Tumor-associated Tissue Eosinophilia Research Articles

Eosinophils: An imperative histopathological prognostic indicator for oral squamous cell carcinoma.

Background:Inflammation in tumor microenvironment assists in both promotion and growth of tumor. Tumor-associated tissue eosinophilia (TATE) is the term used when eosinophils are observed in a tumor tissue with inflammatory infiltrate. Although carcinogenesis with inflammation is one of the important hallmarks, the exact role of eosinophils remains unclear. Various studies on oral squamous cell carcinoma (OSCC) that focused on eosinophils reported both favorable and unfavorable prognosis in cancer tissue, because of which the exact function of eosinophils still remains uncertain.Aims and Objectives:The present study aims at identifying the role of TATE in OSCC and in malignant transformation of oral epithelial dysplasia (OED).Materials and Methods:The study includes 70 samples that divided into two groups, of which 50 histopathologically proven cases of different grades of OSCC and 20 cases of OED (oral leukoplakia). Congo red stain was used to stain the tissue sections. Each slide was viewed under high power in 10 consecutive microscopic fields for counting of eosinophils.Results:Statistical analysis of values obtained was done using ANOVA, unpaired t-test and Mann–Whitney test. The results were statistically significant (P < 0.05) with a mean total eosinophil count of 2.12 in OED and 4.31 in OSCC.Conclusion:The present study showed higher eosinophil counts in OSCC when compared to dysplasia which should prompt for a thorough evaluation of tumor front for invasiveness. Therefore, tissue eosinophil count may be used as an adjunct to predict the malignant transformation of dysplastic lesions to OSCC.

Особенности секреции ростовых факторов эозинофильными гранулоцитами крови при раке желудка и толстого кишечника с тканевой эозинофилией

We analyzed in vitro secretion of growth factors (TGFβ1, VEGF, and EGF) by peripheral blood eosinophil granulocytes in patients with gastric and colon cancer according to the presence of tumor-associated tissue eosinophilia. In gastrointestinal cancer with tissue eosinophilia, an increase in basal in vitro secretion of TGFβ1 and VEGF (in gastric cancer) was detected, while basal eosinophil-derived EGF production in gastric and colon cancer did not differ significantly from that in the comparison group (without tissue eosinophilia). Additionally, it was shown that in patients with gastric cancer and colon cancer, regardless of the presence of tissue eosinophilia, the levels of basal and r-IL-5-induced secretion of TGFβ1, VEGF, and EGF by eosinophil granulocytes in vitro were comparable. An absence of the secretory response of eosinophils to cytokine stimulation (by r-IL-5) indicates a decrease in the functional reactivity of the cells.

Opposing roles of eosinophils in cancer.

Eosinophils are a subset of granulocytes mostly known for their ability to combat parasites and induce allergy. Although they were described to be related to cancer more than 100years ago, their role in tumors is still undefined. Recent observations revealed that they display regulatory functions towards other immune cell subsets in the tumor microenvironment or direct cytotoxic functions against tumor cells, leading to either antitumor or protumor effects. This paradoxical role of eosinophils was suggested to be dependent on the different factors in the TME. In addition, the clinical relevance of these cells has been recently addressed. In most cases, the accumulation of eosinophils both in the tumor tissue, called tumor-associated tissue eosinophilia, and in the peripheral blood were reported to be prognostic markers for a better outcome of cancer patients. In immunotherapy of cancer, particularly in therapy with immune checkpoint inhibitors, eosinophils were even shown to be a potential predictive marker for a beneficial clinical response. A better understanding of their role in cancer progression will help to establish them as prognostic and predictive markers and to design strategies for targeting eosinophils.

Quantitative Analysis of Tumor-associated Tissue Eosinophilia in Recurring Bladder Cancer.

The relatively high incidence of recurrence of bladder cancer is a serious problem in clinical practice. At present, there are no objective microscopic criteria for evaluation of the tendency for local relapse. Besides the phenotypic properties of the tumor parenchymal cells, possible signs in regard to recurrence could also be derived from the peculiarities of the tumor stroma. The stromal reaction, manifested by inflammatory infiltration in the tumor is considered to influence the biological behavior of tumors. Also, a relationship has been reported between the number of eosinophils and the survival of patients. The aim of the present study is to analyze tumor-associated tissue eosinophilia (TATE) and to compare TATE density in the initial foci of age and gender-matched 156 cases of recurrent and non-recurrent bladder cancers; the tumors that have relapsed within six months after removal and contained statistically significant greater numbers of eosinophils in primary cancer sites. These results suggest that TATE may be one of the probable prognostic signs for local relapse of urothelial cancer.

