Significance of neo-angiogenesis and immuno-surveillance cells in squamous cell carcinoma of the tongue

Evaluation of peritumoral inflammatory infiltration and its relationship with different prognostic factors in cutaneous squamous cell carcinoma

BACKGROUND

Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers. Prognostic factors, such as tumor thickness, play a crucial role in the management of these patients. Peritumoral inflammatory infiltration has been shown to influence the prognosis of malignancies. This study aimed to determine different prognostic factors and investigate peritumoral inflammatory infiltration in patients with cSCC.

METHODS

The study population consisted of 272 patients with a diagnosis of cSCC. Clinical data, such as age and tumor location, were extracted from pathology reports, and other information was gathered by contacting the patients via phone calls. All pathology slides were reviewed by an expert dermatopathologist, and the histopathological features and prognostic factors were evaluated.

RESULTS

The highest number of tumors was found in the scalp and forehead (21.3%), while the lowest number was found in the trunk and thighs (3.31%). The highest mean tumor thickness was observed in the group with no inflammatory cells; on the other hand, the lowest tumor thickness was found in the group of lymphocytes and plasma cells. The group with severe eosinophilic infiltration had the highest mean tumor thickness, while the group with no eosinophilic infiltration had the lowest mean tumor thickness.

CONCLUSION

Depending on the type of peritumoral inflammatory cells, the prognosis of cSCC may be predictable.

Horoscopic role of CD105 (Endoglin) in progression of oral lichen planus: An immunohistochemical study

Context

Role of CD105(Endoglin) in Pathogenesis and progression of OLP.

Aim

To assess the role of neoangiogenesis in the progression of OLP by determining the expression of CD105 in OLP and normal mucosa.

Settings and Design

The present study includes a total of 70 formalin-fixed paraffin-embedded blocks of which the study group comprises 50 tissue sections histopathologically confirmed as OLP. They were subdivided into two groups - Group I (Reticular OLP) and Group II (Erosive OLP) - 25 each. The control group (designated as Group III) included 20 sections of normal mucosa.

Materials and Methods

All the sections were 4 μm thick and stained with CD105 antibodies. After identifying areas of highest vascularity (hot spots) in low power (×10) magnification, individual microvessels were counted manually at high power (×40) magnification.

Statistical Analysis Used

Analysis of variance test was used to determine the difference of microvessel density (MVD) between variants of OLP and normal mucosa and Cohen's kappa statistic was used to check interobserver variability.

Results

CD105 staining showed a mean MVD of 1.31 ± 1.8 in the normal mucosa compared to 1.68 ± 1.4 and 4.14 ± 2.7 in the reticular and erosive variants, respectively, with a P = 0.000*, which is statistically significant (*P < 0.05 is statistically significant).

Conclusion

Based on our observations, it is evident that compared to normal mucosa, MVD is greater in lichen planus. Within the two variants of OLP, MVD is higher in Erosive variant compared with Reticular variant, foreshadowing the role of neoangiogenesis in the progression of OLP and its possible malignant transformation.

Mast Cells and Blood Vessels Profile in Oral Carcinogenesis: An Immunohistochemistry Study

Background:

The objectives of the present study were to evaluate angiogenesis and mast cell density in oral epithelial dysplasia and oral squamous cell carcinoma (OSCC).

Materials and Methods:

This was an observational, retrospective and quantitative study. The samples consisted of 60 tissue specimens from patients with squamous cell carcinoma, epithelial dysplasia and controls (n=20/group). Immunohistochemistry was performed using an anti-tryptase antibody to mast cells and anti-CD31 and anti-CD34 for blood vessels and we count the number of mast cells and determine the percentage of CD31 and CD34 antibody staining (vascular density).

Results:

The mast cells had lower density in OSCC compared to control and dysplasia (p = 0.009). In angiogenesis, the expression of CD31 showed a higher percentage of blood vessels in OSCC (p < 0.001), however, CD34 showed no difference between groups (p=0.092). The CD31 antibody presented as a high immunostaining in oral mucosa than CD34.

Conclusions:

The increased vascularity in squamous cell carcinoma suggests that angiogenesis begins when malignant transformation starts that seems to be inversely associated with the number of mast cells.

Evaluation of myeloid cells (tumor-associated tissue eosinophils and mast cells) infiltration in different grades of oral squamous cell carcinoma

Background:

The multifunctional involvement and infiltration of myeloid cells (tumor-associated tissue eosinophils [TATE] and mast cells) can provide a unique opportunity to define relevant effectors functions that may represent novel, therapeutic options for modulation of tumor onset/growth.

Aim:

Our study aimed to evaluate infiltration of myeloid cells (TATE and Mast cells) infiltration in different grades (WHO grading) of oral squamous cell carcinoma (OSCC).

Materials and Methods:

Total 30 cases of OSCC were selected for this study. Hematoxylin and eosin stain and toluidine blue special stain, to evaluate TATE and the mast cells infiltration, were used. Three-year follow-up of OSCC cases was done.

Result:

Among 30 cases, 63.33% cases of OSCC showed TATE-positive and 36.66% cases showed TATE-negative. Regarding mast cells infiltration, 66.66% OSCC cases showed mast cells positive and 33.33% cases did not show significant mast cells infiltration. We found significant association of TATE and mast cells infiltration in OSCC cases. These myeloid cells infiltration significantly associated with age of patients but did not show any significant association with gender, site, and habit of cases. When we compared these cells infiltration with clinical stages and different histological grades of tumor, we found their infiltration is decreasing, from Stages 1 to Stage 3 of tumor and from well to poorly differentiated carcinoma. We have also found the less infiltration of these myeloid in recurrence cases of OSCC.

