Different Grades Of Oral Squamous Cell Carcinoma Research Articles

Correlation of prognosis of oral squamous cell carcinoma with CD44 expression: A retrospective immunohistochemical analysis

ABSTRACT Background: Cluster of differentiation (CD44) is a cancer stem cell marker responsible for angiogenesis, invasion, and migration in oral squamous cell carcinoma (OSCC). Objectives: The primary objective of the study was to analyze the difference in expression of CD44 among different grades of OSCC. The secondary objective was to correlate the prognosis with the expression. Materials and Methods: Based on histopathological diagnosis, we retrieved OSCC paraffin-embedded blocks from the archives of the Department of Oral Pathology, Sri Ramaswamy Memorial (SRM) Dental College, Chennai, India, reported from January 2012 to May 2022. We evaluated sections from 15 tissues of normal oral mucosa, 15 paraffin blocks of well-differentiated OSCC, 15 moderately differentiated OSCC, and 15 poorly differentiated OSCC for CD44 immunostaining. Immunohistochemical expression of CD44 was studied in these tissues and graded based on the intensity of staining. The difference in immune expression of CD44 between different grades was quantitatively analyzed using image analysis by Fiji image analysis software. Analysis of variance (ANOVA) was used to compare the mean difference in expression between different groups by using the Statistical Package for Social Sciences (SPSS) software version 16. Statistical significance was set at P < 0.05. Results: We identified that 10% (n = 6) of the normal mucosa showed strong expression of CD44, whereas 13.3% (n = 8) of well-differentiated OSCC, 10% (n = 6) of moderately differentiated OSCC, and 0% (n = 0) of poorly-differentiated OSCC were strongly positive for CD44 expression. The difference in comparison was statistically significant (P, 0.003). By quantitative analysis, the mean expression of CD44-positive cells in well-differentiated OSCC was 38258 ± 4762, moderately-differentiated OSCC was 27353 ± 1357, and poorly-differentiated OSCC was 10265 ± 1685. Upon comparison, the difference in mean was found to be significant (P, 0.002). Conclusion: The expression of CD44 was noted to decrease from well-differentiated to poorly-differentiated OSCC.

Study of expression of GLUT-1 in oral potentially malignant disorders and oral squamous cell carcinoma: An immuno-histochemical analysis.

Glucose is the chief source of energy for cells, and glucose transporter 1 (GLUT-1) is one of the most common glucose transporters in humans. Tumour cells are known to express hypoxia-related protein, and these may allow tumour cells to survive under a sustained hypoxic environment. Surviving cells develop a more aggressive phenotype, which results in poor prognosis. Expression and comparison of GLUT-1 in normal tissues, potentially malignant disorders (PMDs), and oral squamous cell carcinoma (OSCC) and comparison of expression in different grades of OSCC. A total of 57 cases (10 normal, 17 PMD, and 30 cases of OSCC) were stained immuno-histochemically with GLUT-1. The expression was scored as 0, 1, 2, 3, and 4 for negative, mild, moderate, severe, and intense staining, respectively. GLUT-1 expression was detected in all grades of OSCC. A significant correlation was found on comparing normal and OSCC, normal and PMDs, and PMD and OSCC. The expression of GLUT-1 was significant when compared with different histopathological grades of OSCC. Expression of GLUT-1 increased from normal to PMDs to increasing grades of OSCC and hence can be used as a prognostic predictive marker for OSCC.

Protocol for the evaluation of cyclin D1 expression in tumor tissue and surgical margins in oral squamous cell carcinoma – a retrospective study

Oral squamous cell carcinoma (OSCC) is a malignant epithelial tumor with poor prognosis. There is an increase in the proliferation of epithelial cells in OSCC which is control by cell cycle regulators like Cyclin D1. Cyclin D1 is linked to a poor prognosis for patients, including aggressive malignancies, recurrence, protracted remission, etc. To evaluate Cyclin D1 immunoexpression in different grades and surgical margins in OSCC. All tissue sections will be processed for Cyclin D1 IHC. After that light microscopic evaluation of Cyclin D1 expression was classified as weak (scoring 1-4), moderate (score 5-8), or strong based on a final expression score that was obtained by multiplying the labelling index score by the intensity score (score 9–12). The present study will find the immunohistochemical expression of Cyclin D1 in OSCC. There will be variation in the immunoexpression of Cyclin D1 among different grades of OSCC its surgical margin and normal oral mucosa. We hypothesize that: As the disease condition goes towards poor grade, intensity of cyclin D1 expression immunohistochemically may increase. Hence, the intensity can be used as a prognostic marker.

