Clinical significance of micrometastases in lymph nodes from laryngeal squamous cell carcinoma

Abstract

Objective: To assess the role of lymph nodes micrometastases in laryngeal squamous cell carcinoma and correlate the results with survival.

Methods: We performed immunohistochemical analyses of lymph nodes after the resection of 126 patients for detection of micrometastasis. The lymph nodes were examined with hematoxylin and eosin (HE)-stained and cytokeratin (CK) antibodies AE1/AE3 stained. Recurrences and metastases were recorded during follow-up. The Kaplan-Meier method was used for survival analysis.

Results: In total, 126 patients underwent neck dissection. Forty-one patients were HE positive (group 1), while 85 were HE negative. Thirty-three of these HE negative patients were CK positive (group 2), while 52 were CK negative (group 3). Patients in groups 2 and 3 had a different outcome (P < .001). Survival was worse in patients in group 2 (10-year survival of 52.12% vs 81.16% in group 3, P < .01).

Conclusion: Immunohistochemical analysis is an efficient way to detect micrometastasis in lymph nodes after the resection of conventionally node-negative patients. The detection of CK-positive cells is an independent prognostic factor, and more aggressive treatment should be indicated in these patients.