A study on histological grading of oral squamous cell carcinoma and its co-relationship with regional metastasis

BACKGROUND: Histological grading is an important diagnostic tool to predict the clinical and biological behaviour of cancer. Cervical lymph node metastasis indicate poor prognosis of oral cancer. Considering economical status of a third world country, Anneroth's grading system is less expensive, more informative than TNM staging and Broder's grading system. Anneroth's grading system also shows co-relationship with lymph node metastasis. So we are trying to evaluate the Anneroth's grading as a standard one among these three system. OBJECTIVE: To study the grading of histological malignancy according to Anneroth's classification of biopsy specimens in relation to metastasis in the cervical lymph nodes and comparing the Anneroth's with the other two recognized classifications. MATERIALS AND METHODS: Fifty(50) patients with oral squamous cell carcinoma was included in the study. Specimen of 35 non-metastatic tumors were compared with 15 metastatic cases. All of the patients were graded to TNM, Broder's and Anneroth's system. TNM is clinical assessment and Broder's is based on only differentiation of cells. On the other hand, six parameters of Anneroth's gives a detail about the morphology of the tumor, invasion criteria in the host tissue and show its correlation with lymph node metastasis. Scoring system of Annearoth's grading indicates demarcation points of worseness of tumor and signifies the possibility of lymph node metastasis. RESULTS: Both Anneroth's(P=0.002) and Broder's grading(P=0.012) have been significant but Anneroth's one is more significant then Broder's. CONCLUSION: Anneroth's classification can be taken as a standerd diagnostic factor and predictive factor of lymph node metastasis.