Assessment of Tumor Budding in Different Grades of Oral Squamous Cell Carcinoma

Introduction: Oral squamous cell carcinoma (OSCC) is the most common malignancy affecting the oral cavity in which patient prognosis and treatment primarily depend upon histological grading and clinical staging. Tumor budding has been recognized as a morphological marker of tumor invasion, which represents an aggressive feature of epithelial malignancies. This study was done to assess the activity of tumor budding in different grades of OSCC. Materials and Methods: An immunohistochemical study was performed on tissue sections obtained from 30 paraffin-embedded blocks of clinically and histologically diagnosed cases of OSCC. The sections were stained with pan cytokeratin and observed under high-power magnification. Tumor budding activity and cell nest size were assessed in different grades of OSCC. Results: A significant correlation was observed between tumor budding and cell nest size in OSCC. Conclusion: This study suggests the importance of using tumor buds as an additional parameter in the diagnosis and grading of OSCC.

A Comparison of Podoplanin Expression in Oral Leukoplakia and Oral Squamous Cell Carcinoma: An Immunohistochemical Study.

Oral squamous cell carcinoma (OSCC) accounts for about 90% to 95% of all malignancies of the oral cavity.The majority of OSCCs are preceded by oral potentially malignant disorders (OPMDs). Podoplanin (PDPN) is a mucin-like small transmembrane glycoprotein. Alterations in PDPN immunoexpression have been reported in OPMDs and OSCCs. The objectives of this study were to evaluate the role of PDPN immunoexpression in oral leukoplakia (OL) and different histological grades of OSCC and to assess the role of PDPN as a potential biomarker for predicting the risk of malignant transformation. Immunohistochemical analysis for PDPN was performed in 45 histologically confirmed cases of formalin-fixed, paraffin-embedded specimens of different grades of OSCCs and 15 cases of OLs with 15 cases of the normal oral mucosa (NOM) as controls. The expression and distribution of this marker were analyzed in these lesions. The immunoexpression of PDPN showed a significant increase in the expression of the percentage of positive cells, staining intensity, location of staining in the epithelium, tumor islands, and within the cells, as well as the mean lymphatic micro vessel density between NOMs, OLs, and different grades of OSCCs. Upregulation of PDPN can be related to the malignant transformation of OLs and biological aggressiveness of OSCCs. The enhanced immunoexpression of PDPN signifies that this immunomarker can have a role in tumor cell differentiation and the neoplastic progression of OSCCs. Increased density of lymphatic vessels suggested an important role of lymphangiogenesis in tumor progression and also as a prognostic factor for lymph nodal metastasis.

Role of hypoxia and epithelial-mesenchymal transition in the formation and maintenance of oral cancer stem cells in oral squamous cell carcinomas and metastatic lymph node: An immunohistochemical analysis.

Inspite of having advanced treatment modalities the overall survival rate in oral squamous cell carcinoma (OSCC) remains poor. This is considered to be mainly due to local recurrence and distant metastasis. Various studies have concentrated on the role of oral cancer stem cells (OCSCs) in the progression and metastasis of OSCC. However, the role of tumor microenvironment components has been less delved into. Hence clarity on cell biology and metastatic potential OCSCs is essential for the development of more effective anti-cancer treatment. To establish the role of OCSCs in different grades of OSCC and metastatic lymph nodes through the expression of cluster of differentiation 44 (CD44). To demonstrate and correlate the role of hypoxia and Epithelial mesenchymal transition (EMT) in the various grades and metastatic lymph nodes in the formation and maintenance of OCSCs by employing Hypoxia-inducible factor-1 Alpha (HIF 1α) and Snail respectively. A total of 36 cases of OSCC, 12 from each grade and 12 normal oral mucosal tissues were included in the study. Immunohistochemical staining was performed for the demonstration of CD44, HIF1α, and Snail. Descriptive analysis, Chi-square, and Spearman's rank correlation were used to analyze frequency and proportion, to compare expression and correlate between lesion proper and lymph node in each group respectively. Significant expression of CD44, HIF1 α, and Snail among advancing grades of OSCC and their metastatic lymph node were observed. A positive correlation was seen between them. The prognosis of OSCC can be improved by better understanding and targeting the molecules involved in the formation and maintenance of OCSCs.

