Abstract
Expression of p53, cyclin D1, p21 (WAF1) and Ki-67 (MIB1) was evaluated in oral squamous cell carcinoma (OSCC) to test whether levels of these markers at invasive tumour fronts (ITFs) could predict the development of local recurrence. Archived paraffin-embedded specimens from 51 patients with T1/T2 tumours were stained immunohistochemically and analysed quantitatively. Local recurrence-free survival was tested with Kaplan-Meier survival plots (log-rank test) using median values to define low and high expression groups and with a Cox's proportional hazards model in which the expression scores were entered as continuous variables. The assessment of expression of all markers was highly reliable, univariate analysis showing that patients with clear surgical margins, with low cyclin D1 and high p21 expression at the ITF had the best local recurrence-free survival. Multivariate analysis showed that these three parameters were independent prognostic factors but that neither p53 nor MIB1 expression were of prognostic value. Assessment of p53, cyclin D1, p21 (WAF1), and Ki-67 (MIB1) at the ITF could help to predict local recurrence in early stage oral squamous cell carcinoma cases.
Highlights
Despite the advances in treatment over the past 2030 years, there has been no significant improvement in the prognosis for oral squamous cell carcinoma (OSCC), with a high incidence of local recurrence as the main cause of this poor outcome (Pisani et al, 1993; Malone et al, 2004; Ferlay et al, 2008; Ferlay et al, 2012)
The aim of this study was to investigate whether the immunohistochemical expression of the molecular markers p53, Cyclin D1, p21 and MIB1 at the invasive tumour fronts (ITFs) is associated with local recurrence-free survival (LRFS) in patients with T1/T2 OSCC
A striking accumulation of p53-positive cells was seen in some cases at the ITF compared with more superficial areas
Summary
Despite the advances in treatment over the past 2030 years, there has been no significant improvement in the prognosis for OSCC, with a high incidence of local recurrence as the main cause of this poor outcome (Pisani et al, 1993; Malone et al, 2004; Ferlay et al, 2008; Ferlay et al, 2012). TNM staging and histopathological grading are considered the main prognostic systems in OSCC, yet patients with similar stages of disease treated in a uniform manner experience a wide range of outcomes, presumably because of differences in the underlying biology of the tumour. This differential in treatment success is emphasised in patients with localised relatively small T1 and T2 tumours, many of whom develop recurrences or late metastasis. Expression of p53, cyclin D1, p21 (WAF1) and Ki-67 (MIB1) was evaluated in oral squamous cell carcinoma (OSCC) to test whether levels of these markers at invasive tumour fronts (ITFs) could predict the development of local recurrence. Conclusions: Assessment of p53, cyclin D1, p21 (WAF1), and Ki-67 (MIB1) at the ITF could help to predict local recurrence in early stage oral squamous cell carcinoma cases
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