Pattern-corrected mitotic activity index (pmai): a novel prognosticator of oral squamous cell carcinoma

Abstract

Objective:The main aim was to assess the efficiency of the Mitotic Activity Index (MAI) and a novel index devised by us, the Pattern-Corrected Mitotic Activity Index (PMAI) in prognostication of Oral Squamous Cell Carcinoma in terms of lymph node involvement, margin, recurrence and survival status. Material and Method:The study group consisted of 60 cases of histologically-proven Oral Squamous Cell Carcinoma with known status of prognostic indicators. Hematoxylin and eosin stained sections of the tumor proper were utilized for assessment of mitotic activity and pattern of invasion. The Mitotic Activity Index and Pattern-Corrected Mitotic Activity Index were then calculated and correlated with the prognosticators.Results: Mitotic Activity Index was higher in patients who had better survival and low recurrence rates. Pattern-Corrected Mitotic Activity Index showed the greatest percentage increase in relation to lymph node involvement as compared to the other indices. Kaplan Meier survival analysis showed that a higher Pattern-Corrected Mitotic Activity Index (>1.45) was associated with poorer survival (37.19 months). Conclusion:Lack of significant association of the Mitotic Activity Index in relation to prognosticators could be attributed to a tumor having a migratory phenotype rather than a proliferative phenotype as seen in late-stage tumors. Late-stage tumors have more of a poorer pattern of invasion which is reflected best by Pattern-Corrected Mitotic Activity Index by correlating with poorer survival and lymph node involvement.

The value of Phosphohistone H3 as a cell proliferation marker in oral squamous cell carcinoma. A comparative study with Ki-67 and the mitotic activity index

“…The evaluation of cell proliferation in cancer is considered an important histological parameter for defining the biological behavior of the tumor and for determining the individualized prognosis for each patient ( 7 ). However, in OSCC, evaluation of tumor proliferation is not part of the current staging system ( 2 ).…”

“…Cell proliferation is an essential biological process, key in the growth and maintenance of tissue homeostasis, whose loss of control plays a fundamental role in the development of malignant neoplasms ( 4 , 6 ). In fact, in several types of human cancer, the evaluation of cell proliferation is considered an important histological parameter ( 7 ). For its assessment, different molecular antigens have been identified, which, when expressed by cells in active proliferation, can be used as predictive biomarkers of sustained proliferation ( 8 ).…”