Prognostic Nomogram for Lymph-Node Metastasis in Oral Squamous Cell Carcinoma (OSCC) Using Immunohistochemical Marker...

Area of Science:

• Oncology
• Pathology
• Biostatistics

Background:

• Nomograms are established for risk prediction in various cancers.
• Immunohistochemical markers and histopathological parameters can improve metastasis prediction accuracy.
• D2-40 staining assesses tumor cell motility and lymphatic vessel presence, crucial for metastasis in OSCC.

Purpose of the Study:

• To develop a predictive nomogram for lymph node metastasis (LNM) in oral squamous cell carcinoma (OSCC).
• To incorporate D2-40 immunostaining of individual tumor cells (ITCs) alongside standard histopathological variables.

Main Methods:

• Sixty OSCC cases (30 pN0, 30 pN+) were analyzed.
• Histopathological grading (Bryne's ITF) and D2-40 immunostaining for ITCs and lymphatic vessels were performed.
• Multivariate regression analysis generated a nomogram using depth of invasion, D2-40 ITCs, gender, histological grade, and worst pattern of invasion (WPOI).

Main Results:

• The nomogram identified WPOI as the strongest predictor in H+E staining, followed by D2-40-positive ITCs and gender.
• A lower WPOI score combined with numerous D2-40-positive ITCs significantly increased metastasis probability.

Conclusions:

• A predictive nomogram integrating D2-40 immunostaining and histopathological criteria can effectively predict LNM in OSCC.
• This approach supports individualized risk prediction for metastasis in OSCC.