Prediction of occult lymph node metastasis in squamous cell carcinoma of the oral cavity and the oropharynx using peritumoral Prospero homeobox protein 1 lymphatic nuclear quantification

Head Neck. 2016 Sep;38(9):1407-15. doi: 10.1002/hed.24452. Epub 2016 Apr 4.

Abstract

Background: The use of lymphatic vessel density as a predictor of occult lymph node metastasis (OLNM) in head and neck squamous cell carcinoma (HNSCC) has never been reported.

Methods: Staining of the specific lymphatic endothelial cells nuclear marker, PROX1, as an indicator of lymphatic vessel density was determined by counting the number of positive cells in squamous cell carcinomas (SCCs) of the oral cavity and the oropharynx with clinically negative necks. Correlation with histopathological data was established.

Results: Peritumoral PROX1 lymphatic nuclear count significantly correlated with the detection of OLNM in multivariate analysis (p < .005). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of this parameter was 60%, 95%, 85%, and 90%, respectively.

Conclusion: Peritumoral PROX1 lymphatic nuclear count in primary SCCs of the oral cavity and the oropharynx allows accurate prediction of occult lymph node metastasis. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1407-1415, 2016.

Keywords: PROX1; microvascular lymphatic density; occult lymph node metastasis; oral squamous cell carcinoma; prognosis.

MeSH terms

  • Aged
  • Analysis of Variance
  • Biomarkers, Tumor / metabolism*
  • Carcinoma, Squamous Cell / pathology*
  • Cohort Studies
  • Female
  • Head and Neck Neoplasms / pathology*
  • Homeodomain Proteins / metabolism*
  • Humans
  • Immunohistochemistry
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis / pathology
  • Lymphatic Vessels / pathology*
  • Male
  • Middle Aged
  • Mouth / pathology
  • Mouth Neoplasms / pathology*
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Squamous Cell Carcinoma of Head and Neck
  • Switzerland
  • Tumor Suppressor Proteins / metabolism*

Substances

  • Biomarkers, Tumor
  • Homeodomain Proteins
  • Tumor Suppressor Proteins
  • prospero-related homeobox 1 protein