Štefanička P., Valach M., Profant M.: The Incidence of Regional Occult Micrometastases in Squamous Cells Carcinoma Patients


Authors: P. Štefanička 1;  M. Valach 2;  M. Profant 1
Authors‘ workplace: I. ORL klinika LF UK, SZU, FNsP, Bratislava, prednosta prof. MUDr. M. Profant, CSc. 1;  Alfa medical patológia, s. r. o., Bratislava, prednosta doc. MUDr. F. Ondriáš, CSc. 2
Published in: Otorinolaryng. a Foniat. /Prague/, 60, 2011, No. 1, pp. 26-32.
Category: Original Papers

Overview

Objectives:
The aim of the study was to determine incidence of occult micrometastases by semiserial sectioning and immunohistochemistry with cytokeratin in patients with head and neck squamous cell carcinoma with clinically negative neck.

Material and methods:
Eighteen patients with squamous cell carcinoma of the head and neck who primary underwent surgical treatment of the primary tumor and elective selective neck dissection were included in the study. Lymph nodes of neck dissection specimen were evaluated by semiserial sectioning at 200 μm interval with hematoxylin-eosin staining and immunohistochemical stain method using pan-cytokeratin AE1/3. Results: Of 18 patients, 28 neck dissections were harvested 600 lymph nodes. The incidence of occult micrometastases was 22.2% per patient, 14.3% per neck and 1% per lymph node. In 4 patients was pN upgrading from pN0 to pN+, 28.6%.

Conclusion:
The incidence of occult micrometastases in head and neck cancer patients detected by semiserial sectioning with cytokeratin immunohistochemistry is higher than conventional pathologic techniques. Use of this technique should more accurately identify patients for postoperative adjuvant treatment.

Key words:
occult metastases, micrometastases, isolated tumor cells, cytokeratin immunohistochemistry, head and neck squamous cell carcinoma.


Sources

1. Barrera, J. E., Miller, M. E., Said, S., Jafek, B. W., Campana, J. P., Shroyer, K. R.: Detection of occult cervical micrometastases in patients with head and neck squamous cell cancer. Laryngoscope, 113, 2003, s. 892-896.

2. Becker, M. T., Shores, C. G., Yu, K. K., Yarbrough, W. G.: Molecular assay to detect metastatic head and ­neck squamous cell carcinoma. Arch. Otolaryngol Head Neck Surg., 130, 2004, s. 21-27.

3. Brennan, J. A, Mao, L, Hruban, R. H., Boyle, J. O., Eby, Y. J., Koch, W. M, Goodman, S. N., Sidransky, D.: Molecular assessment of histopathological staging in squamous cell carcinoma of the head and neck. N. Engl. J. Med., 332, 1995, 7, s. 429-435.

4. Colnot, D. R., Nieuwenhuis, E. J. C. , Kuik, D. J., Leemans, C. R., Dijkstra, J., Snow, G. B., van Dongen, G., Brakenhoff, R. H.: Clinical significance of micrometastatic cells detected by E48 (Ly-6D) reverse transcription – polymerase chain reaction in bone marrow of head and neck cancer patients. Clin. Cancer Res., 10, 2004, 7827-7833.

5. Devaney, S. L., Ferlito, A., Rinaldo, A., Devaney, K. O.: Pathologic detection of occult metastases in regional lymph nodes in patients with head and neck cancer. Acta Otolaryngol, 120, 2000, s. 344-349.

6. Devaney, S. L., Ferlito, A., Rinaldo, A., Devaney, K. O.: The pathology of neck dissection in cancer of the larynx. ORL J. Otorhinolaryngol Relat. Spec., 62, 2000, 4, s. 204-211.

7. Don, D. M., Anzai, Y., Lufkin, R. B., Fu, Y. S., Calcaterra, T. C.: Evaluation of cervical lymph node metastases in squamous cell carcinoma of the head and neck. Laryngoscope, 105, 1995, s. 669-674.

8. Elsheikh, M. N., Rinaldo, A., Hamakawa, H., Mahfouz, M. E., Rodrigo, J. P., Brennan, J., Devaney, K. O., Grandis, J. R, Ferlito, A.: Importance of molecular analysis in detecting cervical lymph node metastasis in head and neck squamous cell carcinoma. Head Neck, 28, 2006, s. 842-849.

9. Enepekides, D. J., Sultanem, K., Nguyen, C., Shenouda, G., Black, M. J., Rochon, L.: Occult cervical metastases: immunoperoxidase analysis of the pathologically negative neck. Otolaryngol Head Neck Surg., 120, 1999, s. 713-717.

10. Ferlito, A., Devaney, K. O., Rinaldo, A., Devaney, S. L., Carbone, A.: Micrometastases: have they an impact on prognosis? Ann. Otol. Rhinol. Laryngol, 108, 1999, 1185-1189.

11. Ferlito, A., Rinaldo, A., Devaney, K. O., MacLennan, K., Myers, J. N., Petruzzelli, G. J., Shaha, A. R., Genden, E. M., Johnson, J. T., Carvalho, M. B., Myers, E. N.: Prognostic significance of microscopic and macroscopic extracapsular spread from metastatic tumor in the cervical lymph nodes. Oral Oncology, 38, 2002, s. 747-751.

12. Ferlito, A., Rinaldo, A., Devaney, K. O., Nakashiro, K., Hamakawa, H.: Detection of lymph node micrometastases in patients with squamous carcinoma of the head and neck. Eur Arch. Otorhinolaryngol, 256, 2008, 1147-1153.

