ArticleDiscover oncology2025
Comparative evaluation of CD34 immunohistochemistry and hematoxylin and eosin staining for detection of lymphovascular emboli in oral squamous cell carcinoma: a retrospective cross-sectional study in a developing country.
Article in Discover oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe primary objective was to evaluate and compare the sensitivity and specificity of CD34 immunohistochemistry (IHC) versus conventional hematoxylin and eosin (H&E) staining in detecting lymphovascular emboli (LVE) in oral squamous cell carcinoma (OSCC). The secondary objective was to correlate LVE detection with tumor size, grade, perineural invasion (PNI), depth of invasion (DOI), worst pattern of invasion (WPOI), and lymph node involvement, with or without extranodal extension (ENE). METHODOLOGY: A retrospective, cross-sectional comparative analysis based on archival cases from the period of January 2021 to December 2023, in pathology department in a tertiary care hospital in central India. A total of 93 patients diagnosed with OSCC were included. All cases had available formalin-fixed, paraffin-embedded (FFPE) tissue blocks. INCLUSION CRITERIA: histologically confirmed OSCC with adequate archived material from all age groups of both sexes. EXCLUSION CRITERIA: non-oral head and neck malignancies and inadequate tissue blocks.
resultsA total of 21 cases with LVE were detected. All these LVE were identified by CD34 immunohistochemistry, out of which, 20 cases were also detected by H&E stain. CD34 identified only one additional case of LVE as compared to H&E stain. The difference was not statistically significant (Chi-square = 0.03, p = 0.86). Significant correlations were observed between LVE and lymph node involvement (p = 0.0008), tumor grade (p = 0.0007), perineural invasion (p = 0.00006), depth of invasion (p = 0.0004), and WPOI (p = 0.00001). No significant correlation of the LVE was found with tumor size (p = 0.1005) or ENE (p = 0.19).
conclusionsCD34 IHC does not significantly improve detection of LVE over conventional H&E staining in OSCC. However, LVE shows strong associations with several high-risk histopathological features, reaffirming its prognostic importance. In a properly processed sample with competent histopathologists, the routine use of CD34 may not be necessary for detecting LVE in cases of OSCC.
trial registrationThis study is registered with the Clinical Trials Registry of India (ICMR-NIMS). The registration number is CTRI/2024/04/065233.
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