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Abstract Objective To investigate the Ki 67 expression and its correlation with clinicopathological features and 3 years as well as 5 years survival rate in oral squamous cell carcinoma (OSCC). Methodology Total 217cases of OSCC primarily treated with surgery with or without radiation were included. All patients were followed up for 3 years and 150 were followed up of 5 years for disease free survival. The immunohistochemistry was carried out on neutral buffered formalin fixed paraffin embedded tissue to evaluate the expression of Ki67. Results The Ki67 labeling index (LI) was significantly higher with respect to adverse clinicopathological parameters such as histopathological grading (p<0.001), clinical TNM staging (p<0.001) and nodal metastasis (p<0.001). The OSCC patients survived for less than 3 and 5 years were showed significantly higher Ki67 LI as compared to diseases free survived more than 3 and 5 years(p<0.001). The three years survival rate of OSCC patient significantly higher with low Ki67 LI (≤45) 96.2%, followed by moderate Ki67 LI (46 to 60) 60.7% and high Ki67 LI (≥61) 37.7% (p<0.001). The five years survival rate of OSCC patient statistically significantly higher with low Ki67 LI (≤45)93.3%, followed by moderate Ki67 LI (46 to 60) 46.8% and Ki67 LI (≥61) 23.3% (p<0.001). Conclusion The measurement of cell proliferative activity by using Ki67 antigen expression in individual OSCC might provide unique, predictive information on clinical outcome, prognosis and deciding treatment modalities in OSCC.
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Humans , Mouth Neoplasms , Carcinoma, Squamous Cell , Head and Neck Neoplasms , Prognosis , Biomarkers, Tumor , Ki-67 Antigen , Squamous Cell Carcinoma of Head and NeckABSTRACT
Oral submucous fibrosis (OSMF) is a chronic progressive, scarring disease affecting oral, oropharyngeal, and sometimes the esophageal mucosa. It is characterized by the progressive fibrosis of the submucosal tissue. The pathogenesis of OSMF has been directly related to the habit of chewing areca nut and its commercial preparation, which is widespread in Indian subcontinent and Southeast Asia. The areca nut has been classified as a “group one human carcinogen.” Oral squamous cell carcinoma in the background of OSMF is one of the most common malignancies in South and Southeast Asian countries. Malignant transformation has been reported in 7%–12% cases of OSMF. Histopathological spectrum of OSMF includes the apparent alterations observed in the epithelium and connective tissue. Epithelial atrophy and sometimes epithelial hyperplasia with or without dysplasia are the peculiar alterations seen in the epithelium. In the connective tissue, there is extracellular matrix remodeling which results in excessive collagenization. Further cross-linking of collagen leads to hyalinization which makes the collagen resistant to proteolysis. Owing to fibrosis in the connective tissue, there is narrowing of blood vessels which further results in compromised blood supply to the local tissue milieu, that is, hypoxia. This tissue hypoxia elicits angiogenesis which may result in the malignant transformation of OSMF. Perpetual irritation of areca nut and its constituents to the oral mucosa leads to upregulation of pro-inflammatory cytokines and further juxtaepithelial inflammation. Thus, these coordinated reactions in epithelium and connective tissue leads the OSMF toward malignant transformation
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Aim: The present study was undertaken with the purpose to assess the correlation between the presence of lymph node metastases and the size of tumor and the thickness of the tumor mass. Methods: The study included 80 consecutive cases of oral squamous cell carcinoma, who underwent radical neck dissection. The various level of lymph nodes in these cases were checked for metastases, which was then correlated with the size of tumor and the thickness of the tumor. Results: In this study it was revealed that there is a statistically non-significant (p = 0.3204) correlation between size of the tumor and regional cervical lymph node metastases, but a significant correlation (p = 0.0148) between thickness of the tumor and regional cervical lymph node metastases was observed. Conclusion: Thus we conclude that the tumor thickness was more in cases with skip metastasis than in cases without skip metastasis and tumors greater than 10mm in thickness have more chances of regional metastases.
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Mitochondria have been an area of scientific study for more than 100 years. It was in early 20th century that Otto Warburg first described differences in the mitochondria of tumors v/s normal cells. It was observed that tumor cells have increased rate of aerobic glycolysis compared with normal cells. The study was carried out in patients diagnosed as premalignant and malignant conditions which had three objectives that is to demonstrate the presence or absence of mitochondria in cytological smears, in order to perform a semi-quantitative analysis on the number of mitochondria and to identify the difference in distribution mitochondria if any. The study was carried out in the Department of Oral and Maxillofacial Pathology of S.P.D.C., Sawangi, Wardha with consent from patients and approval from the institutional ethical committee. 20 patients each diagnosed clinically and histo-pathologically with OSCC and Premalignant conditions or lesions respectively were selected for the purpose of the study. 20 subjects who had come for routine endodontic treatment were taken as control group for the purpose of the study. It was observed that there was even distribution of mitochondria throughout the cytoplasm in smear that had been taken from normal mucosa which appeared sharply defined whereas in premalignant mitochondria were located in the perinuclear zone and 10% in the peripheral zone and in malignant conditions distribution was sparse in the perinuclear area and appeared ill-defined.
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Aim: Our study aimed to evaluate the infiltration of tissue eosinophils and mast cells in oral squamous cell carcinoma (OSCC) by using special stains. Study Design: Comparative study. Place of Study: Sharad Pawar Dental College, Sawangi (Meghe), Wardha, Maharashtra. Methodology: The study was carried out with the sample size of 30 histopathologically diagnosed cases of oral squamous cell carcinoma and comparison of infiltration of these (tissue eosinophil and mast cells) inflammatory cells with control (normal) group of patients, was done by using special stains. Special stains are wonderful because they allow us to see which we cannot see with routine Haematoxylin and eosin stain. Special stains were used to demonstrate tissue eosinophils and mast cells. Carbol Chromotrope and congo red were used for tissue eosinophil and for mast cells staining toluidine blue and thionin were used. Results: The comparison of infiltration of tissue eosinophil and mast cell in OSCC with control group (normal) of patients shows significantly increased infiltration of these immunological cells in OSCC group of patients (P<0.05). We also found that among special stains carbol chromotrope is better than congo red for demonstration of tissue eosinophils and toluidine blue shows better staining intensity for mast cells than thionin. Conclusion: We conclude that both inflammatory cells i.e. number of tissue eosinophils and mast cell infiltration is increased in OSCC. Special stains (carbol chromotrope and toluidine blue) are inexpensive and time saving rapid process for microscopic evaluation of infiltration of immunological cells (tissue eosinophil and mast cell) in tumour stroma.
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Fibrosarcoma has been defined as a malignant tumor of the fibroblasts that shows no other evidence of cellular differentiation and is capable of recurrence and metastasis. Fibrosarcomas are rare but may occur anywhere in the body, most commonly in the retroperitoneum, thigh, knee and distal extremities. Fibrosarcoma is uncommon in the head and neck region and constitutes about 1% of all the malignancies affecting the human race. Of all the fibrosarcomas occurring in humans, only 0.05% occurs in the head and neck region. Of this, almost 23% is seen in the oral cavity. Fibosarcomas generally have a poor prognosis and the overall survival rate is 20-35% over a period of 5 years.