Immunohistochemical expression of E-Cadherin and Cyclin D1 in different grades of oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is the most common oral malignancy, representing up to 80-90% of all malignant neoplasms of the oral cavity. It results from the multistep accumulation of heterogeneous genetic changes. Important risk factors for OSCC include the use of tobacco or betel quid chewing, alcohol consumption, human papillomavirus and poor nutrition. E-Cadherin as a tumour suppressor gene sets a threshold for Wnt/β-catenin signalling. When expression of E-Cadherin is lost, potentiation of Wnt signalling pathway occurs leading to loss of cell-cell adhesion. The cyclin D1 gene (CCND1) located on chromosome 11q13 encodes a nuclear protein that is the regulatory subunit of Cdk-4 and Cdk-6. Cyclin D1 plays a major role in cell cycle transition from G1 to S phase by contributing to inactivation of the retinoblastoma gene product, and overexpression of CCND1 has been reported in 35-40% cases of OSCC. Considering this, we decided to evaluate and compare the expression of CE-Cadherin and Cyclin D1 in different grades of OSCC. A retrospective study was carried out on 60 formalin-fixed paraffin embedded tissue blocks comprising of 20 cases of well-differentiated OSCC, 20 cases of moderately differentiated OSCC and 20 cases of poorly differentiated OSCC. Diagnosed (using H and E), with oral mucosa taken as control. There was downregulation of E-Cadherin and overexpression of Cyclin D1 in increasing grades of OSCC and the difference was statistically significant. E-Cadherin was localised to membranous and shifted to cytoplasm as the grade worsened. Cyclin D1 was localised to nuclei of cells and the expression was seen more at the peripheral portions of tumour islands depicting the proliferative activity of tumour front. The study revealed a good prognostic role of both E-Cadherin and Cyclin D1 in OSCC. The markers can be used for prognostic as well as therapeutic purposes.

Evaluation of extracellular matrix changes among oral submucous fibrosis and oral squamous cell carcinoma patients of Malwa region of Punjab using special histochemical stains: An insight into cancerous transformation.

To assess extracellular matrix changes among oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC) patients using special histochemical stains. Twenty biopsy specimens of OSMF and 30 biopsy specimens of OSCC were included in the present study. Among 20 OSMF specimens, 10 were of early OSMF and the remaining 10 were of advanced OSMF. Out of 30 OSCC specimens, 10 cases each were of well-differentiated OSCC, moderately differentiated OSCC and poorly differentiated OSCC. Three sections, each 4 μm thick, were obtained from all specimens. One section was stained with routine H&E staining, whereas the other section was stained with Masson's trichrome (MT) stain for collagen and Verhoeff-Van Gieson (VVG) for elastic fibres. Evaluation of all specimens was performed under the light microscope. The arrangement of collagen fibres and elastic fibres was compared between the OSMF group and OSCC group, in between different grades of OSMF and in between different grades of OSCC. The results were evaluated using SPSS software. Early OSMF cases were associated with fibrosis in the superficial lamina propria, whereas advanced OSMF had fibrosis involving deeper muscle fibres. In all early OSMF cases, elastic fibres were arranged in thin bundles, whereas in advanced OSMF cases, elastic fibres were in thick bundles. In well- and moderately differentiated OSCCs, the collagen fibres were arranged in thick bundles and in poorly-differentiated OSCCs, the collagen fibres appeared to be fragmented. The elastic fibres in well-differentiated OSCC and moderately-differentiated OSCC were thickly arranged, and poorly-differentiated OSCC showed thin fibres and 70% of cases showed the absence of elastic fibres. Changes observed in both collagen and elastic fibres in the extracellular matrix (ECM) can be taken as a study model to further understand the progression of OSMF to OSCC using histochemical stains.