Clinical Implications of Tumor-Associated Tissue Eosinophilia in Tongue Squamous Cell Carcinoma.

The role of tumor-associated tissue eosinophilia (TATE) in oral cavity cancer remains quite controversial. This study investigated the potential role of TATE in tongue squamous cell carcinoma (TSCC). Retrospective case series. This study retrospectively enrolled 259 consecutive TSCC patients who underwent surgery between July 2004 and December 2015. Histopathological examinations for TATE in TSCC tumors were reviewed, and the association of TATE with different clinicopathological factors was evaluated. A nomogram was generated based on several major clinicopathological factors and TATE to improve the accuracy of prognostic prediction. Higher levels of TATE were significantly associated with male sex, alcohol consumption, cigarette smoking, higher pT classification, advanced disease stage, and tumor depth (P = .006, .003, .024, .041, .013 and .006, respectively). Our results indicated that extranodal extension, cell differentiation, and TATE were independent predictors of overall survival (P < .001, .004, and .032, respectively) and disease-free survival (P < .001, .012, and .013, respectively). TATE levels significantly correlated with circulating eosinophils (r = 0.139, P = .040), and the c-index of our nomogram foroverall survival was 0.786, which demonstrates better accuracy in prognosis prediction than the TNM stage only (c-index = 0.738). Higher levels of TATE were associated with several clinicopathological factors and poorer survival rates, and a nomogram incorporating TATE levels may strengthen the prediction accuracy of prognosis in TSCC patients. 4 Laryngoscope, 129:1123-1129, 2019.

New Insights Into the Role of Tissue Eosinophils in the Progression of Colorectal Cancer: A Literature Review

Amongst the inflammatory cells implicated in the immune surveillance of colorectal cancer, a growing body of evidencesuggests a role for eosinophils in carcinogenesis. We aimed to review the value of tumour-associated tissue eosinophilia (TATE) in theprognosis of colorectal cancer emphasizing the identification and measurement of tissue-infiltrating eosinophils and their associationwith the clinicopathological features of the disease. We used PubMed and Web of Science search engines to retrieve studies that looked at the associationbetween tissue eosinophils and colorectal cancer prognosis. We selected 15 studies for our review. In the majority of the studies, eosinophils were identified in hematoxylin-eosin stainedsections and scores were generated for analysis. Most of the studies pointed to tumour-associated tissue eosinophilia as a favourableprognostic marker in colorectal cancer and found an inverse association between eosinophil count and the metastatic potential ofthese neoplasms. The association between tumour-associated tissue eosinophilia and established prognostic markers of colorectalcancer was assessed in some studies, with inconsistent results. Additionally, tumour-associated tissue eosinophilia decreased with theadenoma-carcinoma progression of colorectal lesions. Several mechanisms have been proposed regarding eosinophil chemoatraction to tumour tissues and eosinophil-cancercell cross-talk, suggesting that eosinophils are actively involved in colorectal cancer progression. Although a scoring system is stilllacking, tumour-associated tissue eosinophilia meets the criteria of a convenient histopathological prognosticator in colorectal cancer. Collectively, current evidence associates the presence of eosinophils in the colorectal cancer microenvironment with themodulation of tumour progression. The clinical impact of this finding deserves future research.

Eosinophil infiltrates in astrocytic tumors

Eosinophils may affect each stage of tumor development. The presence of eosinophils appears to correlate with longer patient survival in several non-CNS malignant tumors. Tumor-associated tissue eosinophilia (TATE) has been increasingly recognized. Two previous studies (Hayes RL, et al. 1995; 2001) revealed eosinophils in the intracavitary tissues of malignant gliomas following the infusion of IL-2 combined with activated autologous killer cells, but not in the primary operative specimens. Our recent study (Lu JQ, et al. 2014) demonstrated the infiltration of eosinophils in 19 of 44 pilocytic astrocytomas but not in 10 ependymomas. In the present study, we examined 7 cases of subependymal giant cell astrocytoma (SEGA; 4 with tuberous sclerosis; age range: 13 – 33 years; 4 males and 3 females), as SEGA is well known to contain infiltrating mast cells and lymphocytes. Five of 7 SEGA contained eosinophils that were focally scattered to rare in frequency; intratumoral and/or perivascular in location. In comparison, only one of 8 consecutive cases of glioblastoma showed infiltrating eosinophils. The incidence of TATE is significantly higher in SEGA than that in glioblastoma (71.4 % versus 12.5%; p=0.04, by Fisher’s exact test) but is not significantly different from that in pilocytic astrocytoma (71.4 % versus 43.2%, previously reported; p=0.232). Our findings support the concept that eosinophils may play a functional role in the development of astrocytic tumors, especially those with longer patient survival.

