Shergill Khushdeep, Sen Arijit, Pillai Hari Janardanan
Department of Pathology, Armed Forces Medical College, Pune, India.
Department of General Surgery, Armed Forces Medical College, Pune, India.
J Korean Assoc Oral Maxillofac Surg. 2018 Aug;44(4):182-190. doi: 10.5125/jkaoms.2018.44.4.182. Epub 2018 Aug 29.
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Inconsistency in various histopathologic features for predicting nodal metastasis and overall prognosis and a better understanding of molecular mechanisms of tumourigenesis have shifted the focus to a search for more definitive predictive markers. To identify the role of two immunohistochemical (IHC) markers, E-cadherin and cyclin D1, as predictive markers of aggressiveness in HNSCC and to assess clonal expansion of tumour cells.
A total of 66 cases of HNSCC with neck node dissection were studied. IHC was performed on primary tumour sections and lymph nodes showing metastatic deposits. Histopathological parameters such as tumour grade and TNM stage together with nodal status were compared according to expression of the two markers. Fischer's chi-square test was used to assess the correlation between the two markers and histopathological parameters.
Out of 66 cases studied, 37 showed LN metastasis. Most of the patients were male, and the most common tumour site was buccal mucosa. We found a significant association between loss of E-cadherin and node metastasis (<0.001) and higher TNM stage (<0.001). Cyclin D1 overexpression was significantly associated with only nodal metastasis (=0.007). No significant association with tumour grade was found for either marker. The subgroup of E-cadherin loss with cyclin D1 overexpression was associated with the maximum incidence of nodal metastasis and higher TNM stage, highlighting the importance of using a combination of these two markers. A significant association was noted between the expression of markers at the primary site and at nodal deposits, indicating clonal expansion.
A combination of the two markers E-cadherin and cyclin D1 can predict prognosis in HNSCC, although tumour heterogeneity may affect this association in some cases.
头颈部鳞状细胞癌（HNSCC）是全球第六大常见恶性肿瘤。各种用于预测淋巴结转移和总体预后的组织病理学特征存在不一致性，并且对肿瘤发生分子机制的更好理解已将重点转移到寻找更明确的预测标志物上。为了确定两种免疫组织化学（IHC）标志物E-钙黏蛋白和细胞周期蛋白D1作为HNSCC侵袭性预测标志物的作用，并评估肿瘤细胞的克隆扩增。
共研究了66例接受颈部淋巴结清扫术的HNSCC病例。对原发性肿瘤切片和显示转移灶的淋巴结进行免疫组织化学检测。根据这两种标志物的表达情况，比较肿瘤分级和TNM分期等组织病理学参数以及淋巴结状态。采用费舍尔卡方检验评估这两种标志物与组织病理学参数之间的相关性。
在研究的66例病例中，37例出现淋巴结转移。大多数患者为男性，最常见的肿瘤部位是颊黏膜。我们发现E-钙黏蛋白缺失与淋巴结转移（<0.001）和更高的TNM分期（<0.001）之间存在显著关联。细胞周期蛋白D1过表达仅与淋巴结转移显著相关（=0.007）。两种标志物与肿瘤分级均未发现显著关联。E-钙黏蛋白缺失伴细胞周期蛋白D1过表达的亚组与淋巴结转移的最高发生率和更高的TNM分期相关，突出了联合使用这两种标志物的重要性。在原发部位和淋巴结转移灶处标志物的表达之间存在显著关联，表明存在克隆扩增。
E-钙黏蛋白和细胞周期蛋白D1这两种标志物的联合可预测HNSCC的预后，尽管在某些情况下肿瘤异质性可能会影响这种关联。
