HLA-G Expression is Associated with an Unfavorable Prognosis of Oral Squamous Cell Carcinoma

Background: HLA-G, a major histocompatibility complex of non-classical class Ib, plays a key role in the development of the primary tumors to metastatic stages. The aim of this study was to investigate HLA-G expression in oral squamous cell carcinomas and its relationship with clinicopathological factors. Methods: After immunohistochemical staining for HLA-G with 63 formalin fixed and paraffin embedded blocks (33 oral squamous cell carcinoma and 30 normal oral mucosa samples), staining intensity, percentage of stained cells and final immunoreactivity score were evaluated, along with other variables. Results: Staining intensity, percentage of stained cells and final immunoreactivity scores in oral squamous cell carcinomas were higher than those in normal oral mucosa (all P=0.001). The staining intensity in the parenchyma of squamous cell carcinoma cells was significantly associated with the clinical tumor stage (P=0.022) and the group with lymphatic metastasis exhibited a higher staining percentage (P=0.026). Staining intensity and immunoreactivity score (IRS) exhibited a significant but inverse correlation with survival rate (P=0.004 and P=0.018, respectively) and a significant direct relationship with clinical stage (P=0.001 and P=0.001). Conclusion: The results supported a role of HLA-G in development of oral squamous cell carcinomas and metastasis to lymph nodes. It might be useful in molecular-targeted therapy.

Immunohistochemical Evaluation of Angiogenesis Related Markers in Pyogenic Granuloma of Gingiva.

BACKGROUND: Pyogenic granuloma is a common non-neoplastic connective tissue proliferation. ICAM-1 and VCAM-1 are vascular adhesion molecules and CD34 is a marker for evaluation of angiogenesis. The purpose of this study was to compare the immunohistochemical expression of ICAM-1, VCAM-1 and CD34 in oral pyogenic granuloma and normal gingiva. MATERIALS AND METHODS: This study was performed on thirty five formalin-fixed, paraffin embedded samples of gingival pyogenic granuloma. Also we used thirty five paraffined blocks of normal gingiva as control group which were taken from crown lengthening surgery. We employed immunohistochemistry staining for our prepared microscopic slides using monoclonal mouse anti-human antibodies against ICAM-1 (CD54), VCAM-1 (CD106) and CD34. Slides were examined under light microscope and then the mean amount of stained vessels also known as microvascular density (MVD) in highly vascularized areas (hot spots) was measured. Paired t-test and repeated measures ANOVA were used to compare the difference between quantitative variables and Chi-square test for qualitative variables in different groups. Pearson correlation coefficient was used to compare relations between quantitative variables. P<0.05 was considered significant. RESULTS: The mean of MVD for ICAM-1, VCAM-1 and CD34 was significantly higher in pyogenic granuloma than normal gingiva (p<0.001 and p<0.001 and p<0.001, respectively). Expression of CD34 in pyogenic granuloma was significantly higher than ICAM-1 and VCAM-1 (P<0.001). Besides, expression of ICAM-1 in normal gingiva, was significantly lower than two other markers (p<0.001). CONCLUSIONS: Regarding the results, it seems that ICAM-1, VCAM-1 and CD34 are useful biomarkers in evaluation of vascular and inflammatory lesions such as gingival pyogenic granuloma and the results indicate the role of these biomarkers in pathogenesis of oral pyogenic granuloma.

Immunohistochemical analysis of COX-2 expression in dentigerous cyst, keratocystic odontogenic tumor and ameloblastoma: A comparative study.

BACKGROUND: Cyclo-oxygenase-2 (COX-2) is an early response gene that is induced by growth factors, oncogenes and carcinogens and its expression is increased in various tumors. Increased expression of COX-2 plays a significant role in the development and growth of tumors by interfering in biological processes such as cell division, cellular immunity, cell adhesion, apoptosis, and angiogenesis. This study aimed to investigate the immunohistochemical expression of COX-2 in keratocystic odontogenic tumor (KOT) in comparison with ameloblastoma and dentigerous cyst with regards to different clinical behavior and histopathological features of these lesions. MATERIALS AND METHODS: Paraffined blocks of 45 cases including 15 cases of dentigerous cyst, 15 cases of KOT and 15 cases of ameloblastoma were stained with immunohistochemical method for COX-2. Five high-power fields of each sample were evaluated to determine the percentage of stained cells and the intensity of staining. Degree of immunoreactivity was obtained from the sum of two. Statistical evaluation was performed by the Kruskal-Wallis and ANOVA Mann-Whitney test (P < 0.05). RESULTS: Overexpression of COX-2 in ameloblastoma and KOT was observed compared with dentigerous cyst (P < 0.001). However, no significant difference was observed between the expression of COX-2 in ameloblastoma and KOT (P = 0.148). CONCLUSION: The COX-2 expression in odontogenic tumors such as ameloblastoma and cystic neoplasm with aggressive behavior such as KOT increases. However, it does not seem that COX-2 affects the development and growth of cysts with noninvasive behavior like dentigerous cyst.

Cyclo-oxygenase-2 expression in oral squamous cell carcinoma.