Morphometric Analysis of Collagen in Different Grades of Oral Squamous Cell Carcinoma Using Picrosirius Red Stain and Spectrophotometry.

Oral squamous cell carcinoma (OSCC) is one of the most formidable health problems for mankind. These carcinomas are characterized by invasion of epithelial tumor cells into the stroma, which get embedded in extracellular matrix and collagen producing reactive changes. Such changes in the stroma may alter the biological aggressiveness of the tumor. An attempt was made to evaluate the collagen changes in different grades of OSCC which can contribute to understanding the biologic behavior of oral cancer and predict clinical outcomes. To assess the quantitative changes in collagen in different grades of OSCC using hematoxylin and eosin (H and E) and Picrosirius red (PSR) stain through spectrophotometry and to compare the efficacy of these stains for estimation of collagen. The study comprised a total sample size of 60, which were distributed under 4 different groups, each containing 15 samples. Group I to IV consisted of normal buccal mucosa, with well-, moderately-, and poorly-differentiated OSCC, respectively. The tissues of 10 μm thickness were stained with H and E and PSR for spectrophotometric analysis. The quantity of collagen decreased with increasing grades of OSCC. Comparison between two stains showed that PSR can provide a more reliable and accurate result than H and E. Collagen estimation is one of the methods to assess the progression of tumor. The method used in the present study for collagen estimation in different grades of OSCC is reliable and accurate.

To evaluate an association between prognostic significance of Moesin with histopathological grading of oral squamous cell carcinoma: A systematic review.

The aim of the present Aetiology/Risk type and Prognostic type of systematic review is to evaluate the value of Moesin as a biomarker of invasiveness in Oral Squamous Cell Carcinoma patients and to review/assess the available evidence regarding the prospective prognostic association between Moesin and histopathological grading of OSCC to enhance the quality of life and survival rate of oral cancer patients. A systematic wide-range literature search was performed by authors (BS, KS, and DK) till October 2022 using both, electronic search media and manual search by hand, searching appropriate journals as per the focussed guiding question and inclusion/exclusion criteria. Major databases such as Scopus, EMBASE, Web of Science, Cochrane central register for controlled trials, PubMed & Google Scholar were conducted by two calibrated reviewers independently to gauge the association between the prognostic significance of Moesin with histopathological grading of oral squamous cell carcinoma. As this study is based on tissue samples of oral squamous cell carcinoma patients, all the selected studies were mostly, cross-sectional studies, and retrospective in nature. The studies were integrated with this review to gauge the association between the prognostic significance of Moesin with histopathological grading of oral squamous cell carcinoma (OSCC). The review included a total of 7 studies with tissue samples of 645 cases. The prime outcome was to assess the immunoexpression of Moesin among the different histopathological grades i.e well-differentiated SCC, moderately differentiated SCC, and poorly differentiated SCC and the subordinate outcome was to consider the extent of strong immunoexpression characteristics (cytoplasmic, membranous and mixed type) in different grades of OSCC as well as to correlate with morbidity, mortality, and/or 5 years or 10 years survival rate. The results were analyzed and presented narratively using the Critical Appraisal Tools developed by the University Of Oxford; Risk of Bias - Cochrane Risk of Bias tool - RoB 2.0, and GRADE-pro (Grading of Recommendations, Assessment, Development, and Evaluations) which rates the features of the evidence as high, moderate, low and very low. The risk of mortality expressed in terms of Hazard ratio has been elicited as a 1.37 times higher rate of mortality in the advanced histopathological stages of the OSCC cases. As the sample size of this review was insignificant, therefore, the authors have incorporated hazard ratios of some other studies of carcinomas in diverse sites in the body to give a flavor of prognostic outcomes of Moesin. It was observed that Moesin expression in Breast cancer and UADT carcinomas have a higher mortality rate as compared to OSCC and lung carcinoma cases and this decree strengthens our conviction that Moesin expression in the cytoplasm of advanced histopathological stages of cancer can be assumed as a sign of poor prognosis in all carcinomas including OSCC patients. A sample of seven studies is inadequate as definite evidence for claiming that Moesin is a strong biomarker of invasiveness in OSCC cases and more clinical trials need to be conducted on the prognostic efficacy of Moesin expression in the various histopathological grades of OSCC cases.

