Impact of Histological and Molecular Parameters on Prognosis of Oral Squamous Cell Carcinoma: Analysis of 290 Cases

Abstract

Background. Nodal metastasis is a critical factor in predicting the prognosis of oral squamous cell carcinoma (OSCC). When patients present with a clinically positive neck, the treatment of choice is radical neck dissection. However, management of a clinically negative neck is still a subject of significant controversy. Aim. This study was carried out in order to propose a model to predict regional lymph node metastasis of OSCC using histological parameters such as tumour stage, tumour size, pattern of invasion (POI), differentiation of tumour, and host immune response, together with the expression levels of six biomarkers (periostin, HIF-1α, MMP-9, β-catenin, VEGF-C, and EGFR), and, furthermore, to compare the impact of all these parameters on recurrence and 3 yr and 5 yr survival rates. Materials and Method. Histological materials collected from the archives were used to evaluate histological parameters and immunohistochemical profiles. Standard methods were used for immunohistochemistry and for evaluation of results. Data related to recurrence and survival (3 and 5 years) was also recorded. Clinical data was collected from patients’ records. Results. Male to female ratio was 3 : 1. The commonest site of OSCC was the buccal mucosa, and majority of them were T3 or T4 tumours presented at stage 4. 62.5% of the tumours were well differentiated. Three-year and 5-year survival rates were significantly associated with lymph node metastasis and recurrence. POI was significantly correlated with tumour size, stage, 3-year survival, EGFR, HIF-1α, periostin, and MMP-9 ( p < 0.05 ). Expression of EGFR showed a direct association with metastasis ( p < 0.05 ). Conclusion. POI, level of differentiation, and expression of EGFR are independent prognostic markers for lymph node metastasis. Therefore, these parameters may help in treatment planning of a clinically negative neck.

The Relationship between VEGF-C, TAM, and Lymph Node Metastasis in Oral Cancer

“…Oral cancer, a malignant tumor of the head and neck region, is a malignant tumor that occurs in the patient's oral cavity and is one of the most common malignant tumors in clinical practice [ 1 ]. It can be divided into squamous cell carcinoma and adenocarcinoma according to pathological classification, and squamous epithelial cell carcinoma is the most common [ 2 ]. There are many causes of oral cancer, such as long-term alcohol consumption, smoking, lack of attention to oral hygiene, and long-term areca nut chewing that can lead to oral cancer [ 3 , 4 ].…”

A validated predictive model for risk of nodal metastasis in node negative oral squamous cell carcinoma of the buccal mucosa and tongue

“…All the clinicopathological variables included in our model have been proved to be associated with nodal metastasis in OSCC in previous studies. 6,13,17,25,26 Prognostic systems that have been developed and refined in the…”

“…The risk chart (Figure 3) developed using our model enables us to get the probability of having nodal metastases for a given patient. All the clinicopathological variables included in our model have been proved to be associated with nodal metastasis in OSCC in previous studies 6,13,17,25,26 …”

Chemical Oral Cancerogenesis Is Impaired in PI3Kγ Knockout and Kinase-Dead Mice

“…In a study performed on 102 squamous cell carcinomas of the tongue, the intracytoplasmic expression of Neu, as well as Ki-67 nuclear staining, have been associated with a high risk of recurrence of tongue OSCC [45]. EGFR is more expressed both in preneoplastic and neoplastic lesions from transgenic mice, consistently with its recognized role in oral carcinogenesis; moreover, recently it has also been considered as a possible predictor of metastasis [46].…”