P53 and cyclin D1 staining patterns of malignant and premalignant oral lesions in age-dependent populations

Role of E2F transcription factor in Oral cancer: Recent Insight and Advancements

The family of mammalian E2F transcription factors (E2Fs) comprise of 8 members (E2F1-E2F8) classified as activators (E2F1-E2F3) and repressors (E2F4-E2F8) primarily regulating the expression of several genes related to cell proliferation, apoptosis and differentiation, mainly in a cell cycle-dependent manner. E2F activity is frequently controlled via the retinoblastoma protein (pRb), cyclins, p53 and the ubiquitin-proteasome pathway. Additionally, genetic or epigenetic changes result in the deregulation of E2F family genes expression altering S phase entry and apoptosis, an important hallmark for the onset and development of cancer. Although studies reveal E2Fs to be involved in several human malignancies, the mechanisms underlying the role of E2Fs in oral cancer lies nascent and needs further investigations. This review focuses on the role of E2Fs in oral cancer and the etiological factors regulating E2Fs activity, which in turn transcriptionally control the expression of their target genes, thus contributing to cell proliferation, metastasis, and drug/therapy resistance. Further, we will discuss therapeutic strategies for E2Fs, which may prevent oral tumor growth, metastasis, and drug resistance.

Immunohistochemical expression and evaluation of cyclin D1 and minichromosome maintenance 2 in oral squamous cell carcinoma and verrucous carcinoma

Background

The study of cell proliferation is important for assessing the tumor behavior, prognosis and patient survival of oral carcinomas. As literature search did not reveal sufficient studies of immunohistochemical expression of cyclin D1 and minichromosome maintenance 2 (MCM2) in oral squamous cell carcinoma (OSCC) and verrucous carcinoma (VC), the present study was undertaken.

Materials and Methods

The study group included 20 cases of histopathologically diagnosed OSCC, 10 cases of VC and 10 cases of normal mucosa (NM). All samples were evaluated for the expression of cyclin D1 and MCM2 using standard Immunohistochemistry (IHC) procedure.The present study involved both qualitative and quantitative analyses. Qualitative analysis was done by evaluation of intensity and area of staining. Quantitative analysis was done by calculating the percentage of positively stained cells and assessing the labeling index (LI). Data obtained were subjected to statistical analysis using SPSS statistical package (version 23.0).

Results

On evaluating and comparing the intensity of staining and area of staining of cyclin D1 and MCM2 between the study groups, statistically significant values (P < 0.05) were obtained using Kruskal-Wallis ANOVA. Comparison of LI of cyclin D1 and MCM2 in NM, OSCC and VC statistically significant results (P < 0.05) was obtained using Mann-Whitney U-test. Mean LI of MCM2 was found to be significantly higher than mean LI of cyclin D1 in all the study groups.

Conclusion

From the present study, we conclude that MCM2 has the potential to serve as a novel cell proliferation biomarker in OSCC and VC when compared to cyclin D1.

Analytical Study of Etiopathological Factors Responsible for Oral Squamous Cell Cancer in Bihar Population

Background

Squamous cell carcinoma (SCC) of maxillofacial region is the most usual form of neoplasia causing malignancies in India and Asian continent. An increased prevalence of mortality rate by cancer of maxillofacial region was observed in various parts of the world.

Objectives

Our aim was to correlate age and gender with etiopathological factors contributing to oral squamous cell carcinoma (OSCC) in the urban population of Patna in 2 years.

Materials and Methods

Data were extracted from hospital records. A total of 236 cases of histologically confirmed mild to advance stage of OSCC in either gender of 15-80 years of age range were evaluated.

Results

Out of 236 histopathologically confirmed patients with OSCC, 172 were male and 64 were female. Insignificant difference was found in all age-groups and in all locations. Most common site was found to be buccal mucosa in both genders. Bony invasion was found to be least common. In our study, it was found that habits of chewing areca nuts, nicotine smoke addiction, consumption of alcohol, combination of chewing nuts and nicotine smoke addiction, and combination of alcohol and nicotine smoke addiction are significantly related to the development of OSCC. No significant association was found between histopathological conclusion and gender in all the four groups, and the prevalence was directly proportional to advancement of age.