Histopathological evaluation of minor salivary gland aberrations in oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is one of the most established oral cancers in India, with high morbidity and mortality. The most common etiological agent associated with it is tobacco (in any form), which releases chemical carcinogens that affect not only the oral epithelial lining but also deep stromal structures such as minor salivary glands. They may cause changes in ductal or acinar part of gland depending on tumor grade, thus providing a fertile soil for tumor growth and recurrence. To observe the frequency of minor salivary gland changes associated with tobacco as well as to measure the length and depth of ductal involvement in routine tissue sections of OED and OSCC. A total of 94 hematoxylin and eosinstained archival slides which included cases of well, moderate, and poorly differentiated OSCC and oral epithelial dysplasia were histopathologically evaluated to observe changes in different components of minor salivary gland. Ductal hyperplasia, ductal metaplasia, mucous pooling within duct, acinar degeneration, pattern of malignant cell invasion (single/clusters), inflammatory infiltrate, eosinophilic cuffing around the gland, and glandular/vascular involvement were evaluated in each slide and correlated with different grades of OSCC. Ductal hyperplasia, inflammatory cell infiltrate, mucous pooling, and pattern of malignant cell infiltration came out to be statistically significant with the highest percentage of changes being observed in poorly differentiated squamous cell carcinoma > moderately differentiated squamous cell carcinoma> well differentiated squamous cell carcinoma>oral epithelial dysplasia. Further, the results of this study suggest that extension of dysplasia or squamous cell carcinoma from overlying oral epithelium along salivary gland ducts is an uncommon finding. Conclusion: Hence, histopathological interpretation for OED and OSCC should also include changes related to associated minor salivary gland tissue as detection and eradication of the putative precursors are the best way of decreasing the overall morbidity caused by tumors.

Immunohistochemical evaluation of tumor angiogenesis and architectural changes in regional lymph nodes of oral squamous cell carcinoma (OSCC)

Aim: To evaluate the mean vascular area (MVA) and to correlate it with immunomorphological pattern of lymph nodes. Materials and Methods: A total of 50 positive OSCC cases (clinically and histopathologically diagnosed) from Santosh Medical College and I.T.S Dental college, ghaziabad were taken for the study. The lymph nodes collected were stained with routine hematoxylin & eosin and accessed for immunomorphological pattern. The sections were evaluated immunohistochemically by anti-von Willebrand factor (vWF) VIII to analyze the micro vessels in OSCC. Results: Three hundred and forty two lymph nodes were evaluated and the most predominant lymph node patterns were found to be Germinal Center Predominance (37.43%). Our results showed a significant association between tumor node metastasis (TNM) staging, histopathological grading, and mean vascular area with lymph node reactivity pattern. Conclusion: There was an increase in angiogenesis with in different grades of OSCC and mean vascular area with morphological pattern of lymph nodes can be used as an additional parameter which would help in assessing prognosis and survival of the patient.

Myofibroblasts as important diagnostic and prognostic indicators of oral squamous cell carcinoma: An immunohistochemical study using alpha-smooth muscle actin antibody.

