Relation between lymphatic vessel diameter and clinicopathologic parameters in squamous cell carcinomas of the oral region

BACKGROUND. In an attempt to determine the mechanism of cervical lymph node metastases, the authors studied the relation between lymphatic vessels in or around tumor tissue and lymph node metastases in patients with primary s quamous cell carcinoma (SCC) of the oral region by enzyme histochemistry us ing 5' nucleotidase-alkaline phosphatase. METHODS, The subjects were 23 patients who had biopsy proven oral SCC. Afte r enzyme histochemical staining, the cross-sectional dimension (referred to as diameter) of the lymphatic vessels were measured and analyzed in relati on to the T classification of the tumor, degree of tumor differentiation, a nd mode of invasion. RESULTS. The average diameter of the lymphatic vessels in or around tumor t issue was significantly greater than that in tumor free tissue (P < 0.01). The mode of invasion correlated significantly with the lymphatic vessel dia meter (P < 0.01). The diameter did not correlate significantly with the T c lassification (P range, 0.135-0.254) or tumor differentiation (P = 0.274). The following relation was found between the incidence of cervical lymph no de metastases and the mode of invasion: 40.0% of Grade 2 tumors were positi ve for metastases, 71.4% of Grade 3 tuners were positive, and 75.0% of Grad e 4 rumors were positive (grading was according to Jakobsson's classificati on). CONCLUSIONS. Of the factors evaluated in this study, only the mode of invas ion correlated significantly with the diameter of the lymphatic vessels. Al though other studies have shown that tumor thickness and perhaps even perin eural and blood vessel invasion may be equally important, the findings of t he current study suggest that both lymphatic vessel diameter and the mode o f invasion may be important factors in the prediction of cervical lymph nod e metastases. Cancer 1999;86: 200-6. (C) 1999 American Cancer Society.