Eosinophilia is a favorable prognostic marker for oral cavity and lip squamous cell carcinoma.

Eosinophils are frequently encountered with squamous cell carcinomas (SCC) and it has been proposed that tumor-associated tissue eosinophilia (TATE) could be of prognostic significance in oral SCC. The aim was to evaluate TATE in 83 oral cavity and 16 lip SCCs as well as the best possible use of TATE as a prognostic marker. The number of eosinophils was counted per high power fields (HPF, ×400) in three different representative areas of the tumor and its stroma. The degree of TATE was analyzed in relation to clinicopathological features of tumors and patients' survival (follow-up mean 40.7months) using Fisher's exact test. TATE was detected in 58 (70%) oral and 8 (50%) lip SCC samples. The median number of eosinophils between oral and lip SCC was different (p=0.028) but TATE was similar per HPF (p=0.085). Totally, 6% of lip and 21% of oral SCC patients died during the follow-up. The patients with the higher TATE had significantly better survival than the patients with the lower TATE (p=0.0136). The best cut-off value predicting the survival was 4 eosinophils/HPF. TATE is a prognostic marker for oral and lip SCC: more than 4 eosinophils/HPF may predict more favorable prognosis.

Evaluation of Tumor-associated Tissue Eosinophilia in Different Stages of Oral Squamous Cell Carcinoma using Special Stains: Anin vitroHistopathological Study

To evaluate the tissue eosinophilia in different stages and grades of oral squamous cell carcinoma (OSCC) and correlate its possible role as a prognosticator in primary OSCC using special stains like Congo red and carbol chromotrope. Forty-five intraoral histopathologi-cally proven cases of OSCC were selected (15 cases each of well-differentiated squamous cell carcinoma (WDSCC), moderately differentiated squamous cell carcinoma (MDSCC), and poorly differentiated squamous cell carcinoma (PDSCC)). Three sections of 4 pm were taken for each case. All slides were stained using routine stain, i.e., hematoxylin and eosin (H&E), and special stains, i.e., carbol chromotrope and Congo red respectively, for studying tissue eosinophils in all these groups. Histopathological evaluation was performed on paraffin sections for calculating the quantitative eosinophil distribution by two separate observers who were blinded to clinical and histopathological data. Tumor-associated tissue eosinophilia (TATE) was calculated using the density method. An increase in the degree of TATE from stage I to stage IV suggested that elevated tissue eosinophilia was seen with an increasing size of primary tumor. Also an increase in TATE was observed with an increasing grade of OSCC. Chromotrope stain was found to be a much better and more specific stain for eosinophils, and gave more accurate eosinophil count compared with H&E and Congo red. The findings of the present study highlight the significance of eosinophil counting and that it can be used as an additional morphological parameter in the grading of OSCC which can also be included in the biopsy report.

Quantitative assessment of tumor-associated tissue eosinophilia and mast cells in tumor proper and lymph nodes of oral squamous cell carcinoma.

