Korean J Otorhinolaryngol-Head Neck Surg.  2009 Jan;52(1):51-56. 10.3342/kjorl-hns.2009.52.1.51.

Analysis of Influencing Factors on Cervical Lymph Node Metastasis in Early Oral Tongue Cancer

• Joo YH
• Sun DI
• Cho JH
• Cho KJ
• Park YH
• Kim MS

• KMID: 1978428
• DOI: http://doi.org/10.3342/kjorl-hns.2009.52.1.51

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.

Keyword

Tongue neoplasms; Lymphatic metastasis; Neck dissection; Immunohistochemistry

MeSH Terms

Cadherins
Carcinoma, Squamous Cell
Cell Differentiation
Humans
Immunohistochemistry
Lymph Nodes
Lymphatic Metastasis
Neck Dissection
Neoplasm Metastasis
Prognosis
Tongue
Tongue Neoplasms
Vascular Endothelial Growth Factor A
Cadherins
Vascular Endothelial Growth Factor A