Evaluation of natural killer cell (CD57) as a prognostic marker in oral squamous cell carcinoma: An immunohistochemistry study.

OBJECTIVES: Natural killer (NK) cells are important effector lymphocytes. NK cells are considered to represent innate immune system. NK cells target and kill aberrant cells such as virally infected and tumorigenic cells. The purpose of this study was to assess the expression of CD57 in oral squamous cell carcinoma (OSCC) and to correlate the expression of CD57 with 3 years survival in patients with OSCC. MATERIALS AND METHODS: About 100 histopathologically diagnosed cases of OSCC of various grades were divided into two groups, i.e., Group I (dead patients) and Group II (live patients) from the archives of Department of Oral Pathology and Microbiology. CD57 was detected in these tissues by immunohistochemistry. RESULT: The results were analyzed using Spearman's correlation coefficient and students unpaired t-test. The mean CD57 labeling index in Group II was significantly higher than that found in Group I (P = 0.000). There was a significant correlation (P = 0.00) in the mean CD57 levels between Groups I and II and prognosis of patient. CONCLUSION: CD57 could be a good prognostic marker for OSCC patients.

Evidence based demonstration of the concept of 'field cancerization' by p53 expression in mirror image biopsies of patients with oral squamous cell carcinoma - an immunohistochemical study.

OBJECTIVE: The main rationale for treatment failure and death of the patients with oral squamous cell carcinoma (OSCC) is loco-regional recurrence, development of second primary tumor (SPT) and metastasis, which could be well explained by concept of field cancerization. Identification of patients at high risk for development of SPT is an important part of research for cancer management. This study was designed keeping this aspect in mind and utilizing the increased expression of p53 as an indicator of existence of altered fields in mirror image biopsies of OSCC patients. DESIGN: Forty clinically diagnosed oral cancer patients were included in the study. Biopsy tissue samples from clinically diagnosed oral cancer patients (Group A) and the mirror image, clinically normal looking mucosa at corresponding contralateral anatomical site (Group B) were studied for histopathological evaluation and p53 immunoexpression. RESULTS: Tissue alterations were observed in Groups A and B. There was statistically significant (chi-square value - 126.6, p=0.0001) difference in grades of epithelial dysplasia and p53 immunoexpression in Group B. Spearman's Rank Correlation Coefficient shows non-significant positive correlation between epithelial dysplasia and p53 (r=0.28, p=0.05) in Group B. CONCLUSIONS: Evidence of presence of field cancerization, evaluated by histopathological alterations and enhanced p53 expression was observed in mirror image biopsies of OSCC patients. This could predict the altered state of oral mucosa secondary to carcinogen exposure. The realization of a genetically altered field as a cancer risk factor provides a new paradigm. It would be prudent to keep these patients under close observation and to advice them chemotherapeutic regimes.

The domino effect: Role of hypoxia in malignant transformation of oral submucous fibrosis.

INTRODUCTION: Oral submucous fibrosis (OSMF) is a precancerous condition predominantly seen in people of Asian descent. About 7-12% OSMF patients develop oral squamous cell carcinoma (OSCC). Morphological features of OSMF especially fibrosis suggests a possibility of the hypoxic environment in diseased tissues. Oral cancer usually develops from hyperplasia through dysplasia to carcinoma. Neovascularization and increased glycolysis, represent adaptations to a hypoxic microenvironment that are correlated with tumor invasion and metastasis. The adaptation of cells to hypoxia appears to be mediated via hypoxia inducible factor-1α (HIF-1α). HIF-1α is said to be associated with malignant transformation of epithelium in other sites. It appears that HIF-1α plays a significant role in both prostate and cervical carcinogenesis at early stages. We hypothesize that progression of OSMF and malignant transformation in the background of fibrosis mediates via HIF-1α either by up- or down-regulation of various such molecules. Therefore, the main objective of this study was to investigate the relationship between the expression of HIF-1α in OSMF, OSCC and OSCC with OSMF. AIM: To investigate the relationship between the expression of HIF-1α in OSMF, OSCC and OSCC with OSMF. MATERIALS AND METHODS: The study group consists of histopathologically diagnosed 20 cases of OSCC, oral submucous fibrosis and OSCC with OSMF each. The immunohistochemistry was carried out on neutral buffered formalin-fixed paraffin-embedded tissue sections by using the monoclonal antibody of HIF-1α. RESULTS: A rise in the expression of HIF-1α from OSMF to OSCC to OSCC with OSMF is observed.

Clinicopathological significance of Melkersson-Rosenthal syndrome.

Melkersson-Rosenthal syndrome (MRS) classically shows a triad of orofacial swelling, fissured tongue and facial palsy, more commonly the oligosymptomatic form. The orofacial swelling is characterised by swollen reddish-brown non-pruritic lips and facial oedema. In one-third to one half of patients, fissured tongue is seen, which also aids in diagnosis. The histological finding of MRS includes non-caseating, sarcoidal granulomas, but their absence does not exclude the diagnosis. All these findings together form a basis for a cautious search for confrontational reasons for the symptom complex of MRS.