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Ortiz RC, Gois GG, Costa CA, Costa NL, Rodini CO. Possible role of ALDH1 and CD44 in lip carcinogenesis. J Appl Oral Sci 2023; 31:e20230227. [PMID: 38126564 PMCID: PMC10786456 DOI: 10.1590/1678-7757-2023-0227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Lip squamous cell carcinoma (LSCC) accounts for 12% of all head and neck cancers. It is caused by chronic exposure to ultraviolet light solar radiation and related to previous actinic cheilitis (AC). This study aimed to investigate the immunostaining of the putative cancer stem cells (CSC) markers ALDH1 and CD44 in AC (n=30) and LSCC (n=20). ALDH1 positivity was found to be statistically higher in LSCC than in AC lesions (p=0.0045), whilst CD44 expression was statistically higher in AC than in LSCC lesions (p=0.0155). ALDH1+ cells in AC lesions were associated with specific clinical features: a younger age (<60 years old), the female gender, white skin, not smoking or consuming alcohol, and a fast evolution, and not associated with the chronic exposure to UV radiation (p<0.0001). CD44 positivity was associated with patients who were male, feoderm, smoked, consumed alcohol, underwent occupational exposure to UV-radiation, and demonstrated lesions with log-time evolution (p<0.0001). ALDH1 + cells were associated with mild dysplasia using a system from the World Health Organization (WHO), and with a low risk of malignant transformation, according to the binary system (p<0.0001). CD44+ cells were also associated with moderated dysplasia, according to the WHO system. In LSCC, ALDH1 + cells were positively associated with patients who were older (≥ 60 years old), smokers, and with those who consumed alcohol (p<0.0001). CD44 + cells in LSCC were associated with older (≥ 60 years old) patients as well, but also with female patients, white skin, non-smokers, and individuals who did not consume alcohol (p<0.0001), all of whom showed distinct patterns in pre- and malignant lesions of both markers. Additionally, in LSCC, both ALDH1 and CD44 staining were associated with smaller tumor sizes (T1/T2; p<0.0001). In summary, although both ALDH1 and CD44 were associated with the presence of dysplasia in AC lesions, the present findings suggest that ALDH1 and CD44 may be activated by different etiopathogenic pathways, predominantly in distinct steps of oral carcinogenesis. CD44 would thus be more significantly related to the potentially malignant lesion, while ALDH1 would be closely linked to malignancy.
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Affiliation(s)
- Rafael Carneiro Ortiz
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Ciências Biológicas , Bauru , SP , Brasil
| | - Gabriele Gomes Gois
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Ciências Biológicas , Bauru , SP , Brasil
| | - Camila Alves Costa
- Universidade Federal de Goiás , Faculdade de Odontologia da Goiânia , Centro de Pesquisa em Saúde Bucal Sistêmica da Goiás , Goiânia , GO , Brasil
| | - Nádia Lago Costa
- Universidade Federal de Goiás , Faculdade de Odontologia , Departamento de Patologia Bucal, Estomatologia e Radiologia , Goiânia , GO , Brasil
| | - Camila Oliveira Rodini
- Universidade de São Paulo , Faculdade de Odontologia de Bauru , Departamento de Ciências Biológicas , Bauru , SP , Brasil
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Monteiro L, do Amaral B, Delgado L, Garcês F, Salazar F, Pacheco JJ, Lopes C, Warnakulasuriya S. Podoplanin Expression Independently and Jointly with Oral Epithelial Dysplasia Grade Acts as a Potential Biomarker of Malignant Transformation in Oral Leukoplakia. Biomolecules 2022; 12:biom12050606. [PMID: 35625534 PMCID: PMC9138639 DOI: 10.3390/biom12050606] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/14/2022] [Accepted: 04/17/2022] [Indexed: 11/16/2022] Open
Abstract
Our aim was to evaluate the expression of biomarkers, CD44v6, CD147, EGFR, p53, p63, p73, p16, and podoplanin in oral leukoplakias (OL) and to assess their potential for prediction of malignant transformation (MT). We analyzed the expression of CD44v6, CD147, EGFR, p53, p63, p73, p16, and podoplanin by immunohistochemistry in 52 OL, comprised of 41 low-grade (LG) dysplasia and 11 high-grade (HG) cases. Twelve healthy normal tissues (NT) were also included. Univariate and multivariate analysis were performed to evaluate any association with MT. Variable expression among the studied markers was observed, with a significant increase of high expression from NT to LG and HG cases in CD44v6 (p = 0.002), P53 (p = 0.002), P73 (p = 0.043), and podoplanin (p < 0.001). In multivariate analysis, cases with high podoplanin score showed a significant increased risk of MT (HR of 10.148 (95% CI of 1.503−68.532; p = 0.017). Furthermore, podoplanin combined with binary dysplasia grade obtained a HR of 10.238 (95% CI of 2.06−50.889; p = 0.004). To conclude, CD44v6, p53, p73, and podoplanin showed an increasing expression along the natural history of oral carcinogenesis. Podoplanin expression independently or combined with dysplasia grade could be useful predictive markers of MT in OL.
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Affiliation(s)
- Luís Monteiro
- Medicine and Oral Surgery Department, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (B.d.A.); (F.S.); (J.J.P.)
- UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (L.D.); (F.G.); (C.L.)
- Correspondence: ; Tel.: +351-224157168
| | - Barbas do Amaral
- Medicine and Oral Surgery Department, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (B.d.A.); (F.S.); (J.J.P.)
- UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (L.D.); (F.G.); (C.L.)
- Stomatology Department, Hospital de Santo António, Centro Hospitalar do Porto, 4099-001 Porto, Portugal
| | - Leonor Delgado
- UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (L.D.); (F.G.); (C.L.)
| | - Fernanda Garcês
- UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (L.D.); (F.G.); (C.L.)
| | - Filomena Salazar
- Medicine and Oral Surgery Department, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (B.d.A.); (F.S.); (J.J.P.)
- UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (L.D.); (F.G.); (C.L.)
| | - José Júlio Pacheco
- Medicine and Oral Surgery Department, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (B.d.A.); (F.S.); (J.J.P.)
- UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (L.D.); (F.G.); (C.L.)
| | - Carlos Lopes
- UNIPRO, Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal; (L.D.); (F.G.); (C.L.)
- Molecular Pathology and Immunology Department, Institute of Biomedical Sciences Abel Salazar (ICBAS), Porto University, 4099-001 Porto, Portugal
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, The WHO Collaborating Centre for Oral Cancer, London SE1 9RT, UK;
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