Abstract

Tobacco smoking involves a high risk of human malignancies, including oral cancer, because it contains multiple carcinogens that cause genetic instability. Thus, a worse prognosis would be expected for cancer patients who are smokers. The aim of this study was to assess the DNA damage response through the expression of checkpoint kinase 2 (CHK2), H2A histone family member X (H2AX), and P53 among smokers and non-smokers with oral squamous cell carcinoma (OSCC). Associations between immunoexpression of proteins and clinicopathological data and histopathological grading were also analyzed. A total of 35 individuals (18 non-smokers and 17 smokers) with OSCC of the tongue and/or floor of the mouth were included. Immunohistochemistry for H2AX was conducted for the identification of double-strand breaks, CHK2, and P53 to evaluate the expression of this protein in cell cycle regulation. The sample consisted of 22 males and 13 females, with a mean age of 63.9±11.8 years. OSCC of non-smokers were well-differentiated tumors in 50% of the cases, and those of smokers were equally distributed into moderately differentiated and poorly differentiated tumors (35.3% each). Overall, 31 (88.6%) cases were CHK2-positive, 27 (77.1%) were H2AX-positive, and 23 (65.7%) were P53-positive, with no difference between smokers and non-smokers (p > 0.05). No association was found between proteins and clinicopathologic data (p > 0.05). Similarities in CHK2, H2AX, and P53 immunohistochemical staining patterns were observed between smokers and non-smokers, and immunoexpression was not associated with clinicopathological parameters. However, the findings indicated consistent expression of these proteins in OSCC.

Highlights

  • Oral cancer is a global problem with an annual incidence of 377,000 cases.[1]

  • We evaluated the immunoexpression of checkpoint kinase 2 (CHK2), H2AX, and P53 proteins, which are associated with DNA protection and repair, among smokers and non-smokers with Oral squamous cell carcinoma (OSCC)

  • The cases were obtained from the archives of the Oral and Maxillofacial Pathology Laboratory of Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil

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Summary

Introduction

Oral cancer is a global problem with an annual incidence of 377,000 cases.[1] Oral squamous cell carcinoma (OSCC) is the most common type of oral malignant neoplasia. Epigenetic and environmental factors are involved in this multifactorial disease. Cigarette smoking is the main etiologic factor of oral cancer, and its mechanism of action involves direct DNA damage.[2] During carcinogenesis, some pathways

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