Background:Oral squamous cell carcinoma (OSCC) is the most common cancer of the oral cavity. Tumor stage, thickness, lymph node metastasis (LNM), extranodal spread, perineural invasion, tumor differentiation, mutations, human papillomavirus infection and tumor microenvironment are independent prognostic indicators of OSCC. However, clinically, among all factors, LNM is considered an important prognostic factor in OSCC as it not only determines the stage of disease but also the strongest independent factor which predicts recurrence of disease. Further research proves that there are several biologically important factors in tumor tissue and LNs which promote or defend LNM. While it is proposed that tumor-associated tissue eosinophils (TATE) and mast cells (MCs) have “immuno-protective” effect, this remains unproven and various researchers have conflicting opinion.Aim:The aim is to determine the presence of TATE and MCs in OSCC and to evaluate if any association exists between them and LNM.Study Design:It is a comparative retrospective study between two groups including 35 OSCC cases positive and 35 negative for LNM.Materials and Methodology:Quantification of cells was done by counting total number of cells in 10 high-power fields under ×40 objective lens using “zigzag” method and dividing it by total number of fields. Eosinophils stained bright red with carbol chromotrope and MCs purple-violet with toluidine blue.Statistics:Independent t-test and Pearson's correlation were done using STATA IC 0.2 software. The level of significance was at 5%. Comparison of eosinophil and MC infiltration was done based on gender, metastatic, nonmetastatic LN and in tumor proper.Results and Conclusion:Our study showed weak positive correlation between mean eosinophils count in tumor and LNs which implies a definite association between the microenvironment of tumor, its progression and LNM. There was a significant association between MC density and decreased LNM also. We conclude that an increased number of immunological cells (TATE and MCs) are a favorable prognostic indicator in OSCC. There is evidence of reduction in LNM with increasing density of these immunological cells. Recognition of TATE and MCs as integral to tumor biology opens an avenue for novel approaches to cancer therapies.

Quantitative assessment of tumor-associated tissue eosinophilia and mast cells in tumor proper and lymph nodes of oral squamous cell carcinoma.

Background:Oral squamous cell carcinoma (OSCC) is the most common cancer of oral cavity. Tumor stage, thickness, lymph node metastasis (LNM), extranodal spread, perineural invasion, tumor differentiation, mutations, human papillomavirus infection, and tumor microenvironment are independent prognostic indicators of OSCC. However, clinically, among all factors, LNM is considered an important prognostic factor in OSCC as it not only determines the stage of disease but also the strongest independent factor which predicts recurrence of disease. Further research proves that there are several biologically important factors in tumor tissue and LNs which promote or defend LNM. While it is proposed that tumor-associated tissue eosinophils (TATE) and mast cells (MCs) have “immuno-protective” effect, this remains unproven and various researchers have conflicting opinion.Aim:The aim is to determine the presence of TATE and MCs in OSCC and to evaluate if any association exists between them and LNM.Study Design:It is a comparative-retrospective study between 2 groups including 35 OSCC cases positive and 35 negative for LNM.Materials and Methodology:Quantification of cells was done by counting total number of cells in 10 high-power fields under ×40 objective lens using “zigzag” method and dividing it by total number of fields. Eosinophils stained bright red with carbol chromotrope and MCs purple-violet with toluidine blue.Statistics:Independent t-test and Pearson's correlation were done using STATA IC 0.2 software. Level of significance was at 5%. Comparison of eosinophil and MC infiltration was done based on gender, metastatic, nonmetastatic LN, and in tumor proper.Results and Conclusion:This study showed weak positive correlation between mean eosinophils count in tumor and LNs. Recognition of TATE and MCs as integral to tumor biology opens an avenue for novel approaches to cancer therapies. We conclude that an increased number of immunological cells are a favorable prognostic indicator in OSCC.

Tumor associated tissue eosinophilia: a case report with review

&lt;p class="abstract"&gt;&lt;span lang="EN-IN"&gt;Cancer is one of the most deadly diseases. Even today a lot of research is going on to understand the various aspects of this neoplasm in order to improve the treatment modalities and thus the life of the affected. The role of tumor associated tissue eosinophilia (TATE) has gained much impetus as it is believed to play important role in the biological behavior of the tumor. There are contradictory reports with respect to malignancy and hence its functional role remains ambiguous. We report a case of oral squamous cell carcinoma (OSCC) with TATE and review of literature of the same. A 58 year old female patient presented with a shallow ulcer on the palate. On clinical examination, left submandibular lymph nodes were enlarged and tender on palpation with slightly raised surface temperature. Fine needle aspiration cytology from submandibular lymph nodes was suggestive of squamous cell carcinoma. Incisional biopsy from ulcer confirmed the diagnosis of moderately differentiated squamous cell carcinoma, with the striking feature of tissue eosinophilia. Haematological investigations revealed differential &amp;amp; absolute eosinophil count which was not significant. The review of literature revealed contradictory findings with respect to TATE as a prognostic factor in OSCC patients. It has been found to have a favourable, a poorer or even no influence on patient’s outcome, thus remaining a matter of controversy.&lt;/span&gt;&lt;/p&gt;

