P53 Expression Helps Identify High Risk Oral Tongue Pre- malignant Lesions and Correlates with Patterns of Invasive Tumour Front and Tumour Depth in Oral Tongue Squamous Cell Carcinoma Cases.

Pratibha Ramani,Arvind Krishnamurthy,Thangaraj Soundara Viveka,Vijayalakshmi Ramshankar,Vidyarani Shyamsundar

doi:10.7314/apjcp.2016.17.1.189

Pratibha Ramani, Arvind Krishnamurthy + Show 3 more

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https://doi.org/10.7314/apjcp.2016.17.1.189

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Abstract

Oral tongue squamous cell carcinoma (OTSCC) is the most common oral cancer subtype with a maximum propensity for regional spread. Our objective was to study if p53 expression might have any correlation with aggressive patterns of invasion within oral tongue cancers as well as with the histologically identified degree of oral tongue dysplasia. p53 immunoexpression was studied using immunohistochemistry in early staged OTSCCs (n=155), oral tongue dysplasias, (n=29) and oral tongue normal specimens (n=10) and evaluated for correlations with histological and clinicopathological parameters. Our study (n=194) showed a pattern of p53 expression increasing with different grades of tongue dysplasia to different grades of invasive OTSCC (p=0.000). Among the OTSCC tumours, positive p53 expression was seen in 43.2% (67/155) and a higher p53 labelling index was significantly associated with increased Bryne's grade of the tumour invasive front (p=0.039) and increased tumour depth (p=0.018). Among the OTSCC patients with tobacco habits, (n=91), a higher p53 labelling index was significantly associated with increased risk of local recurrence (p=0.025) and with lymphovascular space involvement (p=0.014). Evaluation of p53 through varying degrees of dysplasia to oral tongue cancer indicates that p53 expression is linked to aggressive features of oral tongue cancers and tongue precancers entailing a closer monitoring in positive cases. Among the OTSCCs, p53 expression is associated with tumour aggressiveness correlating with increased grading of invasive tumour front and tumour depth.

Highlights

Oral Tongue squamous cell carcinoma (OTSCC) is one of the most common sub-site of oral cancers in the world
OTSCCs has been traditionally believed to be associated with a poor prognosis and this may be linked with its maximum propensity of regional spread compared to other oral sub-sites (Yeole et al, 2011)
A HPV independent mechanism of p16 over-expression conferring a poorer prognosis in OTSCCs was reported by us (Ramshankar et al, 2014)

Summary

Introduction

Oral Tongue squamous cell carcinoma (OTSCC) is one of the most common sub-site of oral cancers in the world. The trends in epidemiology of oral cancer in Asia in the past decade (2000-2012) shows oral tongue as the most frequently affected site (Krishna et al, 2013). Earlier studies report a higher incidence of OTSCC in India compared to other countries (Moore et al, 2000; Elango et al, 2006; Krishnamurthy et al, 2013; Mishra et al, 2014). The incidence of OTSCC in the population based cancer registry (PBCR) of Chennai has been showing an increasing trend. OTSCCs has been traditionally believed to be associated with a poor prognosis and this may be linked with its maximum propensity of regional spread compared to other oral sub-sites (Yeole et al, 2011). Our earlier studies reported an increase in tongue cancers among the non-tobacco users (Krishnamurthy et al, 2013). A HPV independent mechanism of p16 over-expression conferring a poorer prognosis in OTSCCs was reported by us (Ramshankar et al, 2014)

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