DEPTH OF TUMOR INVASION AS INDICATOR OF MALIGNANT PROGRESSION IN PATIENTS WITH LOWER LIP SQUAMOUS CELL CARCINOMA WITH AND WITHOUT NECK LYMPH NODE METASTASIS

  • Lena Kakasheva-Mazhenkovska Institute of histology and embriology
  • Elida Mitevska
  • Irena Kostadinova Petrova
  • Vesna Janevska

Abstract

Squamous cell carcinoma (SCC) of the lower lip is a relatively rare carcinoma, but it is the most common carcinoma in the oral cavity and accounts for approximately 25%-30% of all oral malignant tumors. Prognosis of patients with lower lip SCC is predominantly dependent on stage of the disease, but recent research suggest that neoplasm morphological characteristics can have a significant influence on its progression and consequently on patient’s outcome.


The aim of this study was to determine the role of depth of neoplasm invasion in the process of tumor progression, that is, in the onset of neck metastases in patients with lower lip squamous cell carcinoma and to correlate it with the neoplasm grade.


The study comprised 60 tumor tissue specimens obtained from patients with lower lip SCC. The examined group consisted of 45 specimens from patients without metastasis and 15 specimens from patients with metastasis in the regional lymph nodes. Histopathological sections were made with paraffin technique and stained with H.E. method. Depth of invasion was measured with the software for histomorphological morhometry.


There was a difference in the depth of stromal invasion in lower lip SCC, which was registered in the neoplasms of different histological differentiation and it was statistically significant (p=0.00001) according to the Kruskal-Wallis test.


The difference in the depth of stromal invasion in lower lip SCC registered in neoplasms of patients without metastases and in patients with metastases was statistically significant (p=0.000083).


Depth of neoplasm invasion is a parameter that can be used as an indicator for neoplasm progression, that is, as an indicator for neck metastases in patients with squamous cell carcinoma of the lower lip.


 


Keywords: squamous cell carcinoma SCC, lower lip, depth of stromal invasion, neoplasm differentiation, metastasis


 

References

1. Moore SR, Johnson NW, Pierce AM, et al. The epidemiology of lip cancer: a review of global incidence and aetiology. Oral Dis 1999;5:185–195.
2. Khuder SA. Etiologic clues to lip cancer from epidemiologic studies on farmers. Scand J Work Environ Health 1999;25:125–130.
3. Leoit, EP, Gunter B, Weedon D, Sarasin A. Pathology & Genetics Skin Tumours. WHO Classification of Tumours. Lyon: IARC Press; 2006.
4. Taghavi N, Yazdi I. Prognostic factors of survival rate in oral squamous cell carcinoma: clinical, histologic, genetic and molecular concepts. Arch Iran Med 2015;18(5):314-319.
5. Moreti A, Vitullo F, Augurio A, Pacella A, Croce A. Surgical management of lip cancer Acta Otorhinolaryngol Ital 2011;31(1):5-10.
6. Yan W, Wistuba II, Emmert-buck RM, Erickson SH. Squamous cell carcinoma–similarities and differences among anatomical sites. Am J Cancer Res 2011; 1(3):275-300.
7. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FI, Trotti A. Cancer staging handbook: from the AJCC cancer stading manual. AJCC editors, 7th edition. New York: Springer; 2010. p.359-375.
8. Luna-Ortiz K, Güemes-Meza A, Villavicencio-Valencia V, Mosqueda-Taylor A. Lip cancer experience in Mexico. An 11-year retrospective study. Oral Oncol 2004;40(10):992-999.
9. Rodolico V, Barresi E, Di Lorenzo R, Leonardi V, Napoli P, Rappa F, Di Bernardo C. Lymph node metastasis in lower lip squamous cell carcinoma in relation to tumour size, histologic variables and p27Kip1 protein expression. Oral Oncol. 2004;40(1):92-8.
10. Huang SH, Hwang D, Lockwood G, Goldstein DP, O'Sullivan B. Predictive value of tumor thickness for cervical lymph-node involvement in squamous cell carcinoma of the oral cavity: a meta-analysis of reported studies. Cancer 2009;115(7):1489-97.
11. Zitsch RP. Carcinoma of the lip. Otolaryngol Clin North Am 1993;26:265–277.
12. Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 1970;172(5):902–908.
13. Schraut WH, Wang CH, Dawson PJ, Block GE. Depth of invasion, location, and size of cancer of the anus dictate operative treatment. Cancer1983;51:1291–1296.
14. Seto, Y, Shimoyama S, Kitayama J, et al. Lymph node metastasis and preoperative diagnosis of depth of invasion in early gastric cancer. Gastric Cancer 2001;4:34.
15. Ishiguro A, Uno Y, Ishiguro Y, Munakata A, Takayuki Morita T. Correlation of lifting versus non-lifting and microscopic depth of invasion in early colorectal cancer. Cancer 1999;50(3):329–333.
16. Creasman WT, Morrow CP, et al. Surgical pathologic spread patterns of endometrial cancer Cancer 1987;60:2035-2041.
17. Fukano H, Matsuura H, Hasegawa Y, Nakamura Sh. Depth of invasion as a predictive factor for cervical lymph node metastasis in tongue carcinoma. Cancer 1997;19(3):205-210.
18. Kristensen GB, Abeler VM, Risberg B, Tropé C, Bryne M. Tumor size, depth of invasion, and grading of the invasive tumor front are the main prognostic factors in early squamous cell cervical carcinoma. Gynecol Oncol 1999;74(2):245-251.
19. Breuninger H, Black B, Rassner G. Microstaging of squamous cell carcinomas. Am J Clin Pathol 1990;94(5):624-7.
20. Kuan EC, Mallen-St Clair J, Badran KW, St John MA. How does depth of invasion influence the decision to do a neck dissection in clinically N0 oral cavity cancer? Laryngoscope 2016;126(3):547-548.
21. Shariat-Madar B, Lui JC. Role of Depth of Invasion in Evaluation and Management of Early-stage Oral Caviy Squamous Cell Carcinoma. Int Head Neck Surg 2017;8(2):84-88.
Published
2018-12-28
How to Cite
KAKASHEVA-MAZHENKOVSKA, Lena et al. DEPTH OF TUMOR INVASION AS INDICATOR OF MALIGNANT PROGRESSION IN PATIENTS WITH LOWER LIP SQUAMOUS CELL CARCINOMA WITH AND WITHOUT NECK LYMPH NODE METASTASIS. Journal of Morphological Sciences, [S.l.], v. 1, n. 2, p. 34-41, dec. 2018. ISSN 2545-4706. Available at: <http://jms.mk/jms/article/view/36>. Date accessed: 19 july 2019.
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Articles