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Sun L, Kang X, Wang C, Wang R, Yang G, Jiang W, Wu Q, Wang Y, Wu Y, Gao J, Chen L, Zhang J, Tian Z, Zhu G, Sun S. Single-cell and spatial dissection of precancerous lesions underlying the initiation process of oral squamous cell carcinoma. Cell Discov 2023; 9:28. [PMID: 36914617 PMCID: PMC10011538 DOI: 10.1038/s41421-023-00532-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/22/2023] [Indexed: 03/16/2023] Open
Abstract
Precancerous lesions of the oral mucosa, especially those accompanied by moderate to severe dysplasia, contribute to the initiation of oral squamous cell carcinoma (OSCC). However, the cellular compositions and spatial organization of the precancerous stage and how these factors promote human OSCC initiation remain unclear. Here, we built a single-cell transcriptome atlas and a spatial transcriptome map after obtaining data from pairwise human oral mucosal biopsies of 9 individuals consisting of very early-stage OSCC, adjacent precancerous lesions with moderate to severe dysplasia, as well as a matched normal region. An altered epithelial gene-expression profile was identified which favored OSCC initiation. This observation was coupled with distinct fibroblast, monocytic, and regulatory T-cell subclusters involved in reshaping the microenvironment. In particular, a unique immune-inhibitory monocyte subtype and spatial-switching regulation of VEGF signaling were observed surrounding precancerous lesions, concertedly strengthening activities in promoting cancer initiation. Collectively, our work elucidated the cellular landscapes and roles of precancerous lesions underlying OSCC initiation, which is essential for understanding the entire OSCC initiation process and helps inform therapeutic strategies for cancer intervention.
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Affiliation(s)
- Lulu Sun
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xindan Kang
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chong Wang
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Rui Wang
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Guizhu Yang
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Wen Jiang
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.,Department of Oral and Maxillofacial-Head Neck Oncology, Division of Radiation Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Wu
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yujue Wang
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yaping Wu
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jiamin Gao
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lan Chen
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jie Zhang
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhen Tian
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.,Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guopei Zhu
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.,Department of Oral and Maxillofacial-Head Neck Oncology, Division of Radiation Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuyang Sun
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.
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2
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Chakraborti S, Paul RR, Pal M, Chatterjee J, Das RK. Collagen deposition correlates with loss of E-cadherin and increased p63 expression in dysplastic conditions of oral submucous fibrosis. Med Mol Morphol 2021; 55:20-26. [PMID: 34482436 DOI: 10.1007/s00795-021-00304-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/30/2021] [Indexed: 11/26/2022]
Abstract
This paper focuses on the status of epithelial markers, E-cadherin, and p63 in the backdrop of an abnormal amount of collagen in the sub-mucosa of dysplastic and non-dysplastic grades of OSF. Histologically confirmed OSF and normal oral mucosa samples were procured. Samples were stained by Van Gieson's stain (VG) and immunohistochemistry. The captured images were analyzed by ImageJ software to quantify their grayscale intensities. There was a gradual increase in the intensity of VG stain from normal to non-dysplastic and dysplastic OSF and the differences in their mean grayscale values were found to be significant (p < 0.00001). The intensity of E-cadherin was found to be the highest in non-dysplastic conditions and lowest in dysplastic conditions. The intensity difference of E-cadherin between normal and non-dysplastic OSF was found to be significant (p < 0.00001). The grayscale scale intensity values for p63 in whole epithelium depicted significant differences between normal and diseased conditions but for its intensity, in basal cells, significant differences were found between non-dysplastic and other classes of tissues. There was a positive correlation observed between VG and p63 staining intensity. The diseased oral epithelium demonstrated greater deposition of sub-epithelial collagen fibers along with subsequent loss of E-cadherin and an increased p63 expression.
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Affiliation(s)
- Sourangshu Chakraborti
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Ranjan Rashmi Paul
- Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, India
| | - Mousumi Pal
- Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, India
| | - Jyotirmoy Chatterjee
- School of Medical Science and Technology, Indian Institute of Technology (IIT), Kharagpur, West Bengal, India
| | - Raunak Kumar Das
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India.