Механизмы формирования опухолеассоциированной тканевой эозинофилии при раке желудка и толстой кишки

Опухолеассоциированная тканевая эозинофилия определяется как эозинофильная инфильтрация стромы опухоли. Эта реакция, как полагают, играет важную роль в канцерогенезе. Считается, что эозинофилы обладают противоопухолевой активностью за счет высвобождения цитотоксических белков. Цель исследования - изучение молекулярно-генетических механизмов формирования опухолеассоциированной тканевой эозинофилии у больных раком желудка и толстой кишки. Методика. Материалом исследования служили образцы опухолевой ткани пациентов с диагнозом рак желудка или толстой кишки . Подсчитывали количество эозинофилов, инфильтрирующих опухолевую ткань, а также оценивали экспрессию эотаксина-1 (ключевого фактора хемотаксиса эозинофилов) и его рецептора CCR3 в опухолевой ткани методом иммуногистохимии. Было изучено распределение полиморфных вариантов генов CCL11 (А384G) , CCR3 (T51С) , IL5 (С703Т) и IL5R (G80А) . Геномную ДНК выделяли из образцов опухолевой ткани. Генотипирование образцов ДНК по полиморфизмам генов осуществляли путем ПДРФ-анализа продуктов ПЦР-амплификации специфических участков генома с последующей визуализацией в ультрафиолетовом свете. Результаты. Показана более высокая экспрессия эотаксина-1 и CCR3 в ткани опухоли при раке желудка и толстой кишки, ассоциированном с эозинофилией. Установлена ассоциация эозинофильной инфильтрации опухолевой ткани с носительством генотипа СС и аллеля С полиморфизма T51С гена CCR3 и генотипа СС и аллеля С полиморфизма С703Т гена IL5 . Заключение. Формирование опухолеассоциированной тканевой эозинофилии при раке желудка и толстой кишки опосредованно действием эотаксина-1 и его рецептора. Результаты молекулярно-генетического исследования указывают на генетически детерминированный характер эозинофилии при раке желудка и толстой кишки. Tumor-associated tissue eosinophilia is defined as eosinophilic stromal infiltration of a tumor. Tumor-associated tissue eosinophilia is believed to play a significant role in carcinogenesis. It is believed that eosinophils have antitumor activity due to the release of cytotoxic proteins. The aim of this study was to investigate the molecular-genetic mechanisms of formation of tumor-associated tissue eosinophilia in patients with gastric cancer and colon cancer. Methods. Tumor tissue samples from patients with gastric cancer and colon cancer were reviewed. We counted the number of infiltrating eosinophils in neoplastic lesion tissue and we evaluated the expression of eotaxin-1 (a key factor of chemotaxis of eosinophils) and its receptor CCR3 in tumor tissue by immunohistochemical staining. The distribution of polymorphic variants of genes CCL11 (А384G), CCR3 (Т51С), IL5 (С703Т) and of the IL5R (G80А) was studied. DNA was isolated from tumor tissue samples. Genotyping of polymorphisms was carried out by polymerase chain reaction (PCR), followed by digestion with the appropriate restriction enzyme (PCR-RFLP) and agarose-gel electrophoresis. Results. It is shown that higher expression eotaxin-1 and CCR3 is determined in the tumor tissue of gastric cancer and colon cancer associated with eosinophilia. It is established that eosinophilic infiltration of the tumor tissue is associated with the carriers of CC genotype and C allele of the gene CCR3 (Т51С) and CC genotype and C allele of gene IL5 (С703Т) . Conclusion. The formation of tumor-associated tissue eosinophilia in gastric cancer and colon cancer is mediated through the action eotaxin-1 and its receptor. The results of molecular-genetic studies indicate a genetically determined character of eosinophilia in gastric cancer and colon cancer.

The significance of eosinophils in predicting the severity of acute ischemic stroke.

