Correlation of Pattern of Invasion, Stromal Inflammation and Lymphovascular Invasion With Histopathological Grading in Oral Squamous Cell Carcinoma: A Retrospective Study.

INTRODUCTION: Despite the progress in diagnostics and treatment modalities, the survival rate of oral squamous cell carcinoma (OSCC) patients has remained unchanged. Early diagnosis of the disease helps in better treatment and prognosis. Identifying clinicopathological and histopathological parameters that help predict disease progression is crucial. OBJECTIVES: To assess the significance of various clinical and histopathological factors in OSCC and to correlate the patterns of invasion of tumour (POI), stromal inflammation, and lymphovascular invasion with the histopathological grading of OSCC. MATERIALS AND METHODS: This study included 30 oral squamous cell carcinoma cases from 2015 to 2021. The surgically operated cases of OSCC were obtained from the archives of the Oral Pathology Department. The subjects were categorized according to the degree of differentiation of OSCC. The parameters like the pattern of invasion of tumour (POI), stromal inflammation, and lymphovascular invasion were assessed and correlated with the different histopathological grades of OSCC. RESULTS: We observed a statistically significant correlation between the pattern of invasion and stromal inflammation with histopathological grades of OSCC. There was no significant association between lympho-vascular invasion and histopathological grades of OSCC. CONCLUSION: We conclude that histopathological parameters like the pattern of invasion and stromal inflammation significantly impact different grades of OSCC. These parameters should be included in routine histo-pathological reports for predicting clinical outcomes and management of the disease.

Unicystic Ameloblastoma (UA): A Case Series.

Ameloblastomas are true benign tumors of odontogenic epithelial origin mostly seen in the mandible. After odontoma, it is the second most commonly seen odontogenic neoplasm. Ameloblastomas comprise several clinical, radiological, and histological varieties, making them the most significant odontogenic neoplasm. Unicystic ameloblastomas (UAs) refer to those cystic lesions that show clinical, radiographic, or gross features of jaw cysts but on histologic examination, they show a typical ameloblastomatous epithelium lining the cysts' cavities, with or without luminal and/or mural tumor proliferation. UAs are a less encountered variant of ameloblastomas and are believed to be less aggressive. As this tumor shows considerable similarities with dentigerous cysts, both clinically and radiographically the biological behavior of this tumor group was reviewed.

Evidence based demonstration of the concept of 'field cancerization' by p53 expression in mirror image biopsies of patients with oral squamous cell carcinoma - an immunohistochemical study.

OBJECTIVE: The main rationale for treatment failure and death of the patients with oral squamous cell carcinoma (OSCC) is loco-regional recurrence, development of second primary tumor (SPT) and metastasis, which could be well explained by concept of field cancerization. Identification of patients at high risk for development of SPT is an important part of research for cancer management. This study was designed keeping this aspect in mind and utilizing the increased expression of p53 as an indicator of existence of altered fields in mirror image biopsies of OSCC patients. DESIGN: Forty clinically diagnosed oral cancer patients were included in the study. Biopsy tissue samples from clinically diagnosed oral cancer patients (Group A) and the mirror image, clinically normal looking mucosa at corresponding contralateral anatomical site (Group B) were studied for histopathological evaluation and p53 immunoexpression. RESULTS: Tissue alterations were observed in Groups A and B. There was statistically significant (chi-square value - 126.6, p=0.0001) difference in grades of epithelial dysplasia and p53 immunoexpression in Group B. Spearman's Rank Correlation Coefficient shows non-significant positive correlation between epithelial dysplasia and p53 (r=0.28, p=0.05) in Group B. CONCLUSIONS: Evidence of presence of field cancerization, evaluated by histopathological alterations and enhanced p53 expression was observed in mirror image biopsies of OSCC patients. This could predict the altered state of oral mucosa secondary to carcinogen exposure. The realization of a genetically altered field as a cancer risk factor provides a new paradigm. It would be prudent to keep these patients under close observation and to advice them chemotherapeutic regimes.

Comparative analysis of tumour angiogenesis in solid multicystic and unicystic ameloblastoma by using CD 105 (endoglin).

OBJECTIVE: The aim of the present study was to evaluate and compare the expression of CD105 (endoglin) in solid multicystic ameloblastoma (SMA) and unicystic ameloblastoma (UA). MATERIALS AND METHODS: Angiogenesis was assessed in 20 SMA, 15 UA and 10 normal oral mucosa samples by measuring the mean vascular density (MVD), total vascular area (TVA) and mean vascular area (MVA). The immunohistochemistry was carried out by using monoclonal mouse anti-human antibody against CD105. RESULTS: The Kruskal-Wallis test showed significant difference in mean MVD, TVA, and MVA between SMA, UA, and control group (p<0.001). Using the Mann-Whitney test, the mean MVD, TVA and MVA, was statistically significant between SMA and control group (p<0.001) as well as between UA and control group (p<0.001). No significant difference of mean MVD, TVA, and MVA, was observed between SMA and UA (p>0.05). CONCLUSION: Our study results show no significant difference in MVD, TVA and MVA between SMA and UA. This may reflect the fact that though clinical behaviour, histopathological presentation and prognosis of SMA and UA differ, the process of angiogenesis is not different. This suggests that the angiogenesis has an important role in tumour progression and invasiveness of ameloblastoma. Measurement and assessment of tumour angiogenesis may prove very valuable in predicting response to antiangiogenic therapeutic strategies and also provide objective assessment of post therapeutic response particularly in recurrent cases of SMA and UA.