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Štefanička P., Valach M., Profant M.: The Incidence of Regional Occult Micrometastases in Squamous Cells Carcinoma Patients


Authors: P. Štefanička 1;  M. Valach 2;  M. Profant 1
Authors‘ workplace: I. ORL klinika LF UK, SZU, FNsP, Bratislava, prednosta prof. MUDr. M. Profant, CSc. 1;  Alfa medical patológia, s. r. o., Bratislava, prednosta doc. MUDr. F. Ondriáš, CSc. 2
Published in: Otorinolaryngol Foniatr, 60, 2011, No. 1, pp. 26-32.
Category: Original Article

Overview

Objectives:
The aim of the study was to determine incidence of occult micrometastases by semiserial sectioning and immunohistochemistry with cytokeratin in patients with head and neck squamous cell carcinoma with clinically negative neck.

Material and methods:
Eighteen patients with squamous cell carcinoma of the head and neck who primary underwent surgical treatment of the primary tumor and elective selective neck dissection were included in the study. Lymph nodes of neck dissection specimen were evaluated by semiserial sectioning at 200 μm interval with hematoxylin-eosin staining and immunohistochemical stain method using pan-cytokeratin AE1/3. Results: Of 18 patients, 28 neck dissections were harvested 600 lymph nodes. The incidence of occult micrometastases was 22.2% per patient, 14.3% per neck and 1% per lymph node. In 4 patients was pN upgrading from pN0 to pN+, 28.6%.

Conclusion:
The incidence of occult micrometastases in head and neck cancer patients detected by semiserial sectioning with cytokeratin immunohistochemistry is higher than conventional pathologic techniques. Use of this technique should more accurately identify patients for postoperative adjuvant treatment.

Key words:
occult metastases, micrometastases, isolated tumor cells, cytokeratin immunohistochemistry, head and neck squamous cell carcinoma.


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