ABSTRACT
OBJECTIVE: Oral squamous cell carcinoma (OSCC) invades and metastasizes, by degrading the extracellular matrix (ECM) and is associated with poor prognosis. Matrix-metalloproteinase (MMP-9) can initiate ECM degradation and angiogenesis which brings a significant change in tumor microenvironment favoring tumor progression. A major thrust has been laid on understanding this key enzyme as it has significant implications for cancer therapy. Comprehending the association of vasculature with MMP-9 expression in precancerous lesions oral epithelial dysplasia (OED) and OSCC is essential since the data regarding the same are fewer. The aim is to evaluate and correlate MMP-9 expression with morphometric analysis of mucosal vasculature in the normal oral mucosa (NOM), OED, and OSCC. METHODS: A total of 60 histologically diagnosed cases of OED (n = 30); OSCC (n = 30); along with 10 NOM (n = 10) as control were included. Immunohistochemical staining of MMP-9 and vascular morphometric analysis was performed for all the cases. Results were analyzed using the Chi-square test, Fischer exact test, and Spearman correlation test. RESULTS: A statistically significant difference in MMP-9 was noted among the groups with P = 0.011* (epithelium); P = 0.001* (stroma) by the highest value in OSCC group. Morphometry also revealed a progressive increase from NOM to OED to OSCC. Spearman's correlation of MMP-9 with vascular parameters illustrated a positive relation of MMP-9 with mean vascular density (MVD) and mean vascular area percentage (MVAP). CONCLUSION: Positive correlation of MMP-9 with MVD and MVAP demonstrates this markers effect on angiogenesis. Henceforth, MMP-9 can be embattled as a potential therapeutic target in combating tumor progression.
ABSTRACT
BACKGROUND: Immunohistochemistry (IHC) is a molecular technique that has grown tremendously over the years. However, the assessment is only qualitative which is subjective and causes errors. Due to this limitation, several excellent markers have not gained importance and reached clinical trials. Hence, we aimed to quantify IHC by ImageJ analysis with a novel IHC profiler plugin. ImageJ has not been tried in oral precancerous tissues with minimal attempt for matrix markers. AIM: This study aimed to validate the quantification of immunoexpression of tenascin-C (TN-C) in oral precancerous tissues and oral squamous cell carcinoma (OSCC) using ImageJ software with IHC profiler plugin. MATERIALS AND METHODS: After IHC staining for TN-C and image acquisition, ImageJ analysis was performed as per the standard recommended algorithm. Assessment was done by two observers by blinding the histopathological diagnosis. The immunoscore was assessed for interobserver variability using Kohen's kappa statistics. RESULTS: All our cases were in agreement and found to be statistically significant with P < 0.005. Moderate agreement was for mild dysplasia, moderate dysplasia and oral lichen planus. Substantial agreement was for oral submucous fibrosis and OSCC and almost perfect agreement noted for cases of severe dysplasia. CONCLUSION: IHC can now be quantified using freely downloadable software ImageJ analysis in oral precancerous tissues and OSCC. This software with good threshold control can quantify matrix marker such as TN-C. Hence, herewith, we propose that IHC markers should be quantified using ImageJ by our entire oral pathology fraternity so as to have a standard immunoscore for all markers.
ABSTRACT
UNLABELLED: Grossing and microscopic examination of the received specimens in a histopathological laboratory is a routine procedure for achieving a fi nal diagnosis. Errors in either of the steps may lead to an inaccurate diagnosis since wrong orientation of the specimen may either cause diagnostic delays or pose a diagnostic dilemma. Stereomicroscope is an important accessory instrument which can be used to study a variety of specimens. It not only enables us to study the surface details but also aids in minute work including dissection and microsurgery to name a few. AIM: To assess the effectiveness of stereomicroscope in routine grossing and its role in arriving at a final diagnosis. MATERIALS AND METHODS: Cases from the archives of the department for which stereomicroscopic evaluation was done were retrieved and reviewed. RESULTS AND CONCLUSION: Stereomicroscopic images aided not only in the proper orientation of the specimen but also in the diagnosis.