Pathogenesis and detection of micrometastasis in OSCC- An overview

Abstract

Oral squamous cell carcinoma (OSCC) has a remarkable global incidence and equally daunting mortality rates. Despite diagnostic and therapeutic advancements, mortality and morbidity rates in patients diagnosed with oral cancer remain constant. The most fundamental prognostic marker for patients with OSCC is metastasis to cervical lymph nodes or distant organs. Micrometastasis refers to the microscopic deposits of malignant cells distinct from the primary lesion. There are several techniques for detection of micrometastasis including Immunohistochemistry (IHC), Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and serial sectioning but certain special stains that are reliable like Modified Papanicolaou stain and Toluidine can be used on serial sectioned lymph node sections to detect micrometastasis. Early recognition of micrometastatsis in OSCC especially after surgery is undeniably advantageous for the patient and aids in modifying the treatment. Micrometastasis being an essential adverse prognostic factor in oral and oropharyngeal SCC, it becomes the utmost responsibility of the clinician to inculcate various methods for its detection into future clinical trials and management strategies for better understanding and outcome of the disease.