Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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DIAGNOSIS OF MICROMETASTASIS IN LYMPH NODE AND CLINICAL EVALUATION OF PROGNOSTIC FACTOR OF ORAL SCC USING RT-PCR AND IMMUNOHISTOCHEMISTRY FOR CYTOKERATIN

Cytokeratin의 RT-PCR 및 면역조직화학적 분석을 이용한 구강편평세포암종의 임파절 미세전이 진단과 예후인자 효용성 평가

  • Park, Sung-Jin (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Lee, Won-Deok (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Lim, Ku-Young (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Kang, Jin-Han (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Myung, Hoon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Lee, Jong-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University)
  • 박성진 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 이원덕 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 임구영 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 강진한 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 명훈 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 이종호 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김명진 (서울대학교 치과대학 구강악안면외과학교실)
  • Published : 2005.04.30
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Abstract

Purpose: The lymph node status assessed by conventional histological examination is the most important prognostic factor in patients undergoing surgery for oral squamous cell carcinoma. The presence of lymph node metastasis has a strong adverse impact on patient survival even after extended radical resection. Despite these findings, tumour recurrence is not rare after surgery, even when histological examination shows no lymph node metastasis. Recently, molecular-genetically and immunohistochemically demonstrated micrometastasis to the lymph nodes has been shown to have a significant adverse influence on survival in patients with squamous cell carcinoma and histologically negative nodes. The present study sought to determine the incidence and clarify the clinical significance of molecular-genetically and immunohistochemically demonstrated nodal micrometastases and to correlate these data with the stage of oral cancer. Methods: Lymph nodes systematically removed from 71 patients who underwent curative resection between 1998 and 2003 with head and neck squamous cell carcinoma were examined molecular-genetically to detect cytokeratin 5 mRNA with RT-PCR and immunohistochemically to detect cells that stained positively for cytokeratins with the monoclonal antibody cocktail AE1/AE3. The postoperative course and survival rates were compared among patients with and without micrometastases, after numerical classification of overt metastatic nodes. Results: micrometastases were detected in 43(60%) of 71 patients by RT-PCR and 26(36%) of 71 patients by immunohistochemistry. By RT-PCR analysis, patients exhibiting a positive band for CK 5 mRNA had a significantly worse prognosis than those were RT-PCR negative. By immunohistochemistry, the presence of micrometastasis did not predict patient outcome. Conclusion: Micrometastases detected by RT-PCR may be of clinical value in identifying patients who may be at high risk for recurrence and who are therefore likely to benefit from systemic adjuvant therapy.

Keywords

References

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