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Immunohistochemistry, A Valuable Tool in Detection of Cervical Lymph Node Micrometastases in Head and Neck Squamous Cell Carcinoma: A Prospective Study

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

The regional failure after comprehensive clearance of neck metastasis and consequent pathological report of N0 disease has been reported fairly frequently. The role of recurrence of disease in the neck in the cases has been variously reported by different authors. The light microscopy does not detect the micrometastasis and the specimen is reported negative for metastasis. The presence of micrometastasis (the reason for neck failure) has been reported by many studies as 5–58 % (mean 19.6 %). These figures are significantly high. The present study was done to ascertain the micrometastasis after comprehensive neck clearance (pN0 report). Two groups of patients were included in this study. (1) Group I included patients with N0 necks (80 patients). (2) Group II included Patients with N+ necks (107 patients). We found that 20 % case were reported N0 (Group I) in light microscopy but on immunohistochemistry these were positive for disease. 15 % upstaging was reported in N+ cases (Group 2). Immunohistochemistry has been more sensitive for cancer detection and has significantly changed the tumor staging and its consequent management.

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References

  1. Lemaire F, Millon R, Young J et al (2003) Differential expression profiling of head and neck squamous cell carcinoma (HNSCC). Br J Cancer 89:1940–1949

    Article  PubMed  CAS  Google Scholar 

  2. Schuller DE, McGuirt WF, McCabe BF et al (1980) The prognostic significance of metastatic cervical lymph nodes. Laryngoscope 90:557–570

    PubMed  CAS  Google Scholar 

  3. Ferlito A, Rinaldo A, Devaney KO, Maclennan K, Myers JN, Petrujelli GJ et al (2002) Prognostic significance of microscopic and macroscopic extracapsular spread from metastatic tumor in the cervical lymph node. Oral Oncol 38:745–751

    Google Scholar 

  4. Jose J, Ferlito A, Rodrigo JP, Devaney KO, Rinaldo A, Maclennan K (2008) Soft tissue deposits from head and cancer: an under-recognized prognostic factor? J Laryngol Otol 121:1115–1117 (Editorial)

    Google Scholar 

  5. Braams JW, Pruim J, Freling NJ, Nikkeles PG, Roodenberg JL, Boering G et al (1995) Detection of lymph node metastases of squamous cell cancer of head and neck with FDG-PET and MRI. J Nucl Med 36:211–216

    PubMed  CAS  Google Scholar 

  6. Vogl T, Bisdas S (2007) Lymph node staging. Top Magn Reson Imaging 18:303–316

    Article  PubMed  Google Scholar 

  7. Fielding LP, Fenoglio-Preiser CM, Freedman LS (1992) The future of prognostic factors in outcome prediction for patients with cancer. Cancer 70:2367–2377

    Article  PubMed  CAS  Google Scholar 

  8. Feinmesser R, Freeman JL, Feinmesser M, Noyek A, Mullen JB (1992) Role of modern imaging in decision-making for elective neck dissection. Head Neck 14:173–176

    Article  PubMed  CAS  Google Scholar 

  9. Ferlito A, Partridge M, Brennan J, Hamakawa H (2001) Lymph node micrometastases in head and neck cancer: a review. Acta Otolaryngol 121:660–665

    Article  PubMed  CAS  Google Scholar 

  10. Ferlito A, Shaha AR, Rihaldo A (2002) The incidence of lymph node micrometastases in patients pathologically staged N0 in cancer of oral cavity and oropharynx. Oral Oncol 38:3–5

    Article  PubMed  CAS  Google Scholar 

  11. Ferlito A, Rinaldo A (2000) False negative conventional histology of lymph nodes in patients with head and neck cancer. ORL J Othorhinolaryngol Relat Spe 62:112–114

    Article  CAS  Google Scholar 

  12. Stoeckli SJ, Pfaltz M, Steinert H, Schmid S (2002) Histopathological features of occult metastasis detected by sentinel lymph node biopsy in oral and oropharyngeal squamous cell carcinoma. Laryngoscope 112:111–115

    Article  PubMed  Google Scholar 

  13. American Joint Committee on cancer (AJCC) (2002) Cancer staging manual, 6th edn. Springer, New York, pp 223–240

    Google Scholar 

  14. Hermanek P (1999) Disseminated tumor cells versus micrometastasis: definitions and problems. Anticancer Res 19:2771–2774

    PubMed  CAS  Google Scholar 

  15. Jatin P Shah (1990) Pattern of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Am J Surg 160:405–409

    Article  Google Scholar 

  16. Lane EB, Hogan BLM, Kurkinen M, Garrels JI (1983) Coexpression of vimentin and cytokeratin in parietal endoderm cells of early mouse embryo. Nature 303:781–784

    Article  Google Scholar 

  17. Broekaert D, Cornille A, Eto H et al (1988) A comparative immunohistochemical study of cytokeratin and vimentin expression in middle ear mucosa and cholesteatoma. Virchows Arch [A] 413:39–51

    Article  CAS  Google Scholar 

  18. Kim KH, Schwartz F, Fuchs E (1984) Differences in keratin synthesis between normal epithelial cells and squamous cell carcinomas are mediated by vitamin A. Proc Natl Acad Sci USA 81:4280–4284

