Phenotype of tumor lymphatic vessels is a prognostic factor in human tongue squamous cell carcinoma

Immunohistochemical comparative analysis of lymphatic vessel density and VEGF-C expression in squamous cell carcinomas of the tongue between young and old patients

BACKGROUND

Squamous cell carcinoma (SCC) of the oral cavity is a malignant epithelial tumor that most commonly involves the tongue, and mainly affects men between the fifth and seventh decades of life. This study compared the lymphatic vessel density and VEGF-C expression in SCCs of the tongue between young and old patients.

METHODS

Thirty-four SCCs of the tongue, 17 diagnosed in young patients (≤40y) and 17 diagnosed in old patients (>50y), were evaluated by immunohistochemistry. Lymphatic microdensity was determined based on the number of vessels immunoreactive to anti-D2-40 antibody. The percentage of neoplastic cells exhibiting cytoplasmic staining for VEGF-C was established for each case.

RESULTS

Assessment of intratumoral lymphatic microdensity (ILMD) disclosed a median number of 6.20 lymphatic vessels in young patients and of 6.60 in old patients (p=0.809). Analysis of peritumoral lymphatic microdensity (PLMD) revealed a median number of 3.60 lymphatic vessels in young patients and of 3.40 in old patients (p=0.769). In the tumor core, analysis of the percentage of immunopositive cells for VEGF-C revealed a median number of 95.95% in young patients and of 55.48% in old patients (p<0.001). In the deep invasive front, the median number of immunopositive cells for VEGF-C was 97.93% in young patients and 66.09% in old patients (p<0.001).

CONCLUSIONS

The results of this study suggest that the more aggressive biological behavior of SCC of the tongue in young patients may be related to a higher expression of VEGF-C.

Application value of MRI combined with positron emission tomography (PET)/CT in diagnosis and preoperative staging of tongue squamous cell carcinoma

INTRODUCTION

This study aimed to compare and analyse the findings of tongue squamous cell carcinoma (TSCC) on MRI and positron emission tomography (PET)/CT and explore the diagnostic utility of combined MRI-PET/CT in the diagnosis and preoperative staging of TSCC.

METHODS

A prospective analysis of MRI and PET/CT data in 18 TSCC cases was performed. Cases were comprehensively staged on MRI and PET/CT preoperatively according to American Joint Committee on Cancer (AJCC) staging criteria and confirmed by pathological results.

RESULTS

The highest and lowest sensitivities of preoperative AJCC staging I-IV using MRI alone, PET/CT alone and combined MRI-PET/CT were 100.0%, 100.0% and 100.0% (stage II) and 50.4%, 55.6% and 55.6% (stage I), respectively. The highest specificities were 100.0%, 100.0% and 100.0% (stage II), and the highest correct rates were 100.0%, 96.5% and 100.0% (stage II). Compared with the postoperative pathological staging, preoperative staging showed no significant difference for stages I-II and IV (P > 0.05); however, stage III showed a significant difference (P < 0.05). When combined MRI-PET/CT was compared with MRI alone in the accuracy of preoperative TSCC staging, there was no significant difference for stages I-III (P > 0.05), but there was a significant difference for stage IV (P < 0.05).

CONCLUSIONS

Combined MRI and PET/CT could serve as an important tool for the accurate diagnosis and preoperative staging of TSCC and could improve the accuracy of preoperative TSCC staging.