Background:Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, with multifactorial etiopathogenesis. Data from the past literature suggest that myofibroblasts (MFs) can also contribute significantly to the pathogenesis of the disease. Hence, the present study was undertaken for assessing the expression of MF in well-differentiated OSCC (WDOSCC), moderately differentiated OSCC (MDOSCC), poorly differentiated OSCC (PDOSCC) and healthy controls by immunohistochemistry using alpha-smooth muscle actin (α-SMA) antibody.Methodology:Forty cases each of WDOSCC, MDOSCC, PDOSCC and healthy controls were included. 4-μm thick sections from each tissue sample were stained with routine hematoxylin and eosin as well as immunohistochemically using α-SMA. Among different grades of OSCC, expression of MFs was compared. All the results were subjected to statistical analysis.Results:While comparing the expression of MFs in between different grades of OSCC, nonsignificant results were obtained. While comparing the expression of MF in between OSCC cases and normal controls, significant results were obtained.Conclusion:MFs are one of the vital pathogenetic components in OSCC cases in predicting their invasive behaviors. We advocate the use of MFs as a stromal marker for visualizing invasion and progression in OSCC patients.

Expression of syndecan-1 in different grades of oral squamous cell carcinoma: An immunohistochemical study.

Syndecans are a family of transmembrane proteins, belonging to heparin sulphate proteoglycan family and are localized entirely to the epithelial cells with the stratified squamous epithelia. They are involved in cell-cell adhesion and interaction with the extracellular matrix and play a critical role in cell growth, differentiation, cell morphology, and migration. The down regulation of syndecan-1 indicates loss of cellular adhesion and possibility of invasion. The present study is aimed to evaluate the difference in immunohistochemical expression of syndecan-1 in different grades of oral squamous cell carcinoma (OSCC) patients and control group. The present study consists of 42 cases of paraffin-embedded tissue sections of OSCC; 14 well differentiated, 14 moderately differentiated, and 14 poorly differentiated. As a control, 10 paraffin-embedded tissue sections of unaffected oral mucosa were used. The sections were stained for immunohistochemical expression of syndecan -1. The intensity of staining was scored. The immunohistochemistry scores for each sample were obtained by Tissue Quant software. Statistical analysis revealed that there was a significant decrease in intensity of staining between normal and different grades of OSCC. This study shows that as cellular differentiation was lost, syndecan-1 expression was less. This provides an insight and understanding of the pathophysiology of the invasive process of OSCC and helps in establishing the prognostic link.

CD44 related stemness maneuvers oral squamous cell carcinoma biology.

Despite the commendable advancements in oral squamous cell carcinoma (OSCC) diagnostics and therapeutics, it remains a considerable medical challenge. Recent evidence suggests that small populations of stem-like cancer cells are responsible for tumor initiation, progression and metastasis. These cancer stem cells (CSCs) have been identified and characterized in various types of cancers, including OSCCs. CSC hypothesis has been supported by the expression of CD44, CD133, ALDH1 and ABCG2. Amongst them, CD44 (a transmembrane glycoprotein), is the most reported CSC marker in OSCCs. The increasing incidence of OSCC combined with its poor survival rates motivates a need for research into the expression of adhesion molecules and may play a pivotal role in studying tumor biology related to invasion and distant metastasis. To quantify the expression of CD44 in the different grades of OSCC and to correlate the expression of CD44 with clinicopathological parameters. A total of 20 formalin-fixed paraffin-embedded tissues of OSCC were retrieved from department archives. Immunohistochemical staining was performed using anti-CD44 antibody (Biogenex). The expression was assessed semi-quantitatively in varying histopathological grades of OSCC and were correlated with tumor, node, metastasis (TNM) staging which were obtained from the department records. The results were statistically evaluated. Overexpression of CD44 was detected in 48% of well-differentiated OSCCs followed by a linear decrease in moderately differentiated and poorly differentiated OSCCs and the expression correlated with the tumor size (T) in 23% cases and with lymph node metastases (N) in 42% of cases (P ≤0.05). The results of the present study suggested an altered expression of CD44 in OSCC. This depicts an association of CD44 with tumor aggressiveness and Epithelial Mesenchymal Transition (EMT) related to loss of cell adhesion in a subset of OSCC-clearly stating tumor cell stemness as a key factor in malignant potential of OSCC.

Evaluation of e-cadherin and vimentin expression for different grades of oral epithelial dysplasia and oral squamous cell carcinoma - An immunohistochemical study.

