Micrometastasis detection using modified papanicolaou stain in nodal tissues of oral squamous cell carcinoma - A...

Area of Science:

• Oncology
• Pathology
• Surgical Pathology

Background:

• Cervical lymph node metastasis is a critical prognostic factor in Head and Neck Squamous Cell Carcinoma (HNSCC).
• Accurate detection of micrometastasis is vital for staging, treatment, and prognosis in HNSCC.
• Assessing lymph node metastasis without clinical enlargement presents diagnostic challenges.

Purpose of the Study:

• To evaluate micrometastasis and individual tumor cells (ITC) in regional lymph nodes of oral squamous cell carcinoma (OSCC).
• To assess the efficacy of modified Papanicolaou (PAP) stain compared to H&E stain for micrometastasis detection.
• To re-evaluate tumor staging based on enhanced micrometastasis detection.

Main Methods:

• Retrospective study involving 40 lymph nodes from OSCC patients (20 metastatic, 20 non-metastatic).
• Histopathological analysis using Hematoxylin and Eosin (H&E) stain followed by modified Papanicolaou (PAP) stain.
• Statistical analysis using the Chi-square test to determine significance.

Main Results:

• Modified PAP stain demonstrated significantly higher accuracy (p = 0.006) than H&E stain in identifying micrometastasis.
• Micrometastasis was detected in 15% of lymph node sections initially classified as non-metastatic by H&E.
• The study highlights the sensitivity of modified PAP stain for micrometastasis detection.

Conclusions:

• Modified PAP stain is a valuable and sensitive tool for detecting micrometastasis in OSCC lymph nodes, outperforming H&E.
• Detecting micrometastasis in OSCC is clinically advantageous, influencing patient staging.
• Identification of micrometastasis impacts treatment strategies, including radiotherapy and chemotherapy regimens.