Proliferative Index in Invasive Tumor Front of Oral Squamous Cell Carcinoma: A Potential Prognostic Indicator

Abstract

Aim:The aim of the study was to evaluate the proliferative index (PI) at their invasive front of oral cancer and their association with Bryne's grades of oral squamous cell carcinoma (OSCC) and compare the PI with lymph node metastasis, site of involvement, and habits. Materials and methods:The Ki-67 antigen expression was immunohistochemically evaluated in a total of 102 cases that included the histopathologically diagnosed archival specimens of OSCCs. They were subdivided by Bryne's histopathological grading into grade I (40 cases), grade II (32 cases), and grade III (30 cases). The nucleus with brown stain was considered positive. Cells were counted under 400× magnification. The proliferative activity thus determined was then expressed as a percentage of Ki-67 labeling index (Ki-67 LI) positive cells. Results:A stepwise increase in the mean Ki-67 LI was found from grade I to III squamous cell carcinoma, thus correlating with the histological grading. In addition, there was a higher PI seen in cases associated with metastatic lymph node, which concords with the higher biologic aggressiveness and poor prognosis of the lesion. Conclusion:The present study shows a definitive correlation of Ki-67 antigen with the Bryne's histological grading, all the parameters of Bryne's grading for OSCC and lymph node status of the patient proving its association as an effective tool to grade the tumors and finally read the prognosis of the tumor. Clinical significance: Cell proliferation is regarded as one of the most important biologic mechanisms in oncogenesis. The role of cell proliferation in tumor progression has been inferred in studies concerned with human cancer by comparing the PI of normal tissue, preneoplastic and neoplastic lesions. The Ki-67 antigen-labeled cells can prove to be an effective aid to grade the tumors. It might be possible to standardize and objectify tumor grading among pathology laboratories. Proliferative Index in Invasive Tumor

A comparative study of osteopontin expression, Ki67 index and prognosis in squamous cell carcinoma and cysts of the oral cavity

“…Although most reviewed authors, Watanabe et al , Gonzalez-Moles et al , Lopes et al Cortegoso et al did not find statistically significant relation between Ki-67 expression and nodal status of the patients which was in concurrence with our results, some papers showed that the relation in this respect is significant ( 8 , 10 , 34 , 40 , 42 , 47 ).…”

“…Our results did not confirm significant differences in Ki-67 expression when compared to the differentiation grade of the tumor (G). Consistent results were reported by Lopes et al , Watanabe et al , Guimarães et al , however, there were also convincing reports from Bhuyan et al , Verma et al , Gonzalez-Moles et al , Dragomir et al , Motta et al and Coutinho-Camillo et al who found significantly higher Ki-67 expression in poorly differentiated tumors ( 8 , 10 , 34 , 37 , 40 , 47 - 50 ).…”

“…Much greater controversies pertain to the value of Ki-67 expression as a prognostic tool in malignant diseases of oral did not find statistically significant relation between Ki-67 expression and nodal status of the patients which was in concurrence with our results, some papers showed that the relation in this respect is significant (8,10,34,40,42,47).…”

“…In precancerous lesions, it was found that the expression of this factor increases with the severity of the dysplasia ( 8 , 9 ). Recently it was confirmed to be an effective aid to grade the OSCC tumors ( 10 ).…”

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 PHH3 antibody, recognized as a biomarker of cell proliferation and specific for cells in mitosis, has been little studied in comparison with other biomarkers of cell proliferation ( 25 ). In contrast, in OSCC, unlike the PHH3 antibody, one of the cell proliferation biomarkers that has been widely studied is Ki-67 ( 4 , 13 , 22 , 26 ). However, studies on the value of the expression of this biomarker in determining the survival of patients with OSCC have shown contradictory results ( 3 , 15 ).…”