Survey of risk factors contributed to lymphatic metastasis in patients with oral tongue cancer by immunohistochemistry.

OBJECTIVES: The aim of this study was to define the biomarkers of lymphatic spread which facilitate the appropriate therapy for oral tongue squamous cell carcinoma (OTSCC) patients at early stage. Here, we investigated the expression levels of seven biomarkers in oral squamous cell carcinoma (OSCC) tissues as well as their associations with the clinicopathologic features of OTSCC patients.

METHODS: The OTSCC samples were obtained from 138 patients undergoing tumor resection. Immunohistochemical staining was performed by using ColIA, ColIVA, Fn1, MMP-1, MMP-2, uPA, and D2-40 antibodies. Expression level of theses biomarkers in normal and tumor tissues were compared. Risk factors of lymphatic dissemination were evaluated by logistic regression equation.

RESULTS: LVD, MMP-1, MMP-2, and uPA in cancer tissues were significantly higher than those in normal tissue, and ColIA, ColIVA, and Fn1 in cancer tissue were significantly lower than those in normal tissue. Similar results were obtained from the comparison between metastatic tumor and non-metastatic tumor. All biomarker expressions were closely related with lymph node status and clinical stage. Additionally, the regression equation demonstrated that LVD is the risk factor of lymphatic metastasis in OTSCC patients (OR = 1.732; 95% CIs: 1.167-2.057; P < 0.05).

CONCLUSIONS: Down-regulation of ColIA, ColIVA, and Fn1 and up-regulation of LVD, MMP-1, MMP-2, and uPA might be important features of OSCC progression, which may exert their functions and favorably predict lymphatic dissemination for OSCC patients at relatively early stage. Among these biomarkers, increased LVD is an independent risk factor of lymphatic metastasis, which could better predict whether metastasis will occur or not.