Determining the potential of desmoglein 3 as a sensitive and specific immunohistochemical marker for the detection of micrometastasis in patients with primary oral squamous cell carcinoma

Abstract

Aim of the studyDespite advances in surgical and radiotherapy techniques, the presence of lymph node metastasis drastically decreases the survival rate of patients with primary oral squamous cell carcinoma (OSCC). Thus the accurate pathological staging of the neck is critical. Desmoglein 3 (DSG3), a desmosomal cadherin protein is said to be highly expressed in head and neck squamous cell carcinoma (HNSCC) and in metastatic cervical lymph nodes, but absent in non-invaded nodes. With an aim to improve the sensitivity of tumour cell detection, we investigated the potential of DSG3 as an immunohistochemical marker for the detection of occult lymph node metastasis in patients with primary OSCC.Material and methodsForty-seven lymph node specimens from 10 patients who underwent neck dissection for primary OSCC were immunostained with DSG3.ResultsThe DSG3 positivity was noted in the six positive lymph nodes. However, when using DSG3 as an immunohistochemical marker, no additional micrometastatic deposits were evident in the histologically negative nodes. Interestingly, tumour marker DSG3-positive macrophages could be identified within the subcapsular sinuses, medullary sinuses, and the interfollicular areas.ConclusionsOur findings suggest that although DSG3 is overexpressed in HNSCC, it is not specific and may not prove to be a potent immunohistochemical marker to detect micrometastasis. The role of tumour marker-positive macrophages within the lymph nodes needs to be investigated further.

Preoperative platelet-lymphocyte ratio and neutrophil-lymphocyte ratio as predictors of occult lymph node metastasis detected using Desmoglein 3 and Cytokeratin in Indian population

“…Nagvekar et al . [ 25 ] also reported the presence of DSG3+ histiocytes in lymph node tissue and they confirmed the origin of these cells by immunostaining with CD 68 (pan macrophage marker) and CD163 (marker for M2 phenotype). The current study also found substantial number of macrophages in subcapsular sinuses, interfollicular areas, medullary sinuses as well as within the lymphoid follicles which stained positively with DSG3, which is a less reported but interesting finding [ Figure 3 ].…”

“…[ 21 ] Similar staining of dendritic cells with CK was observed in the current study. According to Nagvekar et al .,[ 25 ] these macrophages show positivity for both DSG3 and CK and this may be attributed to the presence of ingested processed antigens within these cells, before migration to lymph nodes. Thus, micrometastatic and macrometastatic deposits were easier to identify in comparison to ITC on staining with DSG3.…”