Head and Neck Pathology
Aarya Unnikrishnan; Vijaya Basavaraj
Abstract
Background & Objective: Head and Neck Squamous Cell Carcinoma (HNSCC) is a highly frequent malignancy worldwide and is also the leading cause of death. The prognosis for individuals with HNSCC remains dismal, with a five-year survival rate of less than 50%. The novel anti-PD-L1 immunotherapy is found ...
Read More
Background & Objective: Head and Neck Squamous Cell Carcinoma (HNSCC) is a highly frequent malignancy worldwide and is also the leading cause of death. The prognosis for individuals with HNSCC remains dismal, with a five-year survival rate of less than 50%. The novel anti-PD-L1 immunotherapy is found to be promising, and immunohistochemistry (IHC) has been established as a reliable method for patient stratification. We intend to evaluate the prognostic significance of the expression of programmed death ligand-1 (PD-L1) in HNSCC and determine its association with clinicopathological variables.Methods: A total of 50 cases of biopsy-confirmed HNSCC were studied in a tertiary hospital between Dec 2020 and June 2022. The specimens were tested for PD-L1 IHC expression with antibody clone CAL-10 (Biocare) and scored by Combined Positive Score (CPS). The association between PD-L1 expression and clinicopathological variables was evaluated.Results: PD-L1 was positive in 92% of the cases, and a significant association (P= 0.024) was seen between PD-L1 expression and tumor-infiltrating lymphocytes (TILs). PD-L1 did not show any significant association with patient demographics, tumor site, grade, or stage.Conclusion: In the present study, evaluation of the immunohistochemical expression of PD-L1 on the tumor cells and TILs in HNSCC revealed a high prevalence of PD-L1 expression. PD-L1 IHC studies for patient selection for immunotherapy would be a promising technique. Frequent PD-L1 expression in tumors with significant TILs may be useful in identifying patients who may benefit from anti-PD-1/PD-L1 therapy.
Head and Neck Pathology
Anjali Mary JIbi; Vijaya Basavaraj
Abstract
Background & Objective: Head and Neck Squamous cell carcinoma (HNSCC) is one of the leading cancers worldwide. Cervical lymph node metastasis is the most adverse prognostic factor for patients with HNSCC. As there are no reliable factors in predicting lymph node metastasis, recent researchers focus ...
Read More
Background & Objective: Head and Neck Squamous cell carcinoma (HNSCC) is one of the leading cancers worldwide. Cervical lymph node metastasis is the most adverse prognostic factor for patients with HNSCC. As there are no reliable factors in predicting lymph node metastasis, recent researchers focus on identifying various metastasis markers that will aid treatment selection. Podoplanin is a recent marker strongly associated with lymph node metastasis, aggressive tumor behavior, and poor prognosis. The expression of podoplanin in human squamous cell cancers and its association with cancer cell motility suggest a possibility that it could be used as a biomarker to predict lymph node metastasis. To study the expression of podoplanin in head and neck squamous cell carcinoma, determine its association with clinicopathological variables, and predict its use as a biomarker in predicting lymph node metastasis.Methods: The present study was conducted in a tertiary care hospital. Podoplanin expression was studied in 45 cases of HNSCC and its association with clinicopathological variables. The predictive power of podoplanin was further analyzed using univariate and multivariate logistic regression analysis. The positive and negative predictive values of podoplanin were determined concerning the presence or absence of lymph node metastasis.Results: Podoplanin expression is significantly associated with histological grade (P=0.03) and lymph node metastasis (P=0.01). In logistic regression analysis, podoplanin expression (Odds Ratio: 5.66, Confidence Interval: 1.23 -25.87, P=0.02) was a significant independent predictor of lymph node metastasis.Conclusion: Our study demonstrates that podoplanin provides prognostic information and predicts lymph node metastasis which was consistent with our studies in the literature. Thus, podoplanin may help better stratify patients selected for elective neck node dissection in early tumor stages and clinically negative regional disease.