Background:Oral cancer is the 11thcommon cancer in the world and ranks 6thglobally in deaths. The incidence of oral cancer in India accounts for approximately 30%–40% of all cancers.Aims and Objective:The present study was undertaken to evaluate the expression of Vimentin and E-cadherin in different grades of oral epithelial dysplasias (OEDs) and oral squamous cell carcinoma (OSCC).Materials and Methods:Biopsies/blocks of oral cavity lesions were retrieved from the archives of the department. Normal oral mucosa (5 cases), oral epithelial dysplastic (60 cases) and different grades of OSCC (60 cases) evaluated by hematoxylin and eosin sections. Immunohistochemical analysis was done on the blocks and expression of E-cadherin and Vimentin was recorded.Results:Our study included various grades of OED, OSCC and normal mucosa as control cases. The mean age of OED and OSCC was 49 and 56 years, respectively, with male predominance. Tobacco habit was present in approximately 90% cases, and buccal mucosa was the most commonly involved site in oral cavity with whitish patch and ulceroproliferative lesions being the common clinical presentations respectively. In OED, downregulation and altered localization of e-cadherin (81.6%) and increased expression of vimentin (52.3%) along with their concurrent increase in the stroma represent epithelial mesenchymal transition. In OSCC, reduction in expression (<50%) for e-cadherin (56.6%) with altered localization for e-cadherin was seen in 88.3% of OSCC along with neoexpression of vimentin in the epithelial cells was seen in 68.3% suggestive of mesenchymal phenotypic modification (P = 0.05).Conclusion:It is very crucial to evaluate the invasiveness of dysplasia and tumor with specific molecular biomarker that may help in early prediction of malignancy and also guide in deciding best treatment strategy for established cases of malignancy.

Iron deficiency and risk of oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is a subset of head and neck squamous cell carcinoma caused by excessive substance abuse like alcohol, tobacco etc. Objectives: Aim of the present study was to evaluate the iron expression in different grades of OSCC and potential of iron staining as a prognostic marker and its importance as an essential nutrient in diet. Methods and Patients: It was a cross sectional study. A total of 40 oral biopsies were evaluated and the mean age of patients was 53.5 years with age range 23-80 years. 14 cases were well differentiated, 14 moderately differentiated and there were 12 poorly differentiated case. Iron staining was performed for all these cases. Results: Iron positivity was observed in 11 (27.5%) of OSCC patients with maximum iron positivity in well differentiated group (64.28%) of age range 20-40 years (70%). More patients had tongue as site of cancer. There was no genderwise difference in iron expression. Iron deficiency was associated with poor prognosis indicating iron as an important nutrient which can prevent OSCC if adequately present in our routine diet. Conclusions: Prevalence of iron positivity in young patients and initial stage of OSCC, indicates the protective effect of iron against oral squamous cell carcinoma

IMMUNOHISTOCHEMICAL EXPRESSION OF P53 AND CYCLIN D1 IN SQUAMOUS CELL CARCINOMAAND EPITHELIAL HYPERPLASIA OF ORAL MUCOSA.

