Markers for nodal metastasis in head and neck squamous cell cancer

Objective: To identify markers that are relevant as predictors of lymph node metastasis in head and neck squamous cell cancer. Design: Expression of p53, Rb, cyclin D1, E-cadherin, and epithelial cell adhesion molecule was examined using immunohistochemical analysis and traditional histological parameters, and the correlation of these markers with the histologically verified presence of regional metastases was determined. Subjects: The study sample comprised 121 patients with head and neck squamous cell cancer from whom paraffin-embedded material of primary tumors was used. Results: Lymph node metastasis was correlated with the loss of expression of Rb (P=.04) and marginally correlated with the loss of expression of E-cadherin (P=.06). If the results are broken down to subsites, loss of E-cadherin expression in oral cancer (P=.04) and absence of eosinophilic infiltration in laryngeal cancer (P=.003) correlated with nodal metastasis. None of the other markers correlated. A combination of relevant parameters did not result in a much stronger correlation. Conclusions: The expression of the investigated genetic markers and histopathological features of primary tumors can supply limited information on the metastatic behavior of tumors. Although the use of markers for regional metastasis would be a welcome additional tool, these results do not warrant the use of these parameters for clinical decision making concerning the treatment of the neck in patients with head and neck squamous cell cancer.