Conclusion

We concluded that the OSCC do not have any significant relation with the age and gender. The habit of nicotine and areca nut chewing, nicotine smoke addiction, and combination of nicotine smoke addiction and alcohol and chewing nut and nicotine smoke addiction has significant relationship in the development of OSCC.

Evaluation of the Role Played by Cyclin D1 as a Diagnostic and Prognostic Marker in the Progression of Oral Carcinogenesis

Abstract

Cyclin D1 is linked with the development and progression of oral squamous cell carcinoma (OSCC). This case-control study was directed to characterise the immunoreactivity of the protein cyclin D1 and its correlation with the clinicopathological parameters of patients with OSCC and potentially malignant disorders (PMD). A group of patients with OSCC were followed up after treatment, and the cyclin D1 expression was reviewed for correlation of cyclin D1 expression with prognosis of the patients.

Methodology

Sixty individuals were included in this study: OSCC (20), PMD (20) and Control (20). Immunohistochemistry assay was evaluated. The clinicopathological parameters were correlated with the staining intensity of cyclin D1. The results were subjected to Pearson's correlation test.

Results

Age, gender and site showed no statistically significant correlation with cyclin D1 expression in OSCC and PMD. The cyclin D1 score did not show a significant difference with histopathological diagnosis of OSCC. Cyclin D1 was not expressed in 60% of the Control and 30% PMD cases while the expression of cyclin D1 was seen in 100% of OSCC cases although cyclin D1 score did not show a statistically significant association in the prognosis of the disease among the OSCC patients.

Immunohistochemical evaluation of p63 and cyclin D1 in oral squamous cell carcinoma and leukoplakia

Objectives

There are only a limited number of studies on cyclin D1 and p63 expression in oral squamous cell carcinoma (OSCC) and leukoplakia. This study compared cyclin D1 and p63 expression in leukoplakia and OSCC to investigate the possible correlation of both markers with grade of dysplasia and histological grade of OSCC.

Materials and Methods

The study included a total of 60 cases, of which 30 were diagnosed with OSCC and 30 with leukoplakia, that were evaluated immunohistochemically for p63 and cyclin D1 expression. Protein expression was correlated based on grades of dysplasia and OSCC.

Results

Out of 30 cases of OSCC, 23 cases (76.7%) were cyclin D1 positive and 30 cases (100%) were p63 positive. Out of 30 cases of leukoplakia, 21 cases (70.0%) were cyclin D1 positive and 30 (100%) were p63 positive (P<0.05).

Conclusion

The overall expression of cyclin D1 and p63 correlated with tumor differentiation, and increases were correlated with poor histological grades, from well-differentiated to poorly-differentiated SCC. Increased cyclin D1 and p63 expression was associated with the severity of leukoplakia. Based on these results cyclin D1 and p63 products can be a useful tool for improved leukoplakia prognosis.

Immunohistochemical evaluation of p63 and cyclin D1 in oral squamous cell carcinoma and leukoplakia

Objectives

There are only a limited number of studies on cyclin D1 and p63 expression in oral squamous cell carcinoma (OSCC) and leukoplakia. This study compared cyclin D1 and p63 expression in leukoplakia and OSCC to investigate the possible correlation of both markers with grade of dysplasia and histological grade of OSCC.

Materials and Methods

The study included a total of 60 cases, of which 30 were diagnosed with OSCC and 30 with leukoplakia, that were evaluated immunohistochemically for p63 and cyclin D1 expression. Protein expression was correlated based on grades of dysplasia and OSCC.

Results

Out of 30 cases of OSCC, 23 cases (76.7%) were cyclin D1 positive and 30 cases (100%) were p63 positive. Out of 30 cases of leukoplakia, 21 cases (70.0%) were cyclin D1 positive and 30 (100%) were p63 positive (P<0.05).

Conclusion

The overall expression of cyclin D1 and p63 correlated with tumor differentiation, and increases were correlated with poor histological grades, from well-differentiated to poorly-differentiated SCC. Increased cyclin D1 and p63 expression was associated with the severity of leukoplakia. Based on these results cyclin D1 and p63 products can be a useful tool for improved leukoplakia prognosis.

