Aim: Head and neck cancers, all over the world, contribute greatly to the number of deaths, despite the advancements in the therapeutic strategies. It is characterized by locoregional disease with a tendency for metastasis to the cervical lymph nodes. The pre-operative detection of lymph node metastasis is critical for the effective treatment of patients with head and neck squamous cell carcinoma. Therefore the objective of this study was to identify E-cadherin as a marker for prediction of

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... h node metastasis in head and neck squamous cell carcinoma (HNSCC). Study Design: Cross-sectional study. Place and Duration of Study: Dow University of Health Sciences, Karachi. 1 Year duration. Methodology: Cross-sectional analysis of 54 subjects with HNSCC, who underwent neck dissections, was carried out. Expression of E-cadherin was evaluated using immunohistochemical analysis and traditional histological parameters, and correlation of E-Cadherin with histologically verified presence of regional metastases was determined. Data was subjected to descriptive statistics and chi-square using Spss v.16.0. Results: 54 patients included 33 males (61.1%) and 21 females (38.9%) aged from 18 to 73 (mean 44.8±12.7). A statistically significant relationship between the Downregulation of E-cadherin and histologically verified presence of nodal metastasis was established. (p value= 0.01). Conclusion: This study shows that low E-cadherin expression is useful for predicting lymph node metastases in cases of head and neck carcinoma.