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Suwasini S, Shrikaar M, Kumari N, Singh A, Kumari K, Kumar M. Expression of p63 and Proliferating Cell Nuclear Antigen in Oral Submucous Fibrosis. J Int Soc Prev Community Dent 2021; 11:448-456. [PMID: 34430507 PMCID: PMC8352049 DOI: 10.4103/jispcd.jispcd_428_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/09/2021] [Accepted: 03/15/2021] [Indexed: 11/29/2022] Open
Abstract
Aim: Oral squamous cell carcinoma (OSCC) may be preceded by potentially malignant disorders such as oral submucous fibrosis (OSMF). p63 can detect genetic changes in OSMF and it facilitates early detection of malignant transformation, whereas proliferating cell nuclear antigen (PCNA) is a marker of proliferation and may prove to be a useful objective indicator of the biological behavior of various tumors. The aim of this study was to investigate the expression and pattern of the intensity of p63 protein and PCNA in normal oral mucosa and OSMF using immunohistochemistry (IHC) and to correlate the expression of these biomarkers. Materials and Methods: A total of 15 archival paraffin-embedded blocks obtained from our department, which were histopathologically diagnosed early OSMF (n = 4), intermediate OSMF (n = 4), and advanced OSMF (n = 2) and normal mucosa (n = 5), were taken as the standard for comparison. p63 and PCNA positivity was analyzed using Kruskall-Wallis test followed by pairwise comparison using Mann-Whitney U test. The pattern of staining and intensity was compared using Chi-Square test for which Statistical Package for the Social Sciences (SPSS, v 22.0, IBM Corporation, Armonk, New York) was used. Results: All samples showed positive staining for p63 and PCNA. A statistically significant difference (P < 0.05) was seen between the frequency of occurrence of p63 and the PCNA pattern of expression among all the groups. The intensity of staining was mild to intense in the basal layer, as there was a progression toward the severity of the disease. Almost 75.4% correlation existed between p63 and PCNA, with high correlation and marked relationship. Conclusions: The OSMF is considered a potentially malignant disorder that has the potential to get transformed into OSCC. The malignant transformation is often associated with changes at the genetic level, and these are reflected by the altered expression of proteins. Our results showed that biomarkers such as p63 and PCNA are significant in predicting the malignant transformation in OSMF, so in future they may serve as a prognostic tool in the early detection of malignancies.
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Affiliation(s)
- S Suwasini
- Department of Oral Pathology & Microbiology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
| | - Manisha Shrikaar
- Department of Oral Pathology & Microbiology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
| | - Nishu Kumari
- Department of Oral Pathology & Microbiology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
| | - Abhishek Singh
- Department of Oral Pathology & Microbiology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
| | - Khusboo Kumari
- Department of Oral Pathology & Microbiology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
| | - Madhuresh Kumar
- Department of Oral Pathology & Microbiology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
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Zhao G, Li R, Cao Y, Song M, Jiang P, Wu Q, Zhou Z, Zhu H, Wang H, Dai C, Liu D, Yao S, Lv H, Wang L, Dai J, Zhou Y, Hu Y. ΔNp63α-induced DUSP4/GSK3β/SNAI1 pathway in epithelial cells drives endometrial fibrosis. Cell Death Dis 2020; 11:449. [PMID: 32528070 PMCID: PMC7289806 DOI: 10.1038/s41419-020-2666-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
Abstract
Epithelial homeostasis plays an essential role in maintaining endometrial function. But the epithelial role in endometrial fibrosis has been less studied. Previously, we showed that ectopic expression of ΔNp63α is associated with fibrosis process and epithelial dysfunction in endometria of patients with intrauterine adhesions (IUAs). Since ΔNp63α is profoundly involved in maintaining the epithelial homeostasis, we hereby focused on its roles in regulating the function and phenotype of endometrial epithelial cells (EECs) in context of endometrial fibrosis. We identified a typical type 2 epithelial-to-mesenchymal transition (EMT) in EECs from IUA patients and this process was induced by the forced expression of ΔNp63α in EECs. In transcriptomic analysis, we found that diverse signaling pathways regulated by ΔNp63α were involved in pro-EMT. We demonstrated that the DUSP4/GSK-3β/SNAI1 pathway was critical in transducing the pro-EMT signals initiated by ΔNp63α, while bFGF reversed ΔNp63α-induced EMT and endometrial fibrosis both in vitro and in vivo by blocking DUSP4/GSK3β/SNAI1 pathway. Taken together, our findings are important to understand the molecular mechanisms of endometrial fibrosis and to provide potential therapeutic targets.
