Podoplanin is an efficient predictor of neck lymph node metastasis in tongue squamous cell carcinoma with low tumor budding grade

Abstract

The current study investigated the efficacy of podoplanin expression in tumor budding cells as a predictor of neck lymph node metastasis (NLM) in patients with tongue squamous cell carcinoma (SCC) of low tumor budding grade (TBG). A total of 99 patients with early T-stage tongue SCC of any clinical N status who received the initial curative treatment were enrolled. The association between podoplanin expression and NLM was immunohistochemically analyzed, with a focus on tongue SCC with low TBG. The disease-specific survival (DSS) rate was 77% at 5 years, and a significant difference was observed between the NLM-positive and NLM-negative groups, and between the low (n=77) and high (n=22) TBG groups. In the low TBG group, there was a significant difference in DSS between the NLM-positive and NLM-negative groups. The multivariate analysis showed that lymphatic vessel invasion (ly) [odds ratio (OR)=11.5, 95% confidence interval (CI): 1.50-87.6; P=0.02] and podoplanin expression (OR=7.07, 95% CI: 1.80-27.7; P=0.005) were significantly correlated with NLM. Furthermore, negative predictive values (NPV) of ly and podoplanin expression for NLM were 75% and 88%, respectively. Considering the balance of stratification case number adding to ratio, NLM-negative prediction by podoplanin was more significant than that by ly for the low TBG group. The results of the present study demonstrated that podoplanin expression in tumor budding is an independent and efficient predictor of NLM in the tongue SCC with low TBG. The low TBG and podoplanin-negative cases may be candidates for the wait and watch policy, therefore, reducing inappropriate elective neck lymph node dissections.

Emerging histopathologic markers in early‐stage oral tongue cancer: A systematic review and meta‐analysis

“…Four studies 25,27–29 on tumor budding reported statistical values for overall survival (OS) including HRs and 95% CI. These studies were included in the meta‐analysis and are presented using a forest plot (Figure 2A) with results from multivariate analysis of the relevant studies.…”

“…Regarding the emerging prognostic markers that are not included in the pathology report, the published studies revealed a promising prognostic value for cancer‐related histopathologic markers including cell‐in‐cell structures (one study), 19 tumor budding (seven studies), 13,15,25–29 and pattern of invasion (15 studies) which were evaluated either as mode of invasion, 22,30 pattern of invasion, 31–34 invasive pattern, 28 or WPOI 13,16,25,35–39 . At the same time, some of the relevant studies analyzed stromal‐related histopathologic markers including stromal infiltrating lymphocytes (one study) 18 and tumor–stroma ratio (TSR; three studies) 17,40,41 which were significantly associated with prognosis.…”

Identification of key endometrial microRNAs and its target genes associated with pathogenesis of recurrent implantation failure by integrated bioinformatics analysis

“…Overexpression of PDPN, a small mucin-like type-1 transmembrane protein and a speci c marker for lymph vessel endothelial cells [43], signi cantly increased endothelial cell adhesion, migration, and tube formation, whereas inhibition of PDPN expression decreased dermal lymphatic endothelial cell adhesion [44]. PDPN is a speci c marker for the lymphatic endothelium in histopathology [45].…”

The Pattern and Spread of Invasion Can Predict Late Cervical Lymph Node Metastasis in Early Tongue Squamous Cell Carcinoma

“…The immunohistochemical expression patterns of pan-cytokeratin and podoplanin were reported to be an effective predictor of late cervical lymph node metastasis of TSCC. 25 A 2004 study attempted to predict late cervical lymph node metastasis by detecting vessels. 26 Such research requires complicated methods (e.g., immunostaining or speci c staining), whereas only the common tissue stain hematoxylin-eosin was the only method needed in the present study.…”