Genetic diagnosis of micro-metastasis in oral cancer

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Cervical lymph node metastasis is one of the major prognostic factors in oral squamous cell carcinomas (SCCs). Accurate evaluation of cervical lymph node metastasis is,. therefore, expected to improve the survival rate. It was reported that mutant-allele-specific amplification (MASA) was a sensitive method for detecting micrometastasis in historically negative lymph nodes. In colorectal cancer, it has been shown that genetic diagnosis of lymph node metastasis using MASA was useful for estimating its prognosis. This new approach appears very promising; however, studies in oral SCCs have not been done extensively. To examine the clinical importance of detecting micrometastasis, we screened 235 dissected lymph nodes from ten p53 mutation-positive tumors by MASA to detect micrometastasis. P53 mutations were detected in all histologically metastasis-positive lymph nodes. On the other hand, half of histologically metastasis-negative lymph node have p53 mutations. In these cases, lung metastasis and neck recurrence had occurred in one case, respectively. These data suggest that MASA is useful for detecting cervical lymph node micrometastasis, which is one of important prognostic factors, in oral SCCs.