Histological Grading of Oral Cancer: A Comparison of Different Systems and Their Relation to Lymph Node Metastasis
Keywords:
Bryne’s grading system, grading systems, metastasis, oral SCCAbstract
Oral squamous cell carcinoma has a great predisposition to produce metastasis in lymph nodes. In clinical practice, the treatment plan and prognosis of oral squamous cell carcinoma is mainly based on the primary tumor, regional lymph node metastasis, and distant metastasis (TNM) staging system. However, this system does not provide any information on the biological characteristics and thus an aggressive clinical behavior of the tumor. The aim of this study was to assess some indicative histological parameters that would assist in the prognosis of these lesions. All cases of oral squamous cell carcinoma's treated with wide excision of growth with radical neck dissection, registered between 2006 – 2009 in the Department of Pathology, Shree Krishna Hospital, Karamsad were studied retrospectively. Surgical specimens of 31 metastasizing tumors were compared with 26 tumors which did not metastasize. Each case was graded according to: Broders' classification in the whole thickness of tumor, Anneroth’s multifactorial grading system and Bryne’s deep invasive cell grading system. Bryne’s score showed an Odds ratio of 2.12, 95% C.I. (1.41, 3.18). The predictive value of the score is 73.7%. Bryne’s deep invasive cell score showed significant relation with lymph node metastasis. Other grading methods failed to show any relation with metastasis. Bryne’s deep invasive cell grading system in appropriate biopsy specimens would be of great value in predicting lymph node metastasis and treatment results of oral squamous cell carcinoma.
References
Vijay R Tumuluri. A retrospective Analysis of Cell Proliferation in Human Oral Squamous Cell Carcinoma. A thesis submitted to Queen Elizebeth Research Institute for Mothers and Infants, The University of Sydney; Nov 1998.
Dilana Duarte Lima Dantas et al. Clinical-pathological parameters in squamous cell carcinoma of the tongue. Braz Dent J 2003;14:1:22-25.
SP Khandelkarl, PS Bagdey. Oral cancer and some epidemiological factors : A Hospital based study. Indian Journal Of Community Medicine 2006;31:3:157-162.
Kenneth D McClatchey, Richard J. Zarbo. The Jaws and Oral Cavity. Sternberg’s Diagnostic Surgical Pathology 2004;2:884-915.
Juan Rosai. American Joint Committee on Cancer (AJCC) Staging of Oral cavity and lip; 2002. Rosai and Ackerman’s Surgical Pathology, 9th Edn 2004 Appendix C:2:2804-2806.
Yazdi DMD, M. Khalili DMD. Grading of Oral Cancer: Comparison of Different Systems with Respect to Lymph Node Metastasis in Tongue SCC.
Kat, Keizo. A Study of Prognostic Factor of Oral Squamous Cell Carcinoma. Examination of Histologic Grading of Malignancy by Anneroth Classification. Acta Scholae Medicinalis Universitatis in Gifu 2001;49:3:63-67.
Y. Okada, I. Mataga. An analysis of cervical lymph nodes metastasis in oral squamous cell carcinoma: Relationship between grade of histopathological malignancy and lymph nodes metastasis. International journal of oral and maxillofacial surgery, 2003;32:3:284-288.
M.F. Muñoz-Guerra. Early stage oral cancer: prognosis with regard to histological grading, intratumoral lymphangiogenesis, and the expression of vascular endothelial growth factor-C (VEGF-C). Rev Esp Cirug Oral y Maxilofac 2006;28:1:25-40.
Kazunari Karakida. Examination of Factors Predicting Occult Metastasis of the Cervical Lymph Nodes in T1 and T2 Tongue Carcinoma. Tokai J Exp Clin Med 2002;27:3:65-71.
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