13. Ferris, R. L., Xi, L., Raja, S., Hunt, J. L., Wang, J., Gooding, W. E., Kelly, L,. Ching, J., Luketich, J. D., Godfrey, T. E.: Molecular staging of cervical lymph nodes in squamous cell carcinoma of the head and neck. Cancer Res., 65, 2005, s. 2147-2156.

14. Finn, S., Toner, M., Timon, C.: The node-negative ­ neck: accuracy of clinical intraoperative lymph node assessment for metastatic disease in head and neck cancer. Laryngoscope, 112, 2002, s. 630-633.

15. Hamakawa, H., Fukuzumi, M., Bao, Y., Sumida, T., Kayahara, H., Onishi, A., Sogawa, K.: Keratin mRNA for detecting micrometastasis in cervical lymph nodes of oral cancer. Cancer Letters, 160, 2000, s. 115-123.

16. Hamakawa, H., Fukizumi, M., Bao, Y., Sumida, T, Onishi, A., Tanioka H., Sato, H., Yumoto, E.: Genetic diagnosis of micrometastasis based on SCC antigen mRNA in cervical lymph nodes of head and neck cancer. Clin. Exp. Metastasis, 17, 1999, 7, s. 593-599.

17. Hamakawa, H., Takemura, K., Sumida, T., Kayahara, H., Tanioka, H., Sogawa, K.: Histological study on pN upgrading of oral cancer. Virchows Arch., 437, 2000, s. 116-121.

18. Hermanek, P., Hutter, R. V., Sobin, L. H., Wittekind, C.: Classification of isolated tumor cells and micrometastasis. Cancer, 86, 1999, s. 2668-2673.

19. Kocaturk, S., Yilmazer, D., Onal, B., Erkam, U., Urunal, B.: Do micrometastases detected with cytokeratin immunoperoxidase reactivity affect the treatment approach to neck in supraglottic cancers? Otolaryngol Head Neck Surg., 128, 2003, s. 407-411.

20. Kwon, S. Y., Kim, H. J., Woo, J. S., Jung, K. Y., Kim, I.: The usefulness of cytokeratin immunohistochemistry in detection of lymph node micrometastasis in neck dissection specimens. Otolaryngol Head Neck Surg., 131, 2004, s. 300-306.

21. Nieuwenhuis, E. J., Leemans, C. R., Kummer, J. A., Denkers, F., Snow, G. B., Brakenhoff, R. H.: Assessment and clinical significance of micrometastases in lymph nodes of head and neck cancer patients detected by E48 (Ly-6D) quantitative reverse transcription- polymerase chain reaction. Lab. Invest, 83, 2003, s. 1233-1240.

22. Rassekh, C. H., Johnson, J. T., Myers, E. N.: Accuracy of intraoperative staging of the N0 neck in squamous cell carcinoma. Laryngoscope, 105, 1995, 12, s. 1334-1336.

23. Rinaldo, A., Devaney, K. O., Ferlito, A.: 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, 2004, s. 38-41.

24. Ross, G. L., Soutar, D. S., MacDonald, D. G., Shoaib, T., Camilleri, I., Roberton, A. G., Sorensen, J. A., Thomsen, J., Grupe, P. et al: Sentinel lymph node biopsy in head and neck cancer: Preliminary results of a multicenter trial. Ann. Surg. Oncol., 11, 2004, s. 690-696.

25. Shores, C. G., Yin, X., Funkhouser, W., Yarbrough, W.: Clinical evaluation of a new molecular method for detection of micrometastases in head and neck squamous cell carcinoma. Arch. Otolaryngol Head Neck Surg., 130, 2004, s. 937-942.

26. Sobin, L. H., Wittekind, C. H.: TNM klasifikácia zhubných nádorov. 6. vyd., Košice, ETC GRAFO, 2002, 178 s., ISBN 80-968395-5-1

27. Stoeckli, S. J., Alkureishi, L. W. T., Ross, G. L.: Sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma. Eur Arch. Otorhinolaryngol, 266, 2009, s. 787-793.

28. Stoeckli, S. J.: Sentinel node biopsy for oral and oropharyngeal squamous cell carcinoma of the head and neck. Laryngoscope, 117, 2007, s. 1539-1551.

29. van den Brekel, M. W., Castelijns, J. A., Snow, G. B.: Diagnostic evaluation of the neck. Otolaryngol Clin. North Am., 31, 1998, 4, s. 601-620.

30. van den Brekel, M. W., van der Waal, I., Meijer, C. J., Freeman, J. L., Castelijns, J. A., Snow, G. B.: The incidence of micrometastases in neck dissection specimens obtained from elective nech dissections. Laryngoscope, 106, 1996, 8, s. 987-991.

31. Woolgar, J. A.: Micrometastasis in oral/oropharyngeal squamous cell carcinoma: incidence, histopathological features and clinical implications. Br. J. Oral Maxillofac. Surg., 37, 1999, 181-186.

32. Xu, Y., Zhao, X., Guan, M., Li, B., Zhou, Y., Zhou, F.: Determination of lymph node micrometastases in patients with supraglottic carcinoma. Acta Oto-Laryngologica, 127, 2007, s. 1188-1195.

33. Yamazaki, Y., Chiba, I., Hirai, A., Satoh, C., Sakakibara, N., Notani, K., Iizuka, T., Totsuka, Y.: Clinical value of genetically diagnosed lymph node micrometastasis for patients with oral squamous cell carcinoma. Head Neck, 27, 2005, 8, s. 676-681.

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