    Article  PubMed  CAS  Google Scholar 

  19. Franke WW, Schmid E, Winter S, Osborn M, Weber K (1979) Widespread occurrence of intermediate-sized filaments of the vimentin-type in cultured cells from diverse vertebrates. Exp Cell Res 123:25–46

    Article  PubMed  CAS  Google Scholar 

  20. Smedts F, Ramaekers F, Robben H et al (1990) Changing patterns of keratin expression during progression of cervical intraepithelial neoplasia. Am J Pathol 136:657–667

    PubMed  CAS  Google Scholar 

  21. Lindemann F, Schlimok G, Dirschedl P et al (1992) Prognostic significance of micrometastatic tumor cells in bone marrow of colorectal cancer patients. Lancet 340:685–689

    Article  PubMed  CAS  Google Scholar 

  22. Gould VE, Bloom KJ, Franke WW et al (1995) Increased number of cytokeratin-positive interstitial reticulum cells (CIRC) in reactive, inflammatory and neoplastic lymphadenopathies: hyperplastic or induced expression? Virchows Arch 425:617–629

    Article  PubMed  CAS  Google Scholar 

  23. Becker MT, Shores CG, Yu KK, Yarbrough WG (2004) Molecular assay to detect metastatic head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg 130:21–27

    Article  PubMed  Google Scholar 

  24. Ferlito A, Devaney KO, Devaney SL, Rinaldo A (2001) What is the incidence of occult metastasis in patients with stage N(0) cancers of the head and neck? ORL J Otorhinolaryngol Relat Spect 63:1–5

    Article  CAS  Google Scholar 

  25. Barrera JE, Miller ME, Said S, Jafek BW, Campana JP, Shroyer KR (2003) Detection of occult cervical micrometastases in patients with head and neck squamous cell cancer. Laryngoscope 113:892–896

    Article  PubMed  Google Scholar 

  26. Devaney KO, Rinaldo A, Ferlito A (2007) Micrometastases in cervical lymph nodes from patients with squamous carcinoma of the head and neck: should they be actively sought? Maybe. Am J Otolaryngol 28:271–274

    Article  PubMed  Google Scholar 

  27. Rinaldo A, Devaney KO, Ferlito A (2004) Immunohistochemical studies in the identification of lymph node micrometastases in patients with squamous cell carcinoma of the head and neck. ORL J Otorhinolaryngol Relat Spec 66:38–41

    Article  PubMed  Google Scholar 

  28. Rhee D, Wenig BM, Smith RV (2002) The significance of immunohistochemically demonstrated nodal micrometastases in patients with squamous cell carcinoma of the head and neck. Laryngoscope 112:1970–1974

    Article  PubMed  Google Scholar 

  29. Hamakawa H, Takemura K, Sumida T, Kayahara H, Tanaka H, Sogawa K (2000) Histological study on pN upgrading of oral cancer. Virchows Arch 437:116–121

    Article  PubMed  CAS  Google Scholar 

  30. Yoshida K, Kashima K, Suenaga S, Nomi N, Shuto J, Suzuki M (2005) Immunohistochemical detection of cervical lymph node micrometastases from T2N0 tongue cancer. Acta Otolaryngol 125:654–658

    Article  PubMed  Google Scholar 

  31. Kwon SY, Kim HJ, Woo JS, Jung KY, Kim I (2004) The usefulness of cytokeratin immunohistochemistry in detection of lymph node micrometastasis in neck dissection specimens. Otolaryngol Head Neck Surg 131:300–306

    Article  PubMed  Google Scholar 

  32. Enepekides D, Sultanem K, Nguyen C et al (1999) Occult cervical metastases: immunoperoxidase analysis of the pathologically negative neck. Otolaryngol Head Neck Surg 120:713–717

    Article  PubMed  CAS  Google Scholar 

  33. International (Ludwig) Breast Cancer Study Group (1990) Prognostic importance of occult axillary lymph node metastases in patients with invasive breast cancer. Lancet 335:1565–1568

    Google Scholar 

  34. Schurman SH, Sharon N, Goldschmidt RA et al (1990) Improved detection of metastases to lymph nodes and estrogen receptor determination. Arch Surg 125:179–182

    Article  PubMed  CAS  Google Scholar 

  35. Haque MA, Talukaler SI (2003) Evaluation of fine needle aspiration cytology (FNAC) of lymph node in Mymensingh. Mymensingh Med J 12:33–35

    PubMed  CAS  Google Scholar 

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Authors do not have any financial relationship with the organization that sponsored the research. The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of ENT, SMS Medical College, Jaipur, Rajasthan, India

    Anjani Kumar Sharma & Prakash Mishra

  2. Department of Pathology, SDMH, Jaipur, Rajasthan, India

    Shubha Gupta

  3. B-43, Krishna Puri, Old Ramgarh Mod, Amer Road, Jaipur, Rajasthan, India

    Anjani Kumar Sharma

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  1. Anjani Kumar Sharma
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  2. Prakash Mishra
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Correspondence to Anjani Kumar Sharma.

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Sharma, A.K., Mishra, P. & Gupta, S. Immunohistochemistry, A Valuable Tool in Detection of Cervical Lymph Node Micrometastases in Head and Neck Squamous Cell Carcinoma: A Prospective Study. Indian J Otolaryngol Head Neck Surg 65 (Suppl 1), 89–94 (2013). https://doi.org/10.1007/s12070-012-0551-4

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  • DOI: https://doi.org/10.1007/s12070-012-0551-4

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