• 11/29/2005
  • staff
  • cancerconsultants.com

A test to detect changes in the Cyclin D1 gene provides information about the probability of occult (hidden) lymph node metastases in patients with stage I or stage II squamous cell carcinoma of the mouth, according to a study published in the journal Cancer .

Cancer of the oral cavity involves the tongue, gums, the inner lining of the cheeks and lips, the hard palate, or the floor of the mouth. Squamous cell carcinoma is the most common type of oral cancer; it refers to the type of cell in which the cancer originates. Oral squamous cell carcinoma (OSCC) is strongly linked with tobacco use, and the combination of tobacco with alcohol further increases risk.

Among patients with early (stage I or stage II) OSCC, an important clinical decision involves whether or not to remove and evaluate lymph nodes in the neck for evidence of occult metastases. The presence of lymph node metastases is an important indicator of prognosis and guides treatment decisions. Some patients are at greater risk of having lymph node metastases and are therefore more likely to benefit from lymph node dissection.

One potential predictor of the presence of lymph node metastases is the Cyclin D1 gene. The protein produced by this gene plays a role in cell proliferation.

To evaluate the relationship between numerical alterations in the Cyclin D1 gene and postoperative lymph node metastases, researchers in Japan conducted a study among 45 patients with stage I or stage II oral cancer. Patients had surgery to remove the cancer, but did not undergo lymph node dissection. A majority of the patients (33 of 45) had cancer of the tongue.

Abnormalities in the Cyclin D1 gene were evaluated by the laboratory method of fluorescence in situ hybridization (FISH); OSCC tissue removed by fine needle aspiration was used. A numerical alteration in the Cyclin D1 gene was defined as three or more signals for CCND1 in at least 20% of the evaluated nuclei. Fifteen of 45 patients (33%) had evidence of numerical alterations in Cyclin D1.

Patients with numerical alterations in the Cyclin D1 gene were more likely than other patients to be diagnosed with lymph node metastases.

-After a median of 29 months of follow-up, 17 of the 45 patients (38%) were diagnosed with cervical lymph node metastases.

-17% of patients without numerical alterations in Cyclin D1 developed postsurgical lymph node metastases.

-80% of patients with numerical alterations in Cyclin D1 developed postoperative lymph node metastases.

There was no relationship between numerical alterations in Cyclin D1 and age, gender, cancer site, or cancer stage.

The researchers conclude that numerical alterations in the Cyclin D1 gene predict the occurrence of lymph node metastases in patients with stage I or stage II oral cancer. Tests to detect these alterations may help identify patients who are most likely to benefit from cervical lymph node dissection.

Reference:
Myo K, Uzawa N, Miyamoto R et al. Cyclin D1 Gene Numerical Aberration is a Predictive Marker for Occult Cervical Lymph Node Metastasis in TNM Stage I and II Squamous Cell Carcinoma of the Oral Cavity. Cancer. Early Online publication November 1, 2005.