Detection of Micrometastasis in Lymph Nodes of Oral Squamous Cell Carcinoma - IHC Study

Introduction: Squamous cell carcinoma (SCC) of the head and neck is the eighth most common malignancy in the world, which exhibits poor survival due to the high rate of loco regional LN metastasis. Malignant tumors of epithelial origin often metastasize to the RLNs. Micrometastasis (MM) represents tumor deposits measuring less than 2 mm in diameter. It is very difficult to diagnose MM by routine histopathological examination. So detection of MM by immunostaining using Pancytokeratin will yield a greater incidence of positive cervical lymph node MM. Aim: To detect the presence of MM in clinically negative lymph nodes. Material and Methods: In this study clinically and histopathologically confirmed cases of SCC with neck dissection (n=30), retrieved from the department of oral and maxillofacial pathology. Demographic data and Grading of OSCC were collected . Results: The cytokeratin expression was positive in 2 cases (11.8%) and negative in 28 cases (88.2%). The obtained ‘p’ value was 0.47, which is not statistically significant. Reactive changes in lymph nodes of different grades of OSCC were observed using H&E stain, among the nodes studied, the chief pattern noted was lymphocyte predominance. Thus, with this small sample size it is difficult to attain more reliable results. Further studies are required to be done, using more reliable methods and larger sample size for accurate detection of MM in lymph nodes of OSCC.