Expression of survivin and p53 in oral lichen planus, lichenoid reaction and lichenoid dysplasia: An immunohistochemical study

Context:

The malignant transformation potential of oral lichen planus (OLP) and related lesions is a subject of great controversy.

Aim:

The aim of this study was to compare the expression of proteins related to apoptosis and tumour suppressor gene processes in OLP, oral lichenoid reaction (OLR) and oral lichenoid dysplasia (OLD).

Materials and Methods

The immunohistochemical study was carried out to investigate the expressions of survivin and p53 in a total of 30 lesional biopsy specimens - 10 cases each of OLP, OLR and OLD. The expression rates were further compared with 10 control specimens of normal oral mucosa (NORM).

Results:

Immunoreactivity for p53 was seen in 7 cases (70%) of OLD, 4 cases (40%) of OLP and 2 cases (20%) of OLR and none of NORM. We obtained a significant difference (P = 0.01) in mean p53 expression between the different entities. The positive staining rate of survivin was found to be significantly different between OLD (50%), OLP (10%), OLR (0%), and normal mucosa (0%) (P = 0.004). There was a positive correlation between p53 and survivin expression in OLP and OLD using Pearson's correlation coefficient.

Conclusion:

Lichenoid dysplasia has shown p53 and survivin expression in the range of not OLP, but leukoplakia. On the other hand, OLR seems to be an innocuous lesion. The study results with OLP are inconclusive but points toward a small but important malignant potential in OLP. This kind of comparative study highlights the importance of biopsying OLP and related lesions for proper diagnosis and appropriate management.

Cyclin d1 gene expression in oral mucosa of tobacco chewers"-an immunohistochemical study

OBJECTIVE

The objective of the present study was to evaluate the expression of cyclin D1 in normal oral mucosa of both non tobacco habituated and tobacco habituated individuals histologically and also compare and correlate cyclin D1 expression with histopathologically confirmed cases of oral squamous cell carcinomas.

STUDY DESIGN

The present study involved 20 cases of tobacco habituated individuals with normal oral mucosal tissue and 20 histopathologically confirmed cases of squamous cells carcinomas. Twelve cases of non tobacco habituated individuals served as control group. Chi-square analysis was used to determine statistical significance.

RESULTS

Fifty percent of control cases, 70% of squamous cell carcinoma cases and 80% of tobacco habituated individuals of clinically normal mucosa showed cyclin D1 positivity. Thirteen cases with tobacco chewing habit, with clinically normal mucosa, showed dysplasia, out of which seven were mildly dysplastic and six were moderately dysplastic. A larger percentage of cyclin D1 expression was observed in lower grade dysplasias (53.8%) than higher grade dysplasias (46.1%). However statistical analysis showed no significant association between groups. Chi-square value was < 7.82 for p=0.05.

CONCLUSION

The finding of cyclin D1 expression in 80% of tobacco users with clinically normal mucosa indicates that the mutation of cyclin D1 occurs early, even before clinical changes are apparent. This finding appears to be previously unreported. The presence of dysplasia in the same group and cyclin D1 expression in 84.6% of dysplastic cases show that the patients are susceptible for further changes, including progression to higher grades of dysplasia and development of carcinoma. Relatively lower expression of cyclin D1 positivity (70%), in oral cancer patients, when compared with tobacco users with clinically normal mucosa (80%) is indicative of increased traverse of the cell through the cell cycle, which may occur early in tumor progression. Cyclin D1 immunoreactivity was detected in all the three study groups.

TP53 mutation and human papilloma virus status of oral squamous cell carcinomas in young adult patients

OBJECTIVE

Little is known about the molecular carcinogenesis of oral squamous cell carcinoma (OSCC) in young adult patients. The aim of this study was to investigate the detailed TP53 mutation and human papilloma virus (HPV) status of OSCC in patients, younger than 45 years.