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Affiliation(s)
- Guangfeng Zhao
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Ruotian Li
- Department of Laboratory Medicine, Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Yun Cao
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Minmin Song
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Peipei Jiang
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Qianwen Wu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Graduate School of Peking Union Medical College, Nanjing, 210008, China
| | - Zhenhua Zhou
- Department of Obstetrics and Gynecology, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, 210000, China
| | - Hui Zhu
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Huiyan Wang
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Chenyan Dai
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Dan Liu
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Simin Yao
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China
| | - Haining Lv
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Graduate School of Peking Union Medical College, Nanjing, 210008, China
| | - Limin Wang
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Graduate School of Peking Union Medical College, Nanjing, 210008, China
| | - Jianwu Dai
- Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, 3 Nanyitiao, Zhongguancun, Beijing, 100190, China.
| | - Yan Zhou
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Reproductive Sciences, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA, 94131, USA.
| | - Yali Hu
- Department of Obstetrics and Gynecology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Rd., Nanjing, 210008, China.
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Sinha A, Chandra S, Raj V, Zaidi I, Saxena S, Dwivedi R. Expression of p63 in potentially malignant and malignant oral lesions. J Oral Biol Craniofac Res 2015; 5:165-72. [PMID: 26605141 DOI: 10.1016/j.jobcr.2015.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/05/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND p63, a member of p53 family, known to be expressed in embryonic tissues and basal regenerative layers of many epithelial tissues in the adult, is also expressed in various benign and malignant lesions of body including lesions of oral cavity. To evaluate the expression of p63 and compare the expression qualitatively and quantitatively in normal buccal mucosa, epithelial dysplasia, oral submucous fibrosis (OSMF), and oral squamous cell carcinoma (OSCC). METHODS The study material consisted of 45 archival cases which were divided into Group I with 5 cases of normal buccal mucosa, Group II with 15 cases of epithelial dysplasia, and Group III with 10 cases of OSMF and 15 cases of OSCC. Immunohistochemical expression of p63 was assessed by using mean, standard deviation, and analysis of variance. RESULTS Overexpression of p63 was seen in epithelial dysplasia, OSMF, and squamous cell carcinoma with an increased suprabasal expression in cases of epithelial dysplasia. The mean labeling index (LI) of p63 was found to be in increasing order from normal oral mucosa (33.75%), OSMF (57.37%), epithelial dysplasia (63.87%) to squamous cell carcinoma (69.76%). CONCLUSION The results suggest a possible role of p63 in oral carcinogenesis, and an increased LI as well as increased suprabasal expression of this gene in dysplastic lesions may have a potential to be utilized as a marker for premalignancy.
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Affiliation(s)
- Anju Sinha
- Senior Lecturer, Department of Oral Pathology & Microbiology, Shree Bankey Bihari Dental College and Research Center, Ghaziabad, U.P., India
| | - Shaleen Chandra
- Prof. & Head of Department, Department of Oral Pathology & Microbiology, Faculty of Dental Sciences, King George's Medical University, Lucknow, U.P., India
| | - Vineet Raj
- Reader, Department of Oral Pathology & Microbiology, Saraswati Dental College & Hospital, Lucknow, U.P., India
| | - Iram Zaidi
- Reader, Department of Pedodontics & Preventive Dentistry, Shree Bankey Bihari Dental College and Research Center, Ghaziabad, U.P., India
| | - Shikha Saxena
- Senior Lecturer, Department of Pedodontics & Preventive Dentistry, Shree Bankey Bihari Dental College and Research Center, Ghaziabad, U.P., India
| | - Ruby Dwivedi
- Senior Lecturer, Department of Oral Pathology & Microbiology, Daswani Dental College, Kota, Rajasthan, India
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Abdulmajeed AA, Farah CS. Can immunohistochemistry serve as an alternative to subjective histopathological diagnosis of oral epithelial dysplasia? BIOMARKERS IN CANCER 2013; 5:49-60. [PMID: 24179398 PMCID: PMC3798313 DOI: 10.4137/bic.s12951] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Many attempts have been made to identify objective molecular biomarkers to diagnose and prognosticate oral epithelial dysplasia (OED) because histopathological interpretation is subjective and lacks sensitivity. The majority of these efforts describe changes in gene expression at protein level in OED as determined by immunohistochemistry (IHC). However, the literature on these putative markers of oral cancer progression is vast and varied. The main purpose of this article is to review current knowledge on biomarkers of protein expression for OED by IHC approaches. We further discuss these findings in terms of the proposed essential hallmarks of cancer cells to better understand their role in oral oncogenesis.
