Role of immunoreactive patterns of lymph nodes in neck dissection cases of oral squamous cell carcinoma: a clinical and histopathological study

Abstract

ObjectivesMetastasis in oral squamous cell carcinoma (OSCC) can occur in a variety of ways, and draining lymphatics and lymph nodes serve as a common route. Prior to metastasis, lymph nodes elicit an immune response to either wall off or create a favorable environment for homing of tumor cells. This immune response to tumor stimuli is visualized by recognizing various immunoreactive patterns exhibited by the lymph node. The present study aims to evaluate the role of immuno-morphologic patterns of the lymph node in neck dissection for cases of OSCC.Materials and MethodsOur retrospective study included 50 neck dissection cases of OSCC and a total of 1,078 lymph nodes. The grades of primary tumors with eight different immunoreactive patterns were compared. Vascularity and metastasis in lymph nodes were also evaluated.ResultsThe lymphocyte predominant pattern was the most common immunoreactive pattern found in 396 of 1,078 lymph nodes. Patterns of lymphocyte predominant (P=0.0005), sinus histiocytosis (P=0.0500), paracortical hyperplasia (P=0.0001), cortical hyperplasia (P=0.0001), and increased vascularity (P=0.0190) were significantly associated with tumor grade.ConclusionThe present study adds to the understanding of lymph node immunoreactivity patterns and their correlation with tumor grade. We recommend further study of lymph node patterns for all sentinel lymph node biopsies and routine neck dissections for OSCCs.

Expressions of extracellular matrix‐remodeling factors in lymph nodes from oral cancer patients

“…Bhatlande et al supposed that immunoreactive patterns including sinus histiocytosis of the LN was relative to favorable environment for homing tumor cells and emphasized some nodal histological patterns correlated with tumor grade in OSCC, and necessity of LN patterns for sentinel LN biopsies and neck dissections for OSCCs (Bhatlawande et al, 2019). We hypothesized that microenvironment as a pre-metastatic niche was required for lymphatic metastasis from primary OSCC and that ECM remodeling was needed to build the microenvironment.…”

Immunohistochemical evaluation of tumor angiogenesis and architectural changes in regional lymph nodes of oral squamous cell carcinoma (OSCC)

“…Hence our findings supports the fact that the presence of SH indicates more advanced stage of carcinoma (Ioachim and Medeiros, 2009). It is also being associated with the poorer patient prognosis and Tumour invasion ( Bhatlawande et al, 2019) Of the 255 nodes harvested from WDSCC cases in the present study (Table 2), 74.22% (p< 0.005) LNs showed GCP pattern, 69% lymphocyte predominance (p< 0.0003). Suchitra et al, 2015 in their study on OSCC correlated LP with survival rate and found to have a significant association with mortality and improved 5 year survival rate.…”

“…Previous studies have observed tumor progression may aid in release of antigens which can bring a typical immune response in the LN and LP and GCP are early immunological response to antigenic insult. With metastasis LP is replaced by SH and LD pattern and these changes may help to determine disease prognosis (Bhatlawande et al, 2019) There is insufficient literature on individual morphological pattern of lymph node associating with TNM staging, Grading and MVA. Assessment of these parameters can be utilized in classifying the OSCC as high-risk and low-risk cases and planning various therapeutic strategies.…”