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. 2014 Dec 30;9(12):e116452.
doi: 10.1371/journal.pone.0116452. eCollection 2014.

Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma

Masaaki Karino  1 , Eiji Nakatani  2 , Katsumi Hideshima  1 , Yoshiki Nariai  1 , Kohji Tsunematsu  1 , Koichiro Ohira  1 , Takahiro Kanno  1 , Izumi Asahina  3 , Tatsuo Kagimura  2 , Joji Sekine  1
Affiliations

Applicability of preoperative nuclear morphometry to evaluating risk for cervical lymph node metastasis in oral squamous cell carcinoma

Masaaki Karino et al. PLoS One. .

Abstract

Background: We previously reported the utility of preoperative nuclear morphometry for evaluating risk for cervical lymph node metastases in tongue squamous cell carcinoma. The risk for lymph node metastasis in oral squamous cell carcinoma, however, is known to differ depending on the anatomical site of the primary tumor, such as the tongue, gingiva, mouth floor, and buccal mucosa. In this study, we evaluated the applicability of this morphometric technique to evaluating the risk for cervical lymph node metastasis in oral squamous cell carcinoma.

Methods: A digital image system was used to measure the mean nuclear area, mean nuclear perimeter, nuclear circular rate, ratio of nuclear length to width (aspect ratio), and nuclear area coefficient of variation (NACV). Relationships between these parameters and nodal status were evaluated by t-test and logistic regression analysis.

Results: Eighty-eight cases of squamous cell carcinoma (52 of the tongue, 25 of the gingiva, 4 of the buccal mucosa, and 7 of the mouth floor) were included: 46 with positive node classification and 42 with negative node classification. Nuclear area and perimeter were significantly larger in node-positive cases than in node-negative cases; however, there were no significant differences in circular rate, aspect ratio, or NACV. We derived two risk models based on the results of multivariate analysis: Model 1, which identified age and mean nuclear area and Model 2, which identified age and mean nuclear perimeter. It should be noted that primary tumor site was not associated the pN-positive status. There were no significant differences in pathological nodal status by aspect ratio, NACV, or primary tumor site.

Conclusion: Our method of preoperative nuclear morphometry may contribute valuable information to evaluations of the risk for lymph node metastasis in oral squamous cell carcinoma.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Illustration of each level of the cervical lymph node.
Figure 2
Figure 2. Illustration and formulas of parameters for quantitative estimation of nuclear parameters.
NACV: nuclear area coefficient of variation.
Figure 3
Figure 3. Morphometry of pathologic nodal status, pN(+) and pN(−), in all cases of OSCC.
See this image and copyright information in PMC

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