舌扁平上皮癌Stage I, II症例における頸部リンパ節後発転移に関する臨床病理学的研究

抄録

We immunohistologically studied expression levels of Ets-1, u-PA, PD-ECGF, and cyclin D1 in patients with stage I or II squamous cell carcinoma of the tongue; we then analyzed the relation between histological grade of malignancy, using the classification methods proposed by Anneroth and Yamamoto-Kohama (Y K), and subsequent cervical lymph node metastasis.
Our study involved 31 patients with stage I or II squamous cell carcinoma of the tongue who had undergone only a partial glossectomy for primary resection. The invasive front on maximum cut sections of the resected specimens was evaluated. The results showed that 8 patients (25.8%) had subsequent metastasis to the cervical lymph nodes.
High invasviveness, as indicated by a high grade according to Anneroth's classification and grades 3 and 4C according to the Y K classification, was associated with a high frequency of metastasis to the cervical lymph nodes. As for the relation between the expression of Ets-1, u-PA, PD-ECGF, or cyclin D1 and subsequent metastasis to the cervical lymph nodes, a trend toward a high percentage of positive cells was associated with higher histological malignancy scores. Further more, we closely analyzed cases with high grades according to Anneroth's classification or grade 4C according to the Y K classification, and found significant correlations between Ets-1 expression and subsequent metastasis. Our findings suggest that evaluating Ets-1 expression may be a useful method for predicting subsequent metastasis to the cervical lymph nodes.