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Different grading systems of oral Squamous cell carcinoma and their relation to lymph node metastasis – A comparative study

Author: 
Aroonika S. Bedre and Don, K. R.
Subject Area: 
Health Sciences
Abstract: 

Background: Histological grading is an important diagnostic tool to predict the clinical and biological behaviour of cancer. Cervical lymph node metastasis indicate poor prognosis of oral cancer. Oral squamous cell carcinoma has a great predisposition to produce metastasis in lymph nodes. An analysis of the prognostic factors is important for predicting prognosis and reducing the mortality in these patients. Aim: The aim of this study is to do a comparative study of different grading systems in oral squamous cell carcinoma and assess their relationship to Lymph node metastasis. Materials and Methods: This study comprised of 20 excisional biopsy cases of OSCC with neck dissections retrieved from the archives of Department of Oral Pathology, Saveetha dental college, Chennai, India. The examiner was blinded to the clinical details and LN status of the patients. The slides were graded using 3 grading systems, namely, Broder's, Anneroth's and Bryne's invasive front grading. Chi - square test was applied to compare the proportion between grades and lymph node status trend. Binary logistic regression analysis was done to estimate the odds of grades with respect to positivity of lymph nodes. Results: Bryne’s grading system showed significant relation with lymph node metastasis, when compared with Broder’s and Anneroth’s. Chi - square results comparing the 3 grading systems, showed that whenever there is increase in grading from grade I to III, there is increase in positivity of lymph node metastasis. But statistically significant results were seen only in Bryne’s. (P=.009) On comparing the 3 grading systems, the Odds ratio of all 3 showed an increase (>1), but it was not statistically significant. Conclusion: In conclusion, we believe that Bryne’s grading of the invasive parts of oral SCC could be taken as a valuable predictive factor in lymph node metastasis. The clinical value of this system can be increased if more number of samples were taken for the study.

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