Predictors of cervical lymph node metastasis in salivary gland cancer

Head Neck. 2014 Apr;36(4):517-23. doi: 10.1002/hed.23332. Epub 2013 Jun 18.

Abstract

Background: This study compares clinicopathological parameters with novel molecular markers for predicting cervical lymph node metastasis in salivary gland cancer.

Methods: Three hundred sixteen salivary gland carcinomas were included in this study. Genomic epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER2), phosphatase and tensin homolog (PTEN), and hepatocyte growth factor receptor (MET) was determined by fluorescence in situ hybridization (FISH). Chi-square tests, multivariate regression, and Kaplan-Meier survival analysis were used for statistics.

Results: Nodal staging determines long-term survival. Clinicopathological parameters associated with positive neck nodes are advanced age (p = .006), T3/T4 classification, histological high-grade malignancy, and diagnosis of salivary duct carcinoma (p < .001 each). Neck node metastases also correlate with copy number gain of EGFR (p = .004) and HER2, aberration of MET, and deletion of PTEN (p < .001 each). Multivariate analysis showed SDC (p = .002) to be the strongest predictor of lymph node metastasis, followed by MET aberration (p = .009), T3/T4 classification (p = .017), PTEN deletion (p = .042), and adenocarcinoma not otherwise specified (NOS; p = .047).

Conclusion: The histological subtype is crucial for decisions regarding neck dissection. New molecular parameters may also indicate elective treatment of the neck.

Keywords: MET; PTEN; nodal metastasis; predictors; salivary gland cancer.

MeSH terms

  • Age Factors
  • Carcinoma / genetics
  • Carcinoma / metabolism
  • Carcinoma / mortality
  • Carcinoma / pathology*
  • ErbB Receptors / metabolism
  • Female
  • Follow-Up Studies
  • Gene Deletion
  • Humans
  • In Situ Hybridization, Fluorescence
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neck Dissection
  • Neoplasm Staging
  • PTEN Phosphohydrolase / genetics
  • PTEN Phosphohydrolase / metabolism
  • Proto-Oncogene Proteins c-met / genetics
  • Proto-Oncogene Proteins c-met / metabolism
  • Receptor, ErbB-2 / metabolism
  • Retrospective Studies
  • Salivary Gland Neoplasms / genetics
  • Salivary Gland Neoplasms / metabolism
  • Salivary Gland Neoplasms / mortality
  • Salivary Gland Neoplasms / pathology*

Substances

  • ERBB2 protein, human
  • ErbB Receptors
  • Proto-Oncogene Proteins c-met
  • Receptor, ErbB-2
  • PTEN Phosphohydrolase
  • PTEN protein, human