Stromal fibers in oral squamous cell carcinoma: A possible new prognostic indicator?

Kardam, Priyanka; Mehendiratta, Monica; Rehani, Shweta; Kumra, Madhumani; Sahay, Khushboo; Jain, Kishor S.

doi:10.4103/0973-029x.190913

Cited by 15 publications

(31 citation statements)

References 15 publications

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“…During malignant transformation, elongated projection of the core of the papilla from the LP into the tumor has been noted in histology, which presents highly retardant spikes seen in cross-sectional, cumulative PS-OCT ( Figure 3 B,G). These retardant changes in PS-OCT are consistent with previous studies using Picrosirius red staining and polarized light microscopy, which have shown densely packed collagen fibers with high birefringence surrounded the tumor islands in well-differentiated tumors [ 18 , 19 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 91%

Detection of Oral Dysplastic and Early Cancerous Lesions by Polarization-Sensitive Optical Coherence Tomography

Chen

Lee²,

Chen³

et al. 2020

Cancers

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Detection of oral dysplastic and early-stage cancerous lesions is difficult with the current tools. Half of oral cancers are diagnosed in a late stage. Detection of early stromal change to predict malignant transformation is a new direction in the diagnosis of early-stage oral cancer. The application of new optical tools to image stroma in vivo is under investigation, and polarization-sensitive optical coherence tomography (PS-OCT) is potentially one of those tools. This is a preliminary study to sequentially image oral stromal changes from normal, hyperplasia, and dysplasia to early-stage cancer by PS-OCT in vivo. We used 4-Nitroquinoline-1-oxide drinking water to induce dysplasia and early-stage oral cancer in 19 K14-EGFP-miR-211-GFP transgenic mice. A total of 8 normal, 12 hyperplastic, 11 dysplastic, and 4 early-stage cancerous lesions were enrolled. A new analytic process of PS-OCT imaging was proposed, called an en-face birefringence map. From the birefringence map, the sensitivity, specificity, positive predictive value, and negative predictive values to detect dysplasia and early-stage cancer were 100.00%, 95.00%, 93.75%, and 100.00%, respectively, and the kappa value of these images between two investigators was 0.942. The mean size of malignant lesions detected in this study is 1.66 ± 0.93 mm. This pilot animal study validates the use of PS-OCT to detect small and early-stage oral malignancy with high accuracy and consistency.

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Section: Discussionsupporting

confidence: 91%

Detection of Oral Dysplastic and Early Cancerous Lesions by Polarization-Sensitive Optical Coherence Tomography

Chen

Lee²,

Chen³

et al. 2020

Cancers

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“…The arrangement and orientation of collagen fibers were categorized as either parallel or haphazard based on their appearance in relation to the tumor islands. The evaluation was performed in five selected fields at 100 × magnification [ 7 ].…”

Section: Methodsmentioning

confidence: 99%

“…The packing of the collagen fibers was categorized as either dense or loose based on their appearance in 5 selected fields at 100 × magnification in the immediate vicinity of the tumor islands [ 7 ].…”

Section: Methodsmentioning

confidence: 99%

“…Electron microscopic studies have shown that type I collagen fibers are coarse and are composed of closely packed, thick fibrils, whereas type III collagen fibers are fine and are composed of loosely dispersed, thin fibrils [ 6 ]. Collagen fibers exhibit changes in type, diameter, color, orientation, density, and amount with tumor progression [ 7 ].…”

mentioning

confidence: 99%

“…Picrosirius red (PSR) stain is a highly specific and selective stain for collagen fibers due to its ability to differentiate between pathological and normal collagen [ 10 ]. Using this stain, collagen fibers can be evaluated both qualitatively and quantitatively, and this information can provide useful clues to the various aspects of tumor progression [ 7 ].…”

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confidence: 99%

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An Immunohistochemical and Polarizing Microscopic Study of the Tumor Microenvironment in Varying Grades of Oral Squamous Cell Carcinoma

Khalid

Siddiqui

Bordoloi

et al. 2018

J Pathol Transl Med

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BackgroundInvasion of epithelial cells into the connective tissue brings about massive morphological and architectural changes in the underlying stroma. Myofibroblasts reorganize the stroma to facilitate the movement of tumor cells leading to metastasis. The aim of this study was to determine the number and pattern of distribution of myofibroblasts and the qualitative and quantitative change that they cause in the collagen present in the stroma in various grades of oral squamous cell carcinoma (OSCC).MethodsThe study was divided into two groups with group I (test group, 65 cases) consisting of 29 cases of well-differentiated squamous cell carcinoma, 25 moderately differentiated SCC, and 11 poorly differentiated SCC, and group II (control group) consisting of 11 cases of normal mucosa. Sections from each sample were stained with anti–α-smooth muscle actin (α-SMA) antibodies, hematoxylin and eosin, and Picrosirius red. Several additional sections from each grade of OSCC were stained with Masson’s trichrome to observe the changes in collagen. For the statistical analysis, Fisher’s exact test, Tukey’s post hoc honest significant difference test, ANOVA, and the chi-square test were used, and p < .05 was considered statistically significant.ResultsAs the tumor stage progressed, an increase in the intensity α-SMA expression was seen, and the network pattern dominated in more dedifferentiated carcinomas. The collagen fibers became thin, loosely packed, and haphazardly aligned with progressing cancer. Additionally, the mean area fraction decreased, and the fibers attained a greenish yellow hue and a weak birefringence when observed using polarizing light microscopy.ConclusionsMyofibroblasts bring about numerous changes in collagen. As cancer progresses, there isincrease in pathological collagen,which enhances the movement of cells within the stroma.

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The significance of stromal collagen organization in cancer tissue: An in-depth discussion of literature

Zunder

Gelderblom

Tollenaar

et al. 2020

Critical Reviews in Oncology/Hematology

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It has become clear that carcinogenesis goes beyond tumor cell biology. Cancer research has acknowledged the importance of biological functions of the tumor-microenvironment, wherein not only cellular components seem to hold valuable information but also structural components like collagen fibers. Several studies have focused on the significance of stromal collagen fiber organization and reported on its role in cancer progression, invasiveness and treatment response. In this review, we discuss the different imaging methods for stromal collagen organization, followed by an in-depth discussion of current literature on in-vitro and animal experiments and human studies, highlighting its importance with respect to cancer progression, prognosis and prediction. We can conclude that collagen organization contains valuable information with regard to metastatic potential and clinical outcomes in cancer. However, the significance of an aligned versus disorganized collagen morphology differs between cancer types, implying more research is necessary before steps towards clinical implementation can be made.

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Stromal fibers in oral squamous cell carcinoma: A possible new prognostic indicator?

Cited by 15 publications

References 15 publications

Detection of Oral Dysplastic and Early Cancerous Lesions by Polarization-Sensitive Optical Coherence Tomography

Detection of Oral Dysplastic and Early Cancerous Lesions by Polarization-Sensitive Optical Coherence Tomography

An Immunohistochemical and Polarizing Microscopic Study of the Tumor Microenvironment in Varying Grades of Oral Squamous Cell Carcinoma

The significance of stromal collagen organization in cancer tissue: An in-depth discussion of literature

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