ABSTRACT
BACKGROUND: Reports suggested that hormone replacement therapy decreased the incidence of squamous cell carcinoma (SCC) of the oral cavity. AIM: The aim of this study was to analyze and quantify the serum 17ß-estradiol (E2) level by chemiluminescence immunoassay in four groups, Group I (control group with no habit of tobacco and areca), Group II (control group with a habit of tobacco and areca), Group III (potentially malignant disorder-leukoplakia), and Group IV (oral squamous cell carcinoma (OSCC)). It was the first study to evaluate E2 in four study groups with and without the habit of tobacco. METHOD: The serum analysis was carried out in Cobas e411 analyzer by electrochemiluminescence immunoassay analysis. RESULTS: As per the Kruskal--Wallis test, statistically significant rise in estradiol levels in Group IV as in comparison to Group III as compared with Groups II and I. CONCLUSION: This study proved that irrespective of the gender bias, the female sex hormone, estradiol levels were significantly raised in OSCC patients. This study suggests that E2 may play a vital role in determining the patient prognosis in OSCC with tobacco habit. The confounding results of this preliminary study opened up new advents emphasizing the role of E2 in OSCC. The role of E2 in estrogen receptor regulation can also be a subject of study for targeted therapies in improving the patient's prognosis.
ABSTRACT
BACKGROUND: The annual mortality rate from head and neck squamous cell carcinoma (HNSCC) is over 11,000 worldwide. Squamous cell carcinoma of the head and neck (SCCHN) frequently metastasizes to the regional lymph nodes which are the first site of arrest of tumor cells that have invaded the peritumoral lymphatics, hence the strongest predictor of disease prognosis and outcome. AIM: The present study aims to compare the efficacy of frozen sections (cryosection), step-serial sectioning conventional H and E staining, immunohistochemistry (IHC) and RT-PCR analysis in detection of lymph node micrometastasis. MATERIALS AND METHODS: A prospective series of 30 patients who were diagnosed with primary squamous cell carcinoma of the oral cavity and underwent surgical treatment including unilateral or bilateral selective neck dissection were considered for the study. RESULT: Metastatic carcinomatous cells were observed in H and E staining of frozen section in 18 lymph nodes (54%) and in 19 lymph nodes (57%) in step-serial sectioned H and E-stained sections of the 78 lymph nodes from 30 patients. Carcinomatous cells were immunolabeled with pancytokeratin in 18 lymphnodes (54%). CK19 mRNA was detected in 33 lymph nodes of 16 patients. RT-PCR gave positive signals for 24% and 23% of lymph nodes positive by histopathology and immunohistochemistry. CONCLUSION: Our study demonstrated that RT-PCR is far more sensitive in detection of micrometastasis than any other technique used in routine procedures and immunohistochemistry. Fifty-three percent patients with micrometastasis detected by RT-PCR had large T3/T4 tumors. Prognosis was poor for patients who were positive for micrometastasis detected only by RT-PCR, among which two patients died within a period of 6 months.
