Evaluation Of Histomorphological And Immunohistochemical Parameters As Biomarkers Of Cervical Lymph Node Metastasis In Squamous Cell Carcinoma Of Oral Cavity: A Retrospective Study

Abstract

Abstract
Background: Cervical lymph node metastasis is a critical prognostic factor in squamous
cell carcinoma (SCC) of the oral cavity. Identifying reliable biomarkers for metastasis
could enhance diagnosis, treatment planning, and prognosis. This study aims to evaluate
histomorphological and immunohistochemical parameters as potential biomarkers for
cervical lymph node metastasis in oral SCC.
Materials and Methods: A retrospective study was conducted involving 100 patients
diagnosed with oral SCC from 2015 to 2023. Histomorphological analysis included
parameters such as tumor size, differentiation, and lymphovascular invasion.
Immunohistochemical staining was performed using antibodies against p53, Ki-67, and Ecadherin. The association between these parameters and cervical lymph node metastasis
was statistically analyzed using chi-square and multivariate logistic regression tests.
Results: Among the 100 patients, 45% exhibited cervical lymph node metastasis. Tumor
size >4 cm and poor differentiation were significantly associated with metastasis (p < 0.01).
Lymphovascular invasion was observed in 60% of metastatic cases compared to 25% of
non-metastatic cases (p < 0.001). Immunohistochemical analysis revealed that high p53
expression and Ki-67 index >20% were significantly correlated with metastasis (p < 0.05).
Loss of E-cadherin expression was noted in 70% of metastatic cases versus 30% of nonmetastatic cases (p < 0.001). Multivariate analysis identified lymphovascular invasion, high
Ki-67 index, and loss of E-cadherin as independent predictors of cervical lymph node
metastasis.
Conclusion: Histomorphological parameters, particularly lymphovascular invasion, along
with immunohistochemical markers such as high Ki-67 index and loss of E-cadherin
expression, are significant predictors of cervical lymph node metastasis in oral SCC. These
biomarkers could be integrated into routine pathological evaluation to improve the accuracy
of metastasis prediction and patient management.