Oral cancer is among the top three types of cancers in India. Most invasive oral carcinomas are preceded by a pre-invasive stage, that may last for many years. . Understanding the molecular mechanisms involved in the initiation and progression to malignancy of oral cancer will help to improve its prognosis and in the elaboration of new forms of treatment. The most common genetic alterations, include gene amplication and overexpression of oncogenes such as myc, erbB-2, Epidermal Growth Factor Receptor (EGFR), Cyclin D1 and mutations, deletions and hypermethylation leading to p16 and p53 tumor suppressor gene inactivation. There still remains the problem of differentiating epitheliomatous hyperplasia from squamous cell carcinoma (SCC) especially on biopsies. AIMS: 1. To study and evaluate the expression of p53 and Cyclin D1 in oral SCC and epithelial hyperplasia. 2. To correlate the expression of p53 and Cyclin D1 in different grades of oral SCC. SETTINGS AND DESIGN:Cross-sectional study conducted over a period of 18 months. METHODS AND MATERIAL: 30 cases (n=30) of oral squamous cell carcinoma &amp; 30 cases (n=30) of epithelial hyperplasia diagnosed on H &amp; E were included in this study. All these cases of oral SCC were further classied into different histological grades according to BRODERS' HISTOLOGICALGRADE. STATISTICAL ANALYSIS: The data was collected and the association between different groups was analysed by using Chi square test and quantitative variables were compared using Independent Ttest/Mann-Whitney Test (when the data sets were not normally distributed) between the two groups and ANOVA/Kruskal Wallis test between three groups. Ap value of ≤0.05 was considered statistically signicant. RESULTS: There was a signicant increase in the expression of p53 in oral SCC compared to epithelial hyperplasia. The results were statistically signicant (p value &lt;0.0001). Similarly , Cyclin D1 also showed an increased expression in cases of SCC in contrast to epithelial hyperplasia (p value &lt;0.0001). The expression of p53 signicantly increased with increase in grade of the tumor. The results being statistically signicant, p value=0.004. Similarly, poorly and moderately differentiated SCC also showed an increased expression of Cyclin D1 compared to well differentiated SCC (p value=0.03, statistically signicant). CONCLUSION: Thus the author concludes that the expression of both p53 and Cyclin D1 is increased in oral SCC compared to epithelial hyperplasia of oral mucosa and these markers can be used to differentiate between these two lesion especially on biopsy cases.

Tissue eosinophils in different grades of oral squamous cell carcinoma – A special stain (carbol chromotrope) study

Background: In recent days, tissue eosinophils are considered to have more impetus role in the biological behavior of various tumors. Compared to routine hematoxylin and eosin stain, the special stains such as carbol chromotrope for eosinophils are considered to be more specific and definitive for its evaluation in routine histopathology. Aim: This study aims to evaluate and compare the infiltration of tissue eosinophils in different grades of oral squamous cell carcinoma (OSCC) using a special stain – carbol chromotrope and to investigate the prognostic role of tissue eosinophils in OSCC. Methodology: The study was carried out with the sample size of fifty histopathologically diagnosed cases of OSCC, of which twenty cases were well differentiated, twenty cases were moderately differentiated, and ten cases were poorly differentiated, and comparison of infiltration of tissue eosinophils in the different grades of OSCC was done using special stain. The tissue sections were stained with carbol chromotrope special stain. Results: In the present study, more number of tissue eosinophils were seen in well-differentiated OSCC cases than the moderately and poorly differentiated OSCC cases, and the analysis of variance test showed P

Relative Expression of SOX2 and OCT4 in Oral Squamous Cell Carcinoma and Oral Epithelial Dysplasia.

Over 90% of oral cancers including oral squamous cell carcinoma (OSCC), originate from the oral cavity epithelium. Early detection for this lesion is as important. Evaluating cancer stem cell markers can improve the accuracy of early diagnosis, and be used as an OSCC prognostic indicator. We aimed to evaluate SOX2 and OCT4 gene expression among different grades of OSCC and oral epithelial dysplasia (OED) lesions. Sixty samples that contains 45 OSCC and 15 OED samples were retrieved from the pathology department archives at the dental school of Mashhad. Demographic and pathological patient data including the tumor stage and tumor grade were assessed. Finally, SOX2 and OCT4 expression was examined using qRT-PCR. There was a significant difference in SOX2 and OCT4 expression between OSCC and OED samples (p< 0.001). The mean expression of SOX2 and OCT4 in OSCC samples were significantly higher than in the OED group (p< 0.001). The mean expression of SOX2 and OCT4 was higher in grade II and grade III OSCC compared to grade I. There was no significant relationship between the gene expression of SOX2 or OCT4 to the demographic, site and stage of tumors. The correlation between SOX2 and OCT4 expression (p= 0.001) was significant in grade III OSCC specimens compared to other grades (p= 0.005, r= 0.68). The increased expression of SOX2 and OCT4 in higher grades and the significant correlation of these genes with each other among OSCC specimens could suggest the role of SOX2 or OCT4 in oral mucosal carcinogenesis.