Clinicopathological Study of CK19 Expression in Head and Neck Squamous Cell Carcinoma and Its Association with Tumor Grading: A Cross-Sectional Study.

Akhil kumar; Vibhuti Thukral; Rajnish Kalra

doi:10.51168/9fyrr742

Authors

Akhil Kumar Assistant Professor, Department of Pathology, ESIC Medical College and Hospital, Namkum, Ranchi, India
Vibhuti Thukral Senior Resident, Department of Pathology, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India.
Rajnish Kalra Professor, Department of Pathology, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India.

DOI:

https://doi.org/10.51168/9fyrr742

Keywords:

cytokeratin 19 (CK19), Anneroth system, prognostic marker, immunohistochemistry, head and neck squamous cell carcinoma

Abstract

Introduction:

Head and neck squamous cell carcinoma (HNSCC) is a histologically heterogeneous group of tumors with diverse biological behavior. Cytokeratin 19 (CK19), part of the epithelial cytoskeletal network, may indicate tumor differentiation and progression. This cross-sectional study evaluated CK19 immunohistochemical expression in HNSCC and its correlation with histological grade using two grading systems.

Materials and Methods:

A cross-sectional study of 100 biopsy-confirmed HNSCC cases was conducted at the Department of Pathology, Pt. B.D. Sharma PGIMS, Rohtak. Tumors were graded using the WHO system and Anneroth's six-parameter system. CK19 expression was assessed by immunohistochemistry and scored 0-3 based on the percentage of stained tumor cells. Chi-square and Fisher's exact tests were used for statistical analysis.

Results:

Patients ranged from 28-86 years (mean 57.16 ± 11.70 years) with a male predominance (88% male, 12% female). CK19 expression was positive in 69% of cases, rising with tumor grade: 41.4% in well-differentiated, 78.3% in moderately differentiated, and 84% in poorly differentiated carcinomas (p < 0.001). Anneroth grading also showed a rising trend, though with inconsistencies in grade II/III classification. The highest CK19 expression (score 3) predominated in Anneroth grade III/IV tumors.

Conclusion:

CK19 expression is significantly associated with poor tumor differentiation in HNSCC, particularly by WHO grading, supporting its potential as a prognostic biomarker that may enhance grading accuracy and inform treatment strategies.

Recommendation:

CK19 immunohistochemistry should be considered an adjunct to routine histopathological grading in HNSCC, with larger, standardized, multicentric studies recommended to validate its prognostic reliability.

Author Biographies

Akhil Kumar, Assistant Professor, Department of Pathology, ESIC Medical College and Hospital, Namkum, Ranchi, India

is an Assistant Professor in the Department of Pathology at ESIC Medical College and Hospital, Namkum, Ranchi, India, with academic interests in pathology and clinicopathological research.
Vibhuti Thukral, Senior Resident, Department of Pathology, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India.

is a Senior Resident in the Department of Pathology at Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India, with academic interests in diagnostic and clinicopathological pathology.
Rajnish Kalra, Professor, Department of Pathology, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India.

is a Professor in the Department of Pathology at Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India, with academic interests in pathology and clinicopathological research.

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