Immunohistochemistry, A Valuable Tool in Detection of Cervical Lymph Node Micrometastases in Head and Neck Squamous Cell Carcinoma: A Prospective Study

Abstract

The regional failure after comprehensive clearance of neck metastasis and consequent pathological report of N0 disease has been reported fairly frequently. The role of recurrence of disease in the neck in the cases has been variously reported by different authors. The light microscopy does not detect the micrometastasis and the specimen is reported negative for metastasis. The presence of micrometastasis (the reason for neck failure) has been reported by many studies as 5-58 % (mean 19.6 %). These figures are significantly high. The present study was done to ascertain the micrometastasis after comprehensive neck clearance (pN 0 report). Two groups of patients were included in this study. (1) Group I included patients with N0 necks (80 patients). (2) Group II included Patients with N? necks (107 patients).We found that 20 % case were reported N0 (Group I) in light microscopy but on immunohistochemistry these were positive for disease. 15 % upstaging was reported in N? cases (Group 2). Immunohistochemistry has been more sensitive for cancer detection and has significantly changed the tumor staging and its consequent management.

Development and Validation of Machine Learning Models for Predicting Occult Nodal Metastasis in Early-Stage Oral Cavity Squamous Cell Carcinoma

“… 46 This process may not capture micrometastatic disease that has been found to be present using more sophisticated techniques of specimen analysis. 47 Clearance of this micrometastatic disease may account for a survival benefit that has been reported in patients who underwent END, even when no pN disease was identified. 48 , 49 In this sense, pN positivity and nodal recurrence may not truly be equivalent, and it is impossible to retrospectively ascertain whether the 72.6% of patients who may have been spared from neck dissection by the machine learning model in our study would have had durable regional control with observation of the neck.…”

“…Routine histopathological evaluation involves bivalving grossly identified lymph nodes and staining with hematoxylin and eosin . This process may not capture micrometastatic disease that has been found to be present using more sophisticated techniques of specimen analysis . Clearance of this micrometastatic disease may account for a survival benefit that has been reported in patients who underwent END, even when no pN disease was identified .…”

Variability in Recommendations for Cervical Lymph Node Pathology for Staging of Canine Oral Neoplasia: A Survey Study

“…One of the primary benefits of SLN mapping is that if only one or two nodes are submitted, more rigorous pathologic evaluation may be feasible. For example, thin serial sectioning of each node with immunohistochemistry (such as AE1/AE3) has been shown to significantly increase detection of occult metastases in humans (72)(73)(74)(75), and these techniques may also be beneficial in canine tumors.…”