BackgroundPrevious studies have shown that tumor-associated tissue eosinophilia have a role in various types of solid tumors. However, the relationship between eosinophil and acute ischemic stroke (AIS) is unclear. We aimed to investigate the diagnostic significance of eosinophil in AIS patients.MethodsThis study included 300 AIS patients without hypereosinophilic syndrome (HES). The hematologic indices were collected from each patient, including white blood count, eosinophil count, eosinophil percentage, neutrophil count, red blood count, and platelet. The severity of AIS was estimated by national institute of health stroke scale (NIHSS). Logistic regression analyses were performed to confirm the biomarkers for NIHSS and in-hospital non-death among the cases. Moreover, receiver-operating characteristics (ROC) analyses were used to investigate the clinical performances of eosinophils and NIHSS in prediction of non-death.ResultsThe admission NIHSS (P<0.001) and BMI (P<0.001) were predictors to the non-death of the patients. There was a significant correlation between eosinophil counts or eosinophil percentage and NIHSS score (r= -0.451, P < 0.001; r= -0.617, P<0.001, Spearson Correlation). ROC analysis showed that eosinophil counts and eosinophil percentage could predict non-death of the patients in-hospital, with the areas under the curves (AUC) of 0.791 and 0.867, respectively.ConclusionsOur study revealed a relationship between eosinophil and NIHSS score in the patients with AIS. Eosinophils might have certain value for predicting the severity of AIS.

The Impact of Peritumoral Retraction Clefting & Intratumoral Eosinophils on Overall Survival in Oral Squamous Carcinoma Patients.

This retrospective study aimed to investigate the impact of peritumoral retraction clefts (RC) and tumor-associated tissue eosinophilia (TATE) as predictors of overall survival (OS) in oral squamous cell carcinoma (OSCC) patients. Their relationships with tumor-factors were also examined. Eighty-seven OSCC cases (pTNM: I+II/III+IV; 32/55), post-curative surgery, comprised the study cohort. Three observers independently estimated the percent RC semi-quantitatively in the selected tumor sections. Additionally, stromal eosinophils were counted in ten consecutive high-power fields of intratumoral and peritumoral regions to evaluate the corresponding TATE. The percent RC ranged between 0% -90% (Mean±SD: 16±24%; Median: 5%). The stromal eosinophils were greater in peritumoral as compared to intratumoral region. The events of death and tumor recurrence were reached in 16 (18.4%) and 36 (41%) cases respectively. The 3-years OS was 69% [Median OS: 1880days; Mean follow up: 471(Range; 36-1880) days]. Increased percent RC exhibited relationship with pathologic stage (pTNM III&IV), primary tumor (pT III&IV), tumor depth>4mm and categorical tumor recurrence. Additionally, peritumoral eosinophilic infiltrates increased with increasing tumor depths and muscle invasion. Kaplan-Meier curves revealed significantly reduced OS in OSCC cases exhibiting: increased percent RC (>2.5%), mild -moderate/absent intratumoral TATE (versus intense TATE) or categorical tumor recurrence. In subsequent multivariate tests, all the three variables retained significance. Additionally, intraclass correlation coefficient demonstrated acceptable internal consistency for the observers who estimated percent RC. In conclusion, RC and intratumoral TATE proved to be independent predictors of OS in our OSCC cohort. Additionally, increased percent RC pointed towards aggressive tumor behaviour.

Evaluation of Tumour Associated Tissue Eosinophilia and Other Histomorphological Variants as Markers of Metastasis in Squamous Cell Carcinomas

Evaluation of Tumour Associated Tissue Eosinophilia and Other Histomorphological Variants as Markers of Metastasis in Squamous Cell Carcinomas

Assessment of role of eosinophils in the progression of tongue carcinoma

Background: Tumor associated tissue eosinophilia (TATE) is known as stromal infiltration of eosinophils in the stroma of tumor not associated with tumor necrosis or ulceration. It has been described in a variety of neoplasms, but the role in oral squamous cell carcinoma (OSCC) of tongue has not yet been clearly defined. Association of TATE with OSCC has shown variable results ranging from favorable to unfavorable or even no influence on prognosis.Aims and Objectives: The aim of the present study was to correlate TATE with histopathological grades, lymph node status, tumor thickness and nature of tumor cells at the invasive front in OSCC of tongue.Material and Methods: Retrospectively fifty six cases of OSCC of tongue treated with radical neck dissection were included, which were divided into Group I consists 22 cases (lymph node with metastasis) &amp; Group II consists 34 cases (lymph node without metastasis). H &amp; E stained sections were used to analyze TATE and compared with histopathological grades, lymph node status, tumor thickness and nature of invasive front. Statistical analysis was done using Chi-square test.Results: TATE did not have any significant association with histopathological grades, lymph node status and nature of tumor cells at invasive front. But, tumor thickness and presence of eosinophils showed significant association. Also as the tumor thickness increased, the cells were more discohesive at the invasive front region.Conclusion: Microenvironment of tumor significantly contributes in the tumor progression. Tumor thickness, nature of tumor cells at the invasive front and TATE together can help in assessing the behavior of tongue squamous cell carcinoma.Asian Journal of Medical Sciences Vol.7(5) 2016 17-21

Severe eosinophilia associated with cholangiocarcinoma.

