Preoperative assessment of CD44-mediated depth of invasion as predictor of occult metastases in early oral squamous cell carcinoma.
Adult
Aged
Carcinoma, Squamous Cell
/ diagnostic imaging
Epithelial-Mesenchymal Transition
/ genetics
Gene Expression Regulation, Neoplastic
Hospitals, University
Humans
Hyaluronan Receptors
/ genetics
Kaplan-Meier Estimate
Logistic Models
Lymphatic Metastasis
/ genetics
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Mouth Neoplasms
/ diagnostic imaging
Multivariate Analysis
Neoplasm Invasiveness
/ pathology
Neoplasm Staging
Predictive Value of Tests
Preoperative Care
/ methods
Prospective Studies
Retrospective Studies
Risk Assessment
Sentinel Lymph Node Biopsy
Survival Analysis
Switzerland
Tomography, X-Ray Computed
/ methods
Treatment Outcome
biomarkers
carcinoma
cell surface
epithelial-mesenchymal transition
lymph nodes
neoplastic stem cells
oral cancer
receptor
sentinel lymph node biopsy
squamous cell
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
20
12
2017
revised:
31
07
2018
accepted:
28
09
2018
pubmed:
19
12
2018
medline:
10
10
2020
entrez:
19
12
2018
Statut:
ppublish
Résumé
Epithelial-mesenchymal transition and cancer stem-like cells (CSC) have been linked to increased metastatic potential. We evaluated the prognostic impact of CD44, a CSC biomarker, on depth of invasion (DOI) and outcome in oral squamous cell carcinoma (OSCC). Using a multivariable logistic regression model, we evaluated in early OSCCs the relationship between CD44 expression at the invasive tumor front, DOI, sentinel lymph node biopsy, extension of nodal involvement, and survival. We also assessed whether CT and/or MRI could predict DOI preoperatively. CD44 expression was associated with increased DOI (P = .018), worse disease-specific survival (P = .041) but not with positive sentinel lymph node biopsy (P > .05). Each millimeter increase in DOI was associated with a 31.1% higher risk for positive sentinel lymph node biopsy (95% CI: 5.8%-62.4%, P = .013) and with higher metastatic ratio (P = .015). Preoperative estimation of DOI by CT and/or MRI and histopathological DOI showed a strong correlation (P < .0001). CD44 expression correlates with DOI, which predicts occult lymph node metastasis. Preoperative CT and/or MRI provides an accurate estimation of histopathological DOI. Both pieces of information gained preoperatively can help surgeons tailor their operation in regard to the surgical management of the neck.
Sections du résumé
BACKGROUND
Epithelial-mesenchymal transition and cancer stem-like cells (CSC) have been linked to increased metastatic potential. We evaluated the prognostic impact of CD44, a CSC biomarker, on depth of invasion (DOI) and outcome in oral squamous cell carcinoma (OSCC).
METHODS
Using a multivariable logistic regression model, we evaluated in early OSCCs the relationship between CD44 expression at the invasive tumor front, DOI, sentinel lymph node biopsy, extension of nodal involvement, and survival. We also assessed whether CT and/or MRI could predict DOI preoperatively.
RESULTS
CD44 expression was associated with increased DOI (P = .018), worse disease-specific survival (P = .041) but not with positive sentinel lymph node biopsy (P > .05). Each millimeter increase in DOI was associated with a 31.1% higher risk for positive sentinel lymph node biopsy (95% CI: 5.8%-62.4%, P = .013) and with higher metastatic ratio (P = .015). Preoperative estimation of DOI by CT and/or MRI and histopathological DOI showed a strong correlation (P < .0001).
CONCLUSIONS
CD44 expression correlates with DOI, which predicts occult lymph node metastasis. Preoperative CT and/or MRI provides an accurate estimation of histopathological DOI. Both pieces of information gained preoperatively can help surgeons tailor their operation in regard to the surgical management of the neck.
Substances chimiques
CD44 protein, human
0
Hyaluronan Receptors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
950-958Informations de copyright
© 2018 Wiley Periodicals, Inc.