Circulating hybrid cells predict presence of occult nodal metastases in oral cavity carcinoma

Head Neck. 2021 Jul;43(7):2193-2201. doi: 10.1002/hed.26692. Epub 2021 Apr 9.

Abstract

Background: Levels of circulating hybrid cells (CHCs), a newly identified circulating tumor cell (CTC), correlate with disease stage and progression in cancer. We investigated their utility to risk-stratify patients with clinically N0 (cN0) oral cavity squamous cell carcinoma (OCSCC), and to identify patients with occult cervical lymph node metastases (pN+).

Methods: We analyzed peripheral blood samples for CHCs with co-expression of cytokeratin (tumor) and CD45 (leukocyte) from 22 patients with cN0 OCSCC using immunofluorescence microscopy, then correlated levels with pathologic lymph node status.

Results: CHC levels exceeded CTCs and correlated with the presence of both clinically overt (p = 0.002) and occult nodal metastases (p = 0.006).

Conclusions: For evaluated cN0 OCSCC patients, those with cN0 → pN+ status harbored elevated CHC levels compared to patients without occult disease. Our findings highlight a promising blood-based biologic assay with potential utility to determine the necessity of surgical neck dissection for staging and treatment.

Keywords: blood-based analyte; head and neck cancer; occult metastases; oral pharyngeal squamous cell carcinoma; prognostic analyte.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Head and Neck Neoplasms*
  • Humans
  • Hybrid Cells / pathology
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Mouth / pathology
  • Neck Dissection
  • Neoplasm Staging
  • Retrospective Studies