It is widely recognized that eosinophils are found in tumor infiltrates and that their mechanism of action is associated with particular symptoms and prognosis. However, the causes of and reasons for this process remain unclear, as does the exact mechanism by which it occurs. We report on the case of a 71-year-old woman with cholangiocellar carcinoma (CCC) with a marked eosinophilia. When the patient presented at the hospital, she said she was suffering from fatigue, depression, and pain. That triad of symptoms, indicative of peripheral eosinophilia (TABE, or tumor-associated blood eosinophilia) and tissue eosinophilia (TATE, or tumor-associated tissue eosinophilia), are recurrent in oncology. We also conducted a structured review of literature on eosinophilia associated with biliary tumors to try to answer 3 questions: Is eosinophilia (TABE or TATE) associated with solid tumors, with particular reference to the tumor of the bile duct? Is eosinophilia in biliary tumors associated with specific symptoms? Does eosinophilia (TABE or TATE) predict a specific prognosis?

Tumour-Associated Tissue Eosinophilia in Oral Squamous Cell Carcinoma- A Boon or a Bane?

The infiltration of tumour stroma by eosinophils, Tumour-Associated Tissue Eosinophilia (TATE) is known to modulate the evolution of Oral Squamous Cell Carcinoma (OSCC). Identification of eosinophils in the inflammatory stroma has been proven to be an important factor in prognostication of malignant tumours including cancers of mouth, oesophagus, larynx, pharynx, breast, lung, intestine and genitourinary tract. Our study aimed to assess the role of TATE as a prognosticator in OSCC as visualized by Haematoxylin and Eosin (H&E) and congo red staining. Thirty histologically-proven cases of OSCC were retrieved from the archives of Department of Oral Pathology, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka, India. Two serial sections of 4μm thickness were made and subjected to routine staining with H&E and modified congo red staining, where eosinophil granules stained red and nuclei stained blue. In 40x magnification, 10 HPF at invasive tumour front were assessed for counting eosinophils by placing a 49 square grid (measuring 0.0289 sq mm). The TATE was compared with the prognosticators using Mann-Whitney U-test. The grades of carcinoma were correlated with TATE using Kruskal-Wallis test followed by Post-hoc Bonferronis correction. Agreement of the number of eosinophils counted in the two staining techniques (H&E and Congo red) in OSCC was achieved using interclass correlation coefficient, and Friedman's test. A value of p< 0.05 was considered statistically significant. Our results showed that tissue eosinophil counts were higher in well-differentiated cases of OSCC, cases with lymph node involvement, decreased survival, without margin involvement and in cases that did not recur. H&E stain showed significantly better visualization of eosinophils resulting in higher eosinophil counts than when seen with Congo red (p=0.008). Thus, TATE can be used as a surrogate marker in prediction of survival and recurrence in OSCC. H&E proved to be a better stain for evaluation of eosinophils.

Tumour Associated Tissue Eosinophilia as a Prognostic Indicator in Squamous Cell Carcinoma of Upper Aerodigestive Tract

Immune response is known to develop against malignant tumours. Malignant tumours express newer antigen on their cell surface membrane which elicit immunological reaction in and around tumoural tissue. In early part of immune reaction neutrophil, eosinophil migrates followed by monocyte-macrophage cell. Tumor associated tissue eosinophilia (TATE) is believed to play a significant role in the biological behavior of the carcinoma. Eosinophil infiltrate in association with the head and neck squamous cell carcinoma (SCC) have been reviewed from time-to-time. The significance of such an association has been variably thought to be either a potential diagnostic tool for stromal invasion or as a prognostic indicator. The aim of this study was to investigate and evaluate the possible role of the tumour associated tissue eosinophilia (TATE) as a predictive indicator for the grading and establishing prognosis of the upper aerodigestive tract squamous cell carcinoma (SCC).