Analysis of Immune System Responses in Lymph Nodes and The Pattern of Malignant Tumor Cell Infiltration in Oral Squamous Cell Carcinoma

Abstract

The host immune response to malignant tumor cells was evaluated indirectly by the immunomorphological patterns observed in the lymph nodes. (LNs), which function as indicators of the patient's immunological status and may either facilitate or hinder the localization of tumor cells during a metastatic event. This study sought to evaluate the immunomorphological patterns of LNs in head and neck cancer and to correlate these patterns with the histological grading of OSCC.  An additional evaluation was conducted to determine the pattern of tumor cell infiltration in lymph node metastases. The current investigation was conducted on seventy archival paraffin blocks of oral squamous cell carcinoma (OSCC), comprising twenty-five well-differentiated squamous cell carcinoma (WDSCC), twenty-four moderately differentiated squamous cell carcinoma (MDSCC), and twenty-one poorly differentiated squamous cell carcinoma (PDSCC). One hundred thirty-nine lymph nodes were collected from seventy cases of OSCC, which were classified into four distinct patterns. From seventy cases of OSCC, 139 lymph nodes were harvested. The prevailing pattern of lymph node reactivity was lymphocyte predominance (54.7%), followed by germinal center predominance (41%). Furthermore, while analyzing the immunomorphological patterns of LNs and the invasion patterns of neoplastic cells in metastatic lymph nodes, the islands/sheets pattern of tumor cells exhibited a high lymphocyte predominance, whereas the total replacement of neoplastic cells was mainly observed in nodes with germinal center predominance. The immunomorphological patterns of regional lymph nodes in OSCCs appear to be a crucial prognostic predictor. The cell-mediated immune response, characterized by lymphocyte predominance and sinus histiocytosis, restricts metastasis, while the humoral response, marked by germinal center predominance, promotes metastasis.