METHODS

TP53 mutations were determined with direct sequencing on paraffin-embedded carcinoma tissue from 31 young patients and compared with two older age OSCC reference groups: one from the same institute (N = 87) and an independent one (N = 675). Biologically active tumour HPV was detected by p16-immunohistochemistry followed by a HPV-DNA GP5 + /6 + -PCR.

RESULTS

HPV16 was present in one OSCC (3%). TP53 mutations were found in 14 (45%) OSCC: five were missense and nine resulted in a truncated protein. Six of these latter were insertions or deletions of one or more nucleotides leading to frameshift, one was at a splice site and two resulted in a stop codon. The percentage of truncating mutations (64% of all mutations) was higher than that observed in the institute's reference group (44%, P = 0.23) and in the independent reference group (24%, P = 0.002).

CONCLUSIONS

This study shows that TP53 mutations are common in OSCC of young adult patients; infection with biologically active HPV is rare.

Cyclin d1 expression and its correlation with histopathological differentiation in oral squamous cell carcinoma

Background. Cyclin D1 regulates the G1 to S transition of cell cycle. Its deregulation or overexpression may lead to disturbance in the normal cell cycle control and tumour formation. Overexpression of cyclin D1 has been reported in various tumors of diverse histogenesis. This case control retrospective study was carried out to study the immunohistochemical reactivity and expression of cyclin D1 and its association with site, clinical staging, and histopathological differentiation of oral squamous cell carcinoma (OSCC). Methods. Forty formalin-fixed paraffin-embedded tissue blocks of biopsy specimens of oral squamous cell carcinoma were immunohistochemically evaluated for expression of cyclin D1. Results. Cyclin D1 expression was seen in 45% cases of OSCC. It did not correlate with site and clinical staging. Highest expression was seen in well-differentiated, followed by moderately differentiated, and poorly differentiated squamous cell carcinomas, with a statistically significant correlation. Conclusion. Cyclin D1 expression significantly increases with increase in differentiation.

Role for EPS8 in squamous carcinogenesis

We have investigated the role of the signaling intermediate, EPS8, in tumor progression using a model system and in vivo. HN4 primary tumor cells express low levels of EPS8, similar to normal keratinocytes, and show minimal invasion in vitro in response to epidermal growth factor, whereas HN12 cells express high levels of EPS8 and are highly motile in vitro and tumorigenic in vivo. Additional independent tumor cell lines also showed elevated EPS8 expression compared with normal keratinocytes. Using retroviral transduction, we generated HN4 cell lines expressing EPS8 (HN4/EPS8) at levels equivalent to those present in HN12 cells. HN4/EPS8 cells showed increased proliferation and migration compared with controls, together with elevated expression and activity of matrix metalloprotease (MMP)-9, which was dependent on protein kinase B (AKT) activity. Introduction of plasmids that direct synthesis of EPS8 short hairpin RNA (shRNA) into HN12 cells resulted in decreased EPS8 expression in these cells, which correlated with a decrease in their capacity to migrate and invade in vitro. In addition, shRNA-mediated knockdown of EPS8 reduced expression and activity of MMP-9 produced by these cells and reduced MMP-9 promoter activity. EPS8 knockdown cells showed decreased tumorigenicity in vivo compared with controls and lower MMP-9 expression. Conversely, overexpression of EPS8 in HN4 cells was sufficient to induce growth of these non-tumorigenic cells in orthotopic transplantation assays. Furthermore, EPS8 expression in clinical samples of squamous cell carcinoma showed variable expression levels and broadly paralleled expression of MMP-9. The data support a role for EPS8 in squamous carcinogenesis.

Cell cycle dysregulation in oral cancer

The dysregulation of the molecular events governing cell cycle control is emerging as a central theme of oral carcinogenesis. Regulatory pathways responding to extracellular signaling or intracellular stress and DNA damage converge on the cell cycle apparatus. Abrogation of mitogenic and anti-mitogenic response regulatory proteins, such as the retinoblastoma tumor suppressor protein (pRB), cyclin D1, cyclin-dependent kinase (CDK) 6, and CDK inhibitors (p21(WAF1/CIP1), p27(KIP1), and p16(INK4a)), occur frequently in human oral cancers. Cellular responses to metabolic stress or genomic damage through p53 and related pathways that block cell cycle progression are also altered during oral carcinogenesis. In addition, new pathways and cell cycle regulatory proteins, such as p12(DOC-1), are being discovered. The multistep process of oral carcinogenesis likely involves functional alteration of cell cycle regulatory members combined with escape from cellular senescence and apoptotic signaling pathways. Detailing the molecular alterations and understanding the functional consequences of the dysregulation of the cell cycle apparatus in the malignant oral keratinocyte will uncover novel diagnostic and therapeutic approaches.

