Predictive value of cathepsin-D for cervical lymph node metastasis in head and neck squamous cell carcinoma

Regina F Gandour-Edwards, Bruce Trock, Paul J. Donald

Research output: Contribution to journalArticle

21 Scopus citations


Background. Prognosis of head and neck squamous cell carcinoma (HNSCC) is strongly associated with cervical lymph node metastasis. Cathepsin-D is a lysosomal protease expressed in all cells. Its role in extracellular matrix degradation is postulated to promote tumor invasion and metastasis. Increased cathepsin-D has been demonstrated in cervical lymph node metastasis in HNSCC. Methods. Formalin fixed tumor biopsy samples from 34 patients with HNSCC of the oral cavity, oropharynx, or hypopharynx were analyzed for the presence of cathepsin-D by immunohistochemistry (1:8000, Calbiochem, Cambridge, MA). Tumors were considered positive if >50% of cells showed strong cytoplasmic staining. Results. All patients had T1 or T2 lesions ranging in size from 1-4 cm and 19 (56%) had cervical metastasis. Eight (24%) were well differentiated and 26 (76%) were moderately or poorly differentiated. Thirteen tumors (38%) had high cathepsin-D expression that was strongly associated with cervical lymph node metastasis (p = 0.008). When adjusted for tumor stage and grade, cathepsin-D positivity was nearly twice as likely to be associated with node metastasis (p = 0.011). Conclusions. We demonstrated cathepsin-D expression in biopsies from a subset of patients with HNSCC and a strong association between this protease and cervical lymph node metastases. Cathepsin-D is a potential independent predictor of cervical lymph node metastasis in HNSCC and merits additional study.

Original languageEnglish (US)
Pages (from-to)718-722
Number of pages5
JournalHead and Neck
Issue number8
StatePublished - Dec 1999



  • Cathepsin-D
  • Cervical lymph node metastasis
  • Head and neck cancer
  • Predictive markers
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Otorhinolaryngology

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