Clinicopathological Significance of Tumor Lymphatic Vessel Density in Head and Neck Squamous Cell Carcinoma

Abstract

Various studies have demonstrated that the lymphatic system is the additional route for solid tumor metastasis. Lymph nodes metastasis in Head and neck squamous cell carcinoma (HNSCC) is a major prognostic indicator for disease progression and a guide for therapeutic strategies. We conducted a study to compare intratumoral (IT) and peritumoral (PT) lymphatic vessel density (LVD) in HNSCC using lymphatic marker D2-40 and its correlation with lymph node metastasis, histological grading and other clinicopathological parameters. Fifty specimen of HNSCC with modified radical neck dissection tissue were included in the study group. Tissue from tumor, peritumoral tissue, tumor margin and all the lymph nodes were processed for paraffin wax blocks and histopathological diagnosis. Immunohistochemical profile of lymphatic vessels in intratumoral and peritumoral tissue was assessed by subjecting one section each from the tumor and peritumoral tissue to D2-40 immunostain. To determine LVD, four fields with the highest LVD (hot spots) were identified. The mean values were calculated by taking an average of all the measurements. The comparison of LVD between peritumoral and intratumoral area revealed significantly higher PT-LVD ( = 0.001). No significant association was seen between LVD, IT-LVD and PT-LVD and different age groups, gender, site of tumor, risk factors, size of tumor, tumor inflammation, pushing/infiltrating margin and stage of tumors. Significantly higher LVD, IT-LVD and PT-LVD was seen in association with lymph node metastasis. Both high intratumoral and peritumoral LVD were found significantly associated with the presence of lymph node metastasis, however lymphatic vessels were found to be significantly more numerous and larger in peritumoral areas as compared to intratumoral lymphatics. The specificity of D2-40 as a lymphatic endothelial marker was also confirmed. The results of our study support the possibility of using the determination of tumor lymphangiogenesis to identify patients of HNSCC who are at risk of developing the lymph node metastasis.

In situ Molecular Hybridization of Kaposi, s Sarcoma Associated Virus (Human Herpes Virus 8) in Nasopharyngeal Carcinoma Tissues

“…In this study, the nasopharyngeal cancer patients have age range from 18 to77 years and their mean age was (42.85 ± 14.89) years while the mean age of patients with inflammatory nasal polyps was (28.22 ± 17.76) years and their age ranged from 7 -67 years (Table 1) .The patients' age in the present results coincides with the results of many other studies: Ogaet al (10) and Parmar et al, (11) who found the mean age of Nigerian patients with head and neck cancers, including nasopharyngeal cancers, was 43.3 years. Several other studies are also in agreement with the current results, where nasopharyngeal cancers increased with the advancing age with a peak age of 41-60 years and decreased above 60 years (12;13).…”

Toward a Molecular Classification of the Head and Neck Squamous Cell Carcinoma

“…These observations were reconfirmed by other study which reported an important correlation between both high intra-tumoral and peritumoral LVD and lymph node metastasis. The morphology of peri-tumoral lymphatic vessels was similar, with a large lumen, like in the previously study, but the number of lymphatic vessels was higher in peritumoral area compared with intra-tumoral area, opposite to previous study [69].…”

Potential significance of podoplanin immunohistochemical expression in papillary thyroid carcinoma

“…The LVD has been frequently correlated with tumor recurrence and poor prognosis. Moreover, it has a potential role as a predictive marker for lymph node metastasis in colorectal cancer, breast cancer, and head and neck squamous cell carcinoma (HNSCC) [31,32], so we assessed it using PDPN and we found that PDPN labelled LVD is higher in PTC than in non-PTC groups. This is in keeping with Gong et al and Giorgadze et al [23,33].…”