Abstract
The control of cervical lymph node metastasis is extremely important for improving the survival rate in patients with oral squamous cell carcinoma. Many predictive factors of cervical lymph node metastasis have been reported, but a consistent opinion has yet to be obtained. In recent years, tumor budding has been reported to be a prognostic factor in gastrointestinal carcinomas such as colorectal cancer or gastric cancer. Tumor budding is a term that refers to the invasion type of the cancer. Previous studies have shown that tumor budding is associated with lymph node metastases and vascular invasion in colorectal cancer. The present study investigated the association between tumor budding and cervical lymph node metastasis to determine the prognostic significance of tumor budding in oral squamous cell carcinoma.
A total of 63 cases of stage Ⅰto Ⅱ oral squamous cell carcinoma of the tongue that were surgically excised in the Oral Cancer Center, Tokyo Dental College were studied. The associations of tumor budding with clinicopathological factors and cervical lymph node metastasis were analyzed.
The cut-off value of tumor budding was determined using a receiver operating characteristic (ROC) curve, and tumor budding was graded as high intensity or low intensity based on the presence and absence of ≥5 or <5 budding foci in hematoxylin and eosin-stained sections. In univariate analysis, differentiation, depth of invasion, lymphovascular invasion, perineural invasion, and tumor budding were risk factors for cervical lymph node metastasis, and in Cox proportion hazard regression analysis, tumor budding (hazard ratio = 6.51, 95% confidence interval = 1.27−33.48） and lymphovascular invasion (hazard ratio = 4.29, 95% confidence interval = 1.19−15.44) were significant risk factors.
In stage Ⅰ to Ⅱ oral squamous cell carcinoma of the tongue, the possibility that tumor budding and lymphovascular invasion in resected specimens are independent predictive factors of cervical lymph node metastasis was suggested.
