Abstract
In our previous study, an evaluation system was established for the metastatic potential of oral squamous cell carcinoma (SCC), utilizing a combined examination of histopathological grades of carcinomas based on cell differentiation and invasive mode according to the Yamamoto's criteria, and the cellular expressions of CD44, E-cadherin (E-cad), heparan sulfate glycosaminoglycan (HS-GAG) and Phaseolus vulgaris leukoagglutinin (L-PHA)-binding oligosaccharides on carcinomas. Histochemical patterns of expression of these markers were classified as positive (++), weakly positive (+), and negative (-). The histopathological grades and the histochemical patterns of the SCC were shown on a 0 to 2 point scale, i. e.: point 2 for poorly differentiated, mode 4D, CD44++, E-cad-, HS-GAG++, or L-PHA++; point 1 for moderately differentiated, mode 4C, CD44+, E-cad+, HS-GAG+, or L-PHA+; and point 0 for well differentiated, mode 1, mode 2, mode 3, CD44-, E-cad++, HS-GAG-, or L-PHA-. Accrding to this system, metastatic potential of the patient with a total score of more than 6 was significantly higher than that with a total score of less than 5. This evaluation system has been used for SCC patients since 1994, and this system has yielded useful information concerning the metastatic potential. As a result, patients who might be highly metastatic were selected and neck dissection was indicated for these patients. As a consequence, the survival rate of the patients with a total score of more than 6 was improved.
