Cytokeratin Expression In Cervical Lymph Nodes Of Patients With Squamous Cell Carcinoma Of The Gingival

ObjectiveTo study the expression of cytokeratin in cervical lymph nodes of patients with squamous cell carcinoma of the gingival.MethodsA cohort of52cases with squamous cell carcinoma was enrolled at Oral and Maxillofacial Surgery Affiliated Hospital of Qingdao University from May2008to October2013,845lymph nodes were gathered and divided into subgoups according to anatomy regions standard during the cervical neck dissections. The pN+group of167lymph nodes of845presented HE staining postitive of metastasis (pN+) and the pN0group without metastasis (678lymph nodes), In terms of anantomy regions, pN+group was then divided into positive lymph node zone (subgroup A,28positive and44negative lymph nodes were involved) and lymph node-negative zone (subgroup B, up to95lymph nodes) The cytokeratin monoclonal antibody (CK-AE1/AE3) was used as bio-marker which was usually expressed in the variant squamous cell of lymph node.The immunohistochemistry method of SABC was applied to detect of antibodies. The data was analysed with SPSS18.0statistical software to assess the differences between the HE staining and immunohistochemical staining. A new TNM stage assessment was formed by the immunohistochemical method for the cases compared to the conventional HE-based TNM systerm.ResultsGroup pN+(subgroup A):28lymph nodes with metastasis expression by HE staining also showed positive expression by the CK staining.In terms of44lymph nodes of negative HE staining5lymph nodes were positive for CK, the newly added metastasis rate was11.36%(5/44).Subgroup B:95lymph nodes with negative of CK expression,6lymph nodes were found with positive,the newly added metastasis rate is6.31%(6/95). As for Group pNO,678lymph nodes without metastasis stained by HE,4lymph nodes were positive for CK, the newly added expression of CK is0.59%(4/678). The15of newly detected lymph nodes were found in12patients, in which5re-assessed TNM staging were formed. Of note,2of three lymph nodes transferred to Level â…¡ directly accross Level I, characterized by Skip metastasis1lymph node in the Level â…¢.ConclusionThe immunohistochemistry with pan-cytokeratin (CK-AE1/AE3) is a sensitive and accurate method to detect lymph node with metastasis of gingival squamous cell carcinoma, compared with the traditional HE staining The re-assessed TMN stage was formed by the CK immunohistochemistry, especially for the negative patients of HE screening. Of note, the lymph nodes characterized by Skip metastasis was crucial for the sequential treatment and follow up.