Conclusion:

As the infiltration of TATE and mast cells are correlated, along with evaluation of TATE, we should also evaluate the presence of mast cells infiltration in OSCC. The assessment of myeloid cells could become, in the future, useful for therapeutic approaches in this subset of the patient.

The domino effect: Role of hypoxia in malignant transformation of oral submucous fibrosis

INTRODUCTION

Oral submucous fibrosis (OSMF) is a precancerous condition predominantly seen in people of Asian descent. About 7-12% OSMF patients develop oral squamous cell carcinoma (OSCC). Morphological features of OSMF especially fibrosis suggests a possibility of the hypoxic environment in diseased tissues. Oral cancer usually develops from hyperplasia through dysplasia to carcinoma. Neovascularization and increased glycolysis, represent adaptations to a hypoxic microenvironment that are correlated with tumor invasion and metastasis. The adaptation of cells to hypoxia appears to be mediated via hypoxia inducible factor-1α (HIF-1α). HIF-1α is said to be associated with malignant transformation of epithelium in other sites. It appears that HIF-1α plays a significant role in both prostate and cervical carcinogenesis at early stages. We hypothesize that progression of OSMF and malignant transformation in the background of fibrosis mediates via HIF-1α either by up- or down-regulation of various such molecules. Therefore, the main objective of this study was to investigate the relationship between the expression of HIF-1α in OSMF, OSCC and OSCC with OSMF.

AIM

To investigate the relationship between the expression of HIF-1α in OSMF, OSCC and OSCC with OSMF.

MATERIALS AND METHODS

The study group consists of histopathologically diagnosed 20 cases of OSCC, oral submucous fibrosis and OSCC with OSMF each. The immunohistochemistry was carried out on neutral buffered formalin-fixed paraffin-embedded tissue sections by using the monoclonal antibody of HIF-1α.

RESULTS

A rise in the expression of HIF-1α from OSMF to OSCC to OSCC with OSMF is observed.

Expression of interleukin-33 is correlated with poor prognosis of patients with squamous cell carcinoma of the tongue

OBJECTIVE

The aim of this study was to clarify the role of IL-33 in tumor progression.

METHODS

Surgical specimens from 81 patients with squamous cell carcinoma of the tongue were studied using immunohistochemistry. Primary tumor sections were analyzed for IL-33 and ST2 expression. To examine the influence of IL-33 on the microenvironment of the tumor, we determined the mast cell density (MCD) and microvessel density of the stroma.

RESULTS

Patients with high IL-33 expression had a significantly worse prognosis (p=0.004). IL-33 expression was significantly elevated in patients with local and nodal recurrence (p=0.014 and p=0.019). ST2 expression was also associated with a worse prognosis (p=0.024) and was significantly elevated in patients with nodal recurrence (p=0.004). MCD was associated with worse prognosis (p=0.038) and correlated significantly with IL-33 expression (r=0.626, p<0.001). Micovessels in the stroma were significantly increased in the high IL-33 group (p<0.001).

CONCLUSION

These data suggest that the IL-33/ST2 axis contributes to tumor aggressiveness and affects the tumor microenvironment. Immunohistochemical evaluation of IL-33 and ST2 is useful for identifying patients at a high risk for poor prognosis.

Role of macrophages in malignancy

Macrophages themselves are a heterogeneous mixture of cells which mediate their effects not only through phagocytosis but also through the production of various soluble factors such as cytokines and chemokines. The most important function of macrophages is the defense of the body against pathogen aggressions. However, when recruited within neoplastic tissues, tumor-associated macrophages polarize differently and do not predominantly exert their immune function but rather favor tumor growth and angiogenesis.

Mast cell density and angiogenesis in oral dysplastic epithelium and low- and high-grade oral squamous cell carcinoma

OBJECTIVE

Oral squamous cell carcinoma (OSCC) is one of the 10 most common malignant tumors and SCC accounts for approximately 94% of all oral malignancies. The risk of malignant transformation in dysplastic lesions is greater than that of normal oral mucosa. The definite roles of mast cells and angiogenesis in OSCC have been under debate. The aim of this study was to compare mast cell count (MCC) and microvessel density (MVD) among normal oral mucosa, oral dysplastic epithelium and low- and high- grade OSCC.

MATERIAL AND METHODS

A total of 42 specimens of OSCC (21 high- and 21 low-grade) were collected, along with six normal and 22 dysplastic oral mucosa. The mean MCC and MVD, as well as the correlation between them, were evaluated by immunohistochemical staining.

RESULTS

Statistically significant increases in mean MCC and MVD were observed between normal oral mucosa and epithelial dysplasia, normal oral mucosa and OSCC and epithelial dysplasia and OSCC (P < 0.05), but there were no statistically significant differences in MCC and MVD between low- and high-grade OSCC. Also, the Spearman's correlation coefficient showed a significant correlation between MCC and MVD (r = 0.727, P < 0.001).

CONCLUSIONS

The significant correlation found between MCC and MVD is in agreement with the idea that mast cells promote tumor progression via upregulation of angiogenesis. MCC and the degree of angiogenesis can potentially be used as indicators of the evolution of SCC from epithelial dysplasia.