| Abstrakt: |
Oral squamous cell carcinoma (OSCC) is one of the most common cancers in humans, characterized by a high rate of regional lymph node metastasis (LnM), and a 5-year survival rate of 40% to 50%. The premetastatic niche (PMN) are modifications of the lymph node microenvironment at a future metastatic site, but it is still poorly understood. This research aims to determine the association of histomorphological architectural changes of non-metastatic lymph from OSCC patients with and without regional cervical lymph node metastasis. A cohort study was conducted, analyzing 424 non-metastatic lymph nodes in paraffin-embedded blocks from 45 OSCC patients. Architectural features, including capsule and trabeculae thickness, subcapsular and medullary sinus ectasia, fibrosis, follicular organization and hyperplasia, were assessed using hematoxylin and eosin stain. Logistic regression models were used to determine associations with LnM, recurrence, and survival. Intense medullary ectasia increased LnM risk (odds ratio [OR] = 1.63; confidence interval [CI] = 0.99-2.67; P =.051), whereas follicular hyperplasia was protective (OR = 0.27; CI = 0.15-0.5; P <.001). Non-visible sinusoidal trabeculae indicated higher recurrence risk (OR = 2.18; CI = 0.99-4.81; P =.05). Disorganized lymphoid follicles (OR = 1.91; CI = 0.97-3.77; P =.059), focal subcapsular ectasia (OR = 4,4; CI = 1.34-14.37; P =.014), and marked subcapsular ectasia (OR = 3.2; CI = 1.06-9.63; P =.038) were associated with reduced survival. Conversely, follicular hyperplasia (OR = 0.38; CI = 0.19-0.74; P =.005) and medullary fibrosis (OR = 0.13; CI = 0.02-0.67; P =.015) favored survival. Patients presenting lymph nodes with follicular hyperplasia have a higher chance of survival and a lower risk of lymph node metastasis than those with lymph nodes with subcapsular sinus ectasia, regardless of alterations in other architectural features. [ABSTRACT FROM AUTHOR] |
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