A Study on the Type IV Collagen Expression in the Basement Membrane Surrounding the Cancer Nest(Cancer Nest Membrane) and Cervical Lymph Node Metastasis of Head and Neck Squamous Cell Carcinoma / 대한이비인후과학회지

ABSTRACT

BACKGROUND: The first barrier carcinomas must cross is the basement membrane surrounding the cancer nest what we call cancer nest membrane. Since type IV collagen is the most important structure composing the basement membrane, investigation of the immunohistological localization and continuity of type IV collagen is of value in predicting the metastatic aggressiveness of squamous cell carcinoma. OBJECTIVES: This study was designed to investigate the relationship between type IV collagen expression in the cancer nest membrane and cervical lymph node metastasis in head and neck squamous cell carcinoma by immunohistochemistry. MATERIALS AND METHODS: Tissues were obtained from 55 patients with head head and neck squamous cell carcinoma who underwent the surgery of primary tumor resection and radical neck dissection. And paraffin embedded 5nm thin sections were immunohistochemically stained for type IV collagen. RESULTS: 1) The positive reaction of type IV collagen was identified as continuous linear pattern in basement membranes of normal mucosal epithelium and interstitial capillaries. Three main patterns of expression of type IV collagen in the cancer nest membrane were continuity, breaks(partial loss) and absence(total loss). 2) Membrane discontinuity correlated significantly with cervical lymph node metastasis, while intact membrane was associated with a low frequency of cervical lymph node metastasis(p<0.001). 3) Membrane discontinuity was noted in higher clinical stage(TNM classification), increased number of metastatic lymph nodes and poorly differentiated histologic type(p<0.05). 4) There was no significant correlation between the patient age, tumor size, primary tumor site and discontinuity in the cancer nest membrane. CONCLUSION: These results suggest that type IV collagen in the cancer nest membrane may be a biochemical parameter to predict the metastatic potential and aggressiveness of head and neck squamous cell carcinoma.