Volume : 8, Issue : 3, March - 2019

EVALUATION OF CERVICAL NODAL MICROMETASTASIS IN ORAL SQUAMOUS CELL CARCINOMA

Dr. Argha Baruah, Dr. T. N. Suresh, Dr. S. Mazeem Mohiyuddin, Dr. Swaroop Raj

Abstract :

The presence of cervical lymph node metastasis in oral squamous cell carcinoma carries an universally grave prognosis. A single 5-μm section from a 1-cm lymph node samples only 1/2000th of that node. So, micrometastasis present at the time of primary diagnosis is often missed by conventional method. MATERIAL AND METHODS: Paraffin embedded blocks of lymph nodes of neck dissection specimen which were classified as pN0 on routine histopathological examination between the year 2014 to 2016 were included in the study .Serial step sectioning was done at 200µm interval ,stained with H&E and screened by two pathologists for micrometastasis. IHC using PAN cytokeratin antibody was done for further confirmation. Results: 497 lymph nodes from 30 patients classified as pN0 on routine histopathological examination were studied. A total of 2150 sections were examined for micrometastasis. Most cases were pTNM Stage III(50%). On microscopic examination 2 /497 lymph nodes showed micrometastasis. .Statistically significant correlation was found between micrometastasis and pathological TNM staging (p=0.036) and also with bone invasion. Conclusion: On serial step sectioning micrometastasis was observed in 6.6%(2/30) of cases .Serial step sectioning along with IHC helps in detection of micrometastasis especially in higher TNM stage cases.