Clinical significance of micrometastases in lymph nodes from laryngeal squamous cell carcinoma

ObjectiveTo assess the role of lymph nodes micrometastases in laryngeal squamous cell carcinoma and correlate the results with survival.MethodsWe performed immunohistochemical analyses of lymph nodes after the resection of 126 patients for detection of micrometastasis. The lymph nodes were examined with hematoxylin and eosin (HE)–stained and cytokeratin (CK) antibodies AE1/AE3 stained. Recurrences and metastases were recorded during follow-up. The Kaplan-Meier method was used for survival analysis.ResultsIn total, 126 patients underwent neck dissection. Forty-one patients were HE positive (group 1), while 85 were HE negative. Thirty-three of these HE negative patients were CK positive (group 2), while 52 were CK negative (group 3). Patients in groups 2 and 3 had a different outcome (P < .001). Survival was worse in patients in group 2 (10-year survival of 52.12% vs 81.16% in group 3, P < .01).ConclusionImmunohistochemical analysis is an efficient way to detect micrometastasis in lymph nodes after the resection of conventionally node-negative patients. The detection of CK-positive cells is an independent prognostic factor, and more aggressive treatment should be indicated in these patients.