Comparison of apoptotic bodies' count & mitotic index in oral squamous cell carcinoma with regional lymph node involvement

Background & objectives: In early stages of oral cancers, 20-40 per cent of cases have occult metastasis in cervical lymph nodes. Biologic imbalance between cellular proliferation and death culminates in metastasis. The importance of cell cycle dysregulation in relation to lymph node involvement in oral squamous cell carcinoma (OSCC) has not been established yet. The aim was to determine the association between apoptotic bodies count and mitotic index in relation to regional lymph node involvement in OSCC. Methods: Thirty two methyl green-pyronin stained slides from paraffin-embedded sections of OSCC were evaluated for apoptotic bodies count and mitotic index in relation to regional lymph node involvement using light microscopy. Number of apoptotic bodies and mitotic figures were counted in 10 randomly selected hot spot areas (×400). Average count of apoptotic bodies and mitotic figures were determined and compared with regard to the presence/absence of lymph node involvement. Results: The count of apoptotic bodies in cases without metastasis to the regional lymph node was significantly higher than in cases with regional lymph node involvement. The mitotic index was not significantly different between groups in terms of regional lymph node involvement (P=0.24). No significant correlation was found between the apoptotic bodies count (r=−0.094, P=0.72) and mitotic index (r=−0.08, P=0.75) to the number of regional lymph nodes involved. Interpretation & conclusions: Based on the results, it is suggested that apoptotic cell count can be a good parameter for showing the possibility of regional lymph node involvement in people with OSCC who do not have clinical symptoms of lymph node involvement