BACKGROUND: Many evidences showed that cyclooxygenase-2 (COX-2), an enzyme that catalyzes the synthesis of prostaglandins, has an important role in carcinogenesis. It has been observed in experimental models that selective COX-2 inhibitors suppress the formation of tumors including tongue carcinoma. The aim of this study was to investigate the immunohistochemical expression of COX-2 in oral squamous cell carcinoma (OSCC) compared to normal oral mucosa and oral dysplasia. MATERIALS AND METHODS: A total of 60 paraffined blocks (20 cases of OSCC, 20 cases of oral epithelial dysplasia and 20 cases of normal oral mucosa were included in this study and immunohistochemical staining was done for COX-2 expression. From each sample, 5 high power fields were assessed to determine the percentage of stained cells and staining intensity. Immunoreactivity was obtained by multiplying the above two cases. Data were analyzed with using the Kruskal-Wallis test ANOVA, Mann-Whitney test and least significant difference and P<0.05 was declared as significant. RESULTS: High level of COX-2 expression was found in OSCC and dysplasia compared to normal mucosa. Furthermore, a positive correlation was found between COX-2 expression and severity of dysplasia. However, no significant difference between low grade and high grade tumors was found. CONCLUSION: The result of the present study supports from the role of COX-2 in carcinogenesis and progression of premalignant lesion to malignancy.

VCAM1 and ICAM1 expression in oral lichen planus.

Oral lichen planus is a chronic inflammatory immune-mediated disease. ICAM-1 and VCAM-1 are vascular adhesion molecules that their receptors are located on endothelial cells and leukocytes. The aim of this study is the immunohistochemical evaluation of VCAM1 and ICAM1 in oral lichen planus and to compare these two markers with normal mucosa for evaluation of angiogenesis. This descriptive-analytical study was performed on 70 paraffined blocks of oral lichen planus and 30 normal mucosa samples taken from around the lesions. Samples were stained with H & E and then with Immunohistochemistry using monoclonal mouse anti human VCAM1 (CD106), & monoclonal mouse anti human ICAM1(CD54) for confirmation of diagnosis. Slides were evaluated under light microscope and VCAM1 and ICAM1 positive cells (endothelial cells and leukocytes) were counted. Data were analyzed with Mann-Whitney test, Wilcoxon and Chi-Square and p<0.001 was declared significant. VCAM1 and ICAM1 expression significantly increased compared to normal mucosa in oral lichen planus according to the percentage of stained cells (p=0.000& p=0.000, Mann-Whitney test). Thirty cases of oral normal mucosa associated with lichen planus showed that the VCAM1 has increased significantly in comparison to normal mucosa (p<0.001). Also, ICAM1 expression between lichen planus and normal mucosa, showed a significantly difference (p<0.001). A significant difference between VCAM1 and ICAM1 expression and type of lichen planus was not observed (p>0.05). Regarding the results, it seems that high expression of VCAM1 and ICAM1 is related to oral lichen planus.

p53 and PCNA Expression in Keratocystic Odontogenic Tumors Compared with Selected Odontogenic Cysts.

p53 and PCNA expression in keratocystic odontogenic tumors compared with selected odontogenic cysts Summary: The aim of this study was to evaluate p53 and PCNA expression in different odontogenic lesions regarding their different clinical behaviors. Slices prepared from 94 paraffin-embedded tissue blocks (25 radicular cysts (RC), 23 dentigerous cysts (DC), 23 keratocystic odontogenic tumors (KCOT) and 23 calcifying cystic odontogenic tumors (CCOT)) were stained with p53 and PCNA antibodies using immunohistochemistry procedure. The highest level of p53 expression was in the basal layer of RC, and the highest level of PCNA expression was in the suprabasal layer of KCOT. The differences of p53 expression in basal and suprabasal layers as well as PCNA expression in the suprabasal layer were significant but there was no significant difference in PCNA expression in the basal layer of these lesions. The expression of p53 in the basal layer of RC was higher than in other cysts. This may be due to intensive inflammatory infiltration. Also, the high level of PCNA expression in the suprabasal layer of KCOT may justify its neoplastic nature and tendency to recurrence. KCOT and calcifying cystic odontogenic tumors did not show similar expression of studied biomarkers.

p63 expression in randomized odontogenic cysts.

OBJECTIVE: To find out the immunohistochemical assessment of p63 expression in odontogenic cysts based on the differences among their clinical behaviors. METHODS: This study was carried out on 34 archival paraffin-embedded specimens of odontogenic cysts. We obtained the specimens from the Pathology Department of Babol University of Medical Sciences, Babol, Iran from March 2003 to February 2008. The specimens comprised 12 dentigerous cysts, 9 radicular cysts, and 13 keratocystic odontogenic tumors (KCOTs). The immunohistochemical technique was performed using the Envision system for evaluation of p63 expression. RESULTS: The KCOT revealed the highest p63 expression and the differences between the 3 groups was statistically significant. CONCLUSION: P63 expression might be helpful when identifying cyst types with more aggressive and invasive phenotype.

Angiomyofibroblastoma of the vulva.

Angiomyofibroblastoma is a benign well-circumscribed tumor characterized by alternating hypocellular and hypercellular areas with abundant thin-walled blood vessels. The tumor cells are bland and spindle-shaped or epitheloid and tend to concentrate around the vessels or cluster in small nests. Herein, we report a case of angiomyofibroblastoma of the left labia major in a 50-year-old female. The tumor measured 18 x 16 x 11 cm and appeared as an ulcerated rubbery vulvar mass with rapid enlargement during one month. Ultrasonography demonstrated a soft tissue tumor with homogeneous echo and normal vascularity. Histologically, cells were positive for vimentine, desmin, and estrogen and progesterone receptors but negative for cytokeratin; all in favor of the diagnosis of angiomyofibroblastoma.