Abstract
Objectives:To evaluate the immunohistochemical expression of Epstein-Barr virus (EBV) in broad spectrum histological subtypes of oral squamous cell carcinoma (OSCC) and to determine the relationship of EBV with clinicopathological parameters of OSCC.Methods:This cross-sectional study included 150 clinically diagnosed OSCC cases from the outpatient of Ziauddin University Hospital from March, 2017 to October, 2018. These were confirmed on histological examination and categorized into conventional squamous cell carcinoma (SCC) and rare variants. Conventional SCC was subcategorized into keratinizing (KSCC), non-keratinizing (NKSCC), and hybrid SCC (HSCC). EBV status was compared among various histological tumor entities and clinicopathological characteristics of OSCC using immunohistochemistry. Chi-square test was used to determine the association of each histological subtype with EBV status with P-value <0.05 considered as statistically significant.Results:Conventional tumor was the most frequent squamous cell carcinoma (n=126; 84%). A significant statistical link of EBV infection was observed with rare histological tumors exhibiting acantholysis (P=0.01), as well as tumors involving buccal mucosa (P=0.03), and habitual smokers (P=0.001).Conclusions:In this study, acantholytic tumor, a rare histological subtype of OSCC, tended to be EBV related. Moreover, OSCC cases bearing EBV infection were more likely smokers favoring buccal mucosa as primary anatomical site for oral cancer.
Highlights
Oral squamous cell carcinoma (OSCC) accounts for 90% of all cancers arising from the oral cavity.[1]
The degree of squamous maturation may differ among cases which primarily characterize conventional tumors (Conventional Squamous Cell Carcinoma; CSCC) into keratinizing (CKSCC) and nonkeratinizing (CNKSCC) entities, where the latter entity represents lack of mature squamous differentiation.[7]
Majority of oral squamous cell carcinoma (OSCC) cases were males, which constituted the major portion of Epstein-Barr virus (EBV) positive cases, whereas only 01 female case showed expression of EBV protein
Summary
Oral squamous cell carcinoma (OSCC) accounts for 90% of all cancers arising from the oral cavity.[1]. OSCC exhibits atypical squamous epithelial cells with variable degree of maturation, intercellular bridges and keratin pearl formation.[6] The degree of squamous maturation may differ among cases which primarily characterize conventional tumors (Conventional Squamous Cell Carcinoma; CSCC) into keratinizing (CKSCC) and nonkeratinizing (CNKSCC) entities, where the latter entity represents lack of mature squamous differentiation.[7] a hybrid (HSCC) variant depicting a mixed pattern of squamous maturation and an intermediate prognosis between CKSCC and NKSCC has been reported.[8] More than 80% cases of OSCC encountered in clinical practice demonstrate conventional morphology, other rare subtypes of squamous cell carcinoma exist. These subtypes constitute 10-15% of all OSCC cases.[9]
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