Cyclin D1 expression in oral squamous cell carcinoma and verrucous carcinoma: correlation with histological differentiation

OBJECTIVE

To assess the expression of cyclin D1 in oral squamous cell carcinoma (OSCC) and verrucous carcinoma (VC), to compare its expression in both of these carcinomas, and to investigate the possible correlation of cyclin D1 expression in different histological grades of OSCC.

STUDY DESIGN

Paraffin embedded tissues from 71 cases of OSCC and VC were studied immunohistochemically. Expression of protein was correlated between the 2 entities and in different grades of OSCC.

RESULTS

Cyclin D1 overexpression was seen in 29 cases (70.7%) of OSCC and in 19 cases (63.3%) of verrucous carcinoma. Statistical significance at the 5% level was observed for cyclin D1 expression between all categories of squamous cell carcinoma (SCC), that is, between well-differentiated and moderately differentiated carcinomas, and between moderate and poorly differentiated carcinomas, and well and poorly differentiated squamous carcinomas. No statistical significance was observed in cyclin D1 expression between SCC and oral verrucous carcinoma; however, statistical significance was seen between oral VC and poorly differentiated squamous cell carcinoma.

CONCLUSION

Increased expression of cyclin D1 significantly correlated with lack of differentiation in these malignant epithelial neoplasms.

Down-regulation of CXCL5 inhibits squamous carcinogenesis

We report a novel role for the CXC-chemokine, CXCL5, in the proliferation and invasion of head and neck squamous cell carcinoma (HNSCC). Previously, we reported transcriptional up-regulation of CXCL5 in metastatic cells. In this study, we provide biological validation of these findings and show that CXCL5 is intimately involved in tumor cell proliferation, migration, and invasion. Cells derived from a lymph node metastasis, but not from a synchronous primary tumor, secreted CXCL5 as judged by Western blotting of conditioned media. We used RNA interference to generate cell lines (shL5) in which CXCL5 expression was greatly reduced, and tested whether this modulated the cell phenotype. shL5 cells showed decreased proliferation compared with cells harboring nontargeting control sequences. In addition, we found that the ability of shL5 cells to migrate and invade in vitro through a basement membrane substitute was greatly impaired compared with control cells. Finally, whereas control cells were highly tumorigenic in nude mice, the tumorigenic potential in vivo of shL5 cells was found to be ablated. Taken together, these data suggest that CXCL5 production contributes to both enhanced proliferation and invasion of squamous cell carcinomas and that targeting of chemokine pathways may represent a potential therapeutic modality for these lesions.

Expression of cell cycle proteins in head and neck cancer correlates with tumor site rather than tobacco use

Head and neck squamous cell carcinomas of non-smoking patients may result from specific defects in cell cycle control. Expression of p53, pRb, p16(INK4a) and Cyclin D1 was examined by immunohistochemistry of biopsies obtained from 24 non-smoking and 25 smoking patients, both groups representing similar clinical features (tumor site, stage of disease, gender). Expression of p16(INK4a) was restricted to carcinomas of the tonsils (8/24), P=0.0069. In 6/8 p16(INK4a)-positive cases, expression of pRb was absent or reduced. p16 was the only marker showing a significant correlation with a negative smoking history (P=0.0208). Overexpression of Cyclin D1 was frequent in carcinomas of the tongue (6/14) but rare in tonsillar carcinomas (2/24), P=0.0303. Expression of p53 was independent of the smoking history and the tumor site. Our results implicate that there are factors other than tobacco consumption which may influence the development of head and neck cancers at distinct tumor sites.