Detection of lymph node metastasis using cytokeratin19 in OSCC patients

Objective: To improve detective sensitivity of cervical lymph node metastasis in oral squamous cell carcinoma (OSCC) patients. Methods: Ninety-nine cervical lymph nodes from thirty-three patients with primary OSCC were analyzed for presence of metastasis using cytokeratin 19 (CK19) immunohistochemistry and relative quantification of real-time reverse transcription-polymerase chain reaction (RT-PCR). Results: The detective rate of metastatic lymph nodes and OSCC patients, using routine pathological examination, were 12.1% (12/99) and 9.1% (9/33), respectively; however, the detective rate of metastatic lymph nodes and OSCC patients, using immunohistochemistry, were improved by 2.0% (2/99) and 6.1% (2/33), respectively. CK19 mRNA level in positive lymph node was significantly higher than that in negative lymph node (Z=-2.733, P=0.006). The survival rate in the OSCC patients with lymph node metastasis (63.6%) was significantly lower than that in the patients without lymph node metastasis (90.9%), Log Rank=4.19 and P=0.041; the survival rate in the patients with tumor recurrence (28.6%) was also significantly lower than that in the patients without tumor recurrence (96.2%), Log Rank=22.43 and P<0.001. Conclusions: CK19 immunohistochemistry can be used to improve the detective sensitivity of cervical lymph node metastasis in OSCC patients.