The Researching On The Reactive Hyperplasia Of The Draining Lymph Nodes And Oral Cancer Metastasis

Oral cancer is the most common tumor of oral and maxillofacial region, and its main metastatic pathway is through lymphatics, which appearance is a pathological mark of recurrence and poor prognosis. Though many researches are aiming to discover the truth of the metastasis, the molecular mechanisms are still unclear. The molecular and pathological variation of the early stage of metastasis is a key step, so comprehension the interaction of the tumor cells and the target organ is important to make the whole process clear.In clinical, there are many patients whose neck lymph tissues are found reactive hyperplasia, instead of metastasis after operation. Is there some relationship between reactive hyperplasia and metastasis? In this research, We are try to quest the answer.Objective: To make clear the relationship of reactive hyperplasia of the draining lymph nodes and oral cancer metastasis. Methods: The specimen is taken from 12 patients suffered from oral squamous cell carcinoma(SCC) who accepted inpatient care in West China College of Stomatology, SichuanUniversity from March 2004 to October 2004. There are totally 233 lymph nodes, and all the specimens are divided into 5 subregions according to the standard of American foundation of otolaryngology-head and neck surgery, 1991. At first, the lymph nodes are divided into normal, reactive hyperplasia(RH) and metastasis groups by pathological detection. Then immunohistochemistry method is used to inspect micrometastasis(MM). Next, some cytokines correlating with metastasis are continued to be detected, such as CD44,uPA,TGF- P ,VEGFc,CXCL12 and CXCR4. The records are analyzed with SPSS 10.0. Results: 25/233 lymph nodes are detected metastasis, and 79 are RH, 129 are normal. Normal mucosa, SCC and metastatic lymph nodes are all positive to keratin, and there are 29 and 12 specimens with MM in RH and normal lymph nodes separately. The expression of CD44 in the oral mucosa are more outstanding than in the SCC and metastasis lymph node, while the expression in the latter are more than in the non-metastasis lymph node. The level of CD44 in RH lymph nodes is higher than in the normal lymph nodes. The reaction of normal mucosa to antibody of uPA, TGF- P 1 and VEGFc are all negative or poor positive, in the contrast, SCC and metastasis lymph node are all strong positive. The three factors in the metastasis specimen are strong than in the RH and normal lymph nodes. Normal oral mucosa seldom reacts to CXCR4, while SCC has strong reaction with CD44. The expression level of CXCL12 in metastasis lymph nodes is much higher than in the non-metastasis lymph nodes. Conclusion:(T)MM occur on the RH lymph node in the oral cancer draining area easily than on the normal one. ?The expression level of CD44. uPA^ TGF-3 1 and VEGFc in the RH lymph node are betweenmetastatic and normal lymph node. ?The fact that oral SCC strongly expressed the chemokine, while lymph nodes especially the metastatic and RH lymph nodes express the corresponding ligand illustrates CXCL12-CXCR4 biological axis participate the lymphatic metastasis of oral cancer directly.Based on the findings, the research revealed that the RH of lymph nodes in the oral cancer draining area is the prophase manifestation of metastasis. The research provide a basis for continuing investigating the lymphatic metastasis of oral cancer, and offered a objective index and theoretical supporting for choosing therapeutic way in treatment of the cervical part of oral cancer in the early stage in clinical.