Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
Centre for Research in Oral Cancer, University of Peradeniya, Sri Lanka.
Biomed Res Int. 2020 Oct 14;2020:2059240. doi: 10.1155/2020/2059240. eCollection 2020.
Nodal metastasis is a critical factor in predicting the prognosis of oral squamous cell carcinoma (OSCC). When patients present with a clinically positive neck, the treatment of choice is radical neck dissection. However, management of a clinically negative neck is still a subject of significant controversy.
This study was carried out in order to propose a model to predict regional lymph node metastasis of OSCC using histological parameters such as tumour stage, tumour size, pattern of invasion (POI), differentiation of tumour, and host immune response, together with the expression levels of six biomarkers (periostin, HIF-1, MMP-9, -catenin, VEGF-C, and EGFR), and, furthermore, to compare the impact of all these parameters on recurrence and 3 yr and 5 yr survival rates. . Histological materials collected from the archives were used to evaluate histological parameters and immunohistochemical profiles. Standard methods were used for immunohistochemistry and for evaluation of results. Data related to recurrence and survival (3 and 5 years) was also recorded. Clinical data was collected from patients' records.
Male to female ratio was 3 : 1. The commonest site of OSCC was the buccal mucosa, and majority of them were T3 or T4 tumours presented at stage 4. 62.5% of the tumours were well differentiated. Three-year and 5-year survival rates were significantly associated with lymph node metastasis and recurrence. POI was significantly correlated with tumour size, stage, 3-year survival, EGFR, HIF-1, periostin, and MMP-9 ( < 0.05). Expression of EGFR showed a direct association with metastasis ( < 0.05).
POI, level of differentiation, and expression of EGFR are independent prognostic markers for lymph node metastasis. Therefore, these parameters may help in treatment planning of a clinically negative neck.
淋巴结转移是预测口腔鳞状细胞癌（OSCC）预后的关键因素。当患者出现临床阳性颈部时，首选治疗方法是根治性颈清扫术。然而，临床阴性颈部的处理仍然存在很大争议。
本研究旨在提出一种使用组织学参数（如肿瘤分期、肿瘤大小、侵袭模式、肿瘤分化和宿主免疫反应）以及六种生物标志物（骨桥蛋白、HIF-1、MMP-9、-连环蛋白、VEGF-C 和 EGFR）的表达水平来预测 OSCC 区域淋巴结转移的模型，并比较所有这些参数对复发和 3 年和 5 年生存率的影响。从档案中收集组织学材料以评估组织学参数和免疫组织化学特征。使用标准方法进行免疫组织化学和结果评估。还记录了与复发和生存（3 年和 5 年）相关的数据。临床数据从患者记录中收集。
男女比例为 3:1。OSCC 最常见的部位是颊黏膜，大多数为 T3 或 T4 期肿瘤，分期为 4 期。62.5%的肿瘤分化良好。3 年和 5 年生存率与淋巴结转移和复发显著相关。侵袭模式与肿瘤大小、分期、3 年生存率、EGFR、HIF-1、骨桥蛋白和 MMP-9显著相关（<0.05）。EGFR 的表达与转移呈直接相关（<0.05）。
侵袭模式、分化程度和 EGFR 的表达是淋巴结转移的独立预后标志物。因此，这些参数可能有助于临床阴性颈部的治疗计划。
