Evaluation of micrometastasis and isolated tumor cells in node-negative early-stage oral tongue squamous cell carcinoma: a cross-sectional study in tertiary-level hospitals in eastern India

Objective. The present study aimed to investigate the incidence of micrometastasis (MMs) and isolated tumor cells (ITCs) in nodenegative early -stage oral tongue squamous cell carcinoma (T1 -T2 N0). The secondary objective was to correlate the incidence with the clinicopathologic parameters of age, sex, depth of invasion, pattern of invasion, host lymphocytic response, and size and grade of primary tumor. Study Design. Micrometastasis and ITCs in cervical nodes of 30 patients with early -stage oral tongue squamous cell carcinoma were detected and compared using 3 methods: routine hematoxylin and eosin staining, serial -sectioning at intervals of 150 microns employing hematoxylin and eosin, and serial sectioning pan-cytokeratin immunostaining. Associations with clinicopathological variables were analyzed. Results. Metastatic tumor cells were detected in the cervical nodes of 2 patients using serial sectioning and immunohistochemistry, resulting in upstaging of 6.6% of all cases. Level I and II lymph nodes were primarily involved. Conclusions. Early -stage oral tongue squamous cell carcinoma has a significant potential for MMs that frequently go undetected in routine histopathologic examination. However, laborious and technique -sensitive, serial sectioning in combination with pancytokeratin staining (AE1/AE3) may aid in detecting MMs and ITCs in patients with early -stage OTSCC. (Oral Surg Oral Med Oral Pathol Oral Radiol 2024;137:274-281)