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Affiliation(s)
- Ahmad A Abdulmajeed
- The University of Queensland, UQ Centre for Clinical Research, Herston, School of Dentistry, Brisbane, Australia
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Varun B, Ranganathan K, Rao UK, Joshua E. Immunohistochemical detection of p53 and p63 in oral squamous cell carcinoma, oral leukoplakia, and oral submucous fibrosis. ACTA ACUST UNITED AC 2013; 5:214-9. [DOI: 10.1111/jicd.12038] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Accepted: 01/19/2013] [Indexed: 11/29/2022]
Affiliation(s)
- B.R. Varun
- Department of Oral and Maxillofacial Pathology; PMS Institute of Dental Science and Research; Trivandrum Kerala India
| | - K. Ranganathan
- Department of Oral and Maxillofacial Pathology; Ragas Dental College and Hospitals; Uthandi Chennai India
| | - Umadevi K. Rao
- Department of Oral and Maxillofacial Pathology; Ragas Dental College and Hospitals; Uthandi Chennai India
| | - Elizabeth Joshua
- Department of Oral and Maxillofacial Pathology; Ragas Dental College and Hospitals; Uthandi Chennai India
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Abstract
Although ingrown toenail (IT) is a common problem, the morphologic alterations presented in this condition have rarely been presented in literature. We have studied 14 cases from 12 different patients and studied the biopsies of all of them, not only with routine techniques but also with histochemical stains (Masson trichrome, periodic acid-Schiff, and Gram) and with immunohistochemical techniques mindbomb homolog-1 (MIB-1), p63, D2-40, and AE1-AE3). The patients were clinically classified into 4 stages (1, 2a, 2b, and 3). The main changes evidenced were ingrowing of the squamous epithelium (either from the matrix or mostly from the hyponichium) and chronic plasma-cell rich inflammation with prominent vascularization. The intensity of these changes varied depending on the stage: whereas they were mild in stages 1 and 2a, they were prominent in stages 2b and 3. In advanced stages, the epithelial nests showed certain dyskeratosis. The expression of MIB-1 was, nevertheless, only basal and parabasal. p63 was intensively expressed by the epithelial nests. We therefore conclude that (a) IT shows epithelial ingrowing with accompanying granulation tissue; (b) according to the clinical stage of the disease, this pattern can be more or less complex; (c) in advanced stages of IT, the pattern can mimic a well-differentiated squamous cell carcinoma; (d) MIB-1 is not helpful in distinguishing IT from squamous cell carcinoma; (e) the high expression of p63 by the ingrowing epithelium should not be the source of a misdiagnosis of malignancy.
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A limited immunohistochemical panel helps differentiate small cell epithelial malignancies of the sinonasal cavity and nasopharynx. Appl Immunohistochem Mol Morphol 2009; 17:207-10. [PMID: 19077909 DOI: 10.1097/pai.0b013e31818fc85c] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Distinguishing small cell epithelial malignancies of the sinonasal cavity and nasopharynx is difficult due to overlapping morphologic characteristics, particularly in small biopsies. This distinction is important, however, because of the inherent differences in biology, natural history, prognosis, and treatment among these neoplasms. The aim of this study is to identify a limited immunohistochemical panel that may help to differentiate these morphologically similar small cell epithelial malignancies. DESIGN We reviewed 37 cases of histologically similar small cell epithelial malignancies of the sinonasal cavity and nasopharynx: nasopharyngeal carcinoma (NPC) (16), basaloid squamous cell carcinoma (BSCC) (15), and high-grade neuroendocrine carcinoma (HGNEC) (6) obtained at Jackson Memorial Hospital/UM Sylvester Comprehensive Cancer Center between 2003 and 2007. Immunohistochemistry for pancytokeratin (CK), CK5/6, p63, and HLA-DR was performed using the labeled streptavidin-biotin method. RESULTS All cases in this study were positive for CK and p63. The CK staining pattern of HGNEC was characteristically dot-like whereas the remaining tumors stained with strong and diffuse cytoplasmic membrane positivity. Likewise, the p63 staining pattern of HGNEC was focal and weak whereas the remaining tumors stained with diffuse and strong nuclear positivity. Immunohistochemistry for HLA-DR was positive in all cases of NPC, whereas BSCC and HGNEC were uniformly negative. Cases of NPC and BSCC were positive for CK5/6 whereas cases of HGNEC were negative. CONCLUSIONS A limited immunohistochemical panel of CK, CK5/6, p63, and HLA-DR is useful in discriminating nasopharyngeal, basaloid squamous cell, and high-grade neuroendocrine carcinomas of the sinonasal cavity and nasopharynx.
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