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Markers for Nodal Metastasis in Head and Neck Squamous Cell Cancer
Robert P. Takes, MD, PhD;
Robert J. Baatenburg de Jong, MD, PhD;
Martijn J. R. C. Alles, MD;
Cees A. Meeuwis, MD, PhD;
Henri A. M. Marres, MD, PhD;
Paul P. M. Knegt, MD, PhD;
Guy Brutel de la Riviere, MD, PhD;
Peter C. M. de Wilde, MD, PhD;
Wolter J. Mooi, MD, PhD;
Jo Hermans, PhD;
J. Han J. M. van Krieken, MD, PhD
Arch Otolaryngol Head Neck Surg. 2002;128:512-518.
Objective To identify markers that are relevant as predictors of lymph node metastasis
in head and neck squamous cell cancer.
Design Expression of p53, Rb, cyclin D1, E-cadherin, and epithelial cell adhesion
molecule was examined using immunohistochemical analysis and traditional histological
parameters, and the correlation of these markers with the histologically verified
presence of regional metastases was determined.
Subjects The study sample comprised 121 patients with head and neck squamous
cell cancer from whom paraffin-embedded material of primary tumors was used.
Results Lymph node metastasis was correlated with the loss of expression of
Rb (P = .04) and marginally correlated with the loss
of expression of E-cadherin (P = .06). If the results
are broken down to subsites, loss of E-cadherin expression in oral cancer
(P = .04) and absence of eosinophilic infiltration
in laryngeal cancer (P = .003) correlated with nodal
metastasis. None of the other markers correlated. A combination of relevant
parameters did not result in a much stronger correlation.
Conclusions The expression of the investigated genetic markers and histopathological
features of primary tumors can supply limited information on the metastatic
behavior of tumors. Although the use of markers for regional metastasis would
be a welcome additional tool, these results do not warrant the use of these
parameters for clinical decision making concerning the treatment of the neck
in patients with head and neck squamous cell cancer.
From the Departments of Otolaryngology–Head and Neck Surgery,
University Hospital, Leiden (Drs Takes, Baatenburg de Jong, and Alles), Daniël
den Hoed Cancer Center, Rotterdam (Dr Meeuwis), University Hospital, Nijmegen
(Dr Marres), and University Hospital, Rotterdam (Dr Knegt), the Netherlands;
the Departments of Pathology, Daniël den Hoed Cancer Center, Rotterdam
(Dr de la Riviere), University Hospital, Nijmegen (Dr de Wilde), and University
Hospital, Rotterdam (Dr Mooi), and University Hospital, Leiden (Dr van Krieken);
and the Department of Medical Statistics, University of Leiden (Dr Hermans).
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