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Journal of Maxillofacial and Oral Surgery

Tumor Infiltrating Lymphocytes as a Determinant of Lymph Node Metastasis in Oral Squamous Cell Carcinoma

  • Open Access
  • 03-02-2026
  • Metastasis
  • ORIGINAL ARTICLE
Authors
Aswin Arthik
Nawaz Usman
K. Rajgopal Shenoy
Swathi C. Prabhu
U. Manasa
Published in
Journal of Maxillofacial and Oral Surgery

Abstract

Background

Tumor-infiltrating lymphocytes (TILs) represent the host immune response and may influence metastatic behavior in oral squamous cell carcinoma (OSCC).

Objective

To evaluate the diagnostic accuracy of stromal TILs in predicting clinical and pathological lymph node metastasis in OSCC.

Methods

Analytical cross-sectional study including 170 OSCC patients. Stromal TILs were quantified on H&E sections and classified into high vs. low groups. Their association with clinical nodal staging and pathological nodal metastasis was studied. ROC analysis assessed predictive performance.

Results

Low stromal TILs were significantly associated with pathological nodal metastasis (p < 0.001) and with clinical nodal positivity (p < 0.001). Among clinically N0 patients, 76.9% of occult nodal metastasis occurred in low-TIL tumors. ROC analysis showed moderate accuracy overall (AUC 0.603) and better performance in N0 patients (AUC 0.676).

Conclusion

Stromal TILs are inversely associated with nodal metastasis in OSCC and may improve the accuracy of clinical nodal staging, especially in N0 disease.
Title
Tumor Infiltrating Lymphocytes as a Determinant of Lymph Node Metastasis in Oral Squamous Cell Carcinoma
Authors
Aswin Arthik
Nawaz Usman
K. Rajgopal Shenoy
Swathi C. Prabhu
U. Manasa
Publication date
03-02-2026
Publisher
Springer India
Keyword
Metastasis
Published in
Journal of Maxillofacial and Oral Surgery
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-026-02938-5
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