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Objective To investigate the relationship between lymph nodes count after selective neck lymph node dissection and the prognosis of patients with pathologically lymph node-negative (pN0) hypopharyngeal squamous cell carcinoma (HPSCC). Methods The clinical data of 96 patients with pN0 HPSCC undergoing selective neck dissection (bilateralⅡ-Ⅳregion) from October 1995 to October 2012 in Shanxi Provincial Cancer Hospital were analyzed retrospectively. The optimal lymph nodes count cutoff values were determined by using the X-tile program in different prognostic groups, and the univariate and multivariate survival analysis in different groups were analyzed by using SPSS 19.0 software. Results A total of 2116 lymph nodes were detected in this cohort, with a median number of 22 (3-52). Except for the tumor site (P= 0.011), there were no statistical differences in lymph nodes count of patients with different age, gender, history of smoking or drinking, T stage, and differentiation degree (all P> 0.05). Applying 9 and 23 nodes as the cutoff values determined by using X-tile program, all patients could be divided into the high-risk (13 cases, lymph nodes count 3-9), the middle-risk (37 cases, lymph nodes count 10-22) and the low-risk (46 cases, lymph nodes count 23-52) groups. And the 5-year overall survival (OS) rate was 23.1 ％, 55.9％and 86.0％in the high, middle, low risk groups respectively (χ2= 21.73, P< 0.001). Multiple-factor analysis showed that lymph nodes count, T stage and degree of tumor differentiation were independent prognostic factors in patients with pN0 HPSCC (all P< 0.05). Further analysis showed that when the cutoff value of lymph nodes count was 9, the patients could be divided into two groups with significantly differentprognosis. The 5-year OS rate was 23.1％ in the high-risk group and 73.2 ％ in the low-risk group, and the difference was statistically significant (χ2 = 17.87, P< 0.001). Conclusions Lymph nodes count after selective neck lymph node dissection can be used to predict the prognosis of patients with pN 0 HPSCC. It is likely that 9 is the minimum number of lymph nodes in pN0 HPSCC patients.
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ObjectiveTo explore the relation of VEGF-C and CD44V6 expression with cervical lymph metastases in papillary thyroid carcinoma.MethodsThe expression of VEGF-C and CD44V6 in 80 specimens of papillary thyroid carcinoma were evaluated with SP immunohistochemical methods. Lymphangiogenesis was examined by immunohistochemical staining with the specific D2-40 antibody and evaluated by lymphatic vessel density(LVD).In all the 80 cases,there were 38 cases with cervical lymph node metastases and 42 cases without cervical lymph node metastasis. ResultsThe positive expression rates of VEGF-C and CD44V6 in the cases with cervical metastases were 86.84 ％ (33/38) and 81.58 ％ (31/38) respectively,and in the cases without cervical lymph metastases were 61.90 ％ (26/42) and 52.38 ％ (22/42) respectively.There were significant differences in the positive expression rates of VEGF-C and CD44V6between two groups(P＜0.05). In the cases with lymph node metastases,there were positive correlations between VEGF-C and CD44V6 expression(r=0.525,P＜0.0l).Conclusion VEGF-C and CD44V6 play important roles in lymph metastasis and invasion of papillary thyroid carcinoma.VEGF-C and CD44V6 can be considered as a marker of pathological and biological behavior of papillary thyroid carcinoma.