多年来，荷瘤宿主的区域淋巴结一直被视为肿瘤细胞系统性播散的解剖学屏障。区域淋巴结的形态学评估有助于理解免疫反应。
进行本研究以观察区域淋巴结发生的形态学变化，并评估这些特征是否有助于评估患者的免疫状态，进而评估患者的预后。
本研究基于63例接受根治性颈清扫术或改良颈清扫术的口腔鳞状细胞癌患者的淋巴结。在淋巴结中观察到四种形态学模式，包括淋巴细胞为主型、生发中心为主型、混合模式（窦组织细胞增多症）和未受刺激型。然后根据世界卫生组织（WHO）报告人类淋巴结形态的标准化系统，根据主要的免疫反应模式将病例分为四组。
显示淋巴细胞为主型患者发生颈淋巴结转移的风险较低（28.6%），而生发中心为主型患者发生转移的风险较高（68%），这些结果具有统计学意义（P<0.05）。混合模式患者发生转移的风险较低（45.4%），而未受刺激型患者发生转移的风险增加（66.6%），但结果无统计学意义。还发现，在阳性淋巴结中，生发中心增生（50.2%）是主要模式。
本研究显示，淋巴细胞为主型患者发生转移的风险较低，而生发中心为主型患者发生淋巴结转移的风险较高。
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