Quantification of CD44, Epidermal Growth Factor Receptor, E-cadherin, and Vimentin in Oral Squamous Cell Carcinoma as an Indicator for Disease Progression and Survival.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is commonly associated with early recurrence due to loco-regional spread. Changes at the cellular levels can be studied and are often an early indicator of disease progression, much before clinical symptoms become visible. Identifying parameters indicating an impending recurrence could help the clinician plan for early treatment and thus improve survival. Hence, this study aimed to determine if quantifiable parameters could be established for CD44, epidermal growth factor receptor (EGFR), E-cadherin, and vimentin and if these values could be used as indicators of disease progression on follow-up. METHOD: A total of 150 cases of OSCC were included in the study and followed up linearly for 36 months. Paraffin-embedded tissues of these cases were subjected to immunohistochemical analysis for reactivity to CD44, EGFR, E-cadherin, and vimentin. The immunohistochemical staining correlated with the tumor's clinical and histological grade. Statistical analysis was done using SPSS Statistics version 17 (IBM Corp., Armonk, NY, USA). The receiver operating characteristics (ROC) were deployed for determining the correlation of recurrence with the immunohistochemistry (IHC) markers, while the Kaplan-Meier curve was employed for survival analysis. RESULTS: A recurrence rate of 70.0% and a survival rate of 66.6% were noted after a follow-up period of three years. It was found that both CD44 and E-cadherin decreased with the grade of tumor, while EGFR and vimentin increased with tumor de-differentiation. The E-cadherin was found to be the best predictor of recurrence and survival among all the four markers. CONCLUSION: The cut-off values could be identified for all four biomarkers, which on follow-up proved to be a valuable tool with a high sensitivity and specificity for predicting recurrence and three-year survival in patients with OSCC.

Significance of HIF-1α and CD105 in establishing oral squamous cell carcinoma associated with oral submucous fibrosis a distinct clinicopathological entity.

Context: Oral squamous cell carcinoma associated with oral submucous fibrosis (OSCC with OSMF) is clinicopathologically a distinct entity. However, scientific proof in view of assessment of biomarkers of hypoxia and neoangiogenesis to differentiate them are lacking. The expression of hypoxia-inducible factor 1-α (HIF-1α) and CD105 in OSCC with and without OSMF possibly will be explicated along these lines. Aim: This study aims to evaluate the molecular basis of hypoxia and neoangiogenesis in terms of immunohistochemical expression of HIF-1α and CD105 in OSCC with and without OSMF cases. Settings and Design: A retrospective cohort. Subjects and Methods: The study comprise of 203 histopathologically diagnosed surgically operated cases of OSCC retrieved from the departmental archives. The OSCC cases were subgrouped into two, OSCC with OSMF (Group I) and OSCC without OSMF (Group II). The evaluation of hypoxia and angiogenesis was carried out by immunohistochemical markers, HIF-1α and CD105. MVD is the parameter of angiogenesis expressed by CD105. Statistical Analysis Used: Differences in CD105, and HIF-1α immunoreactivity between study groups were done using descriptive statistics using "Kruskal-Wallis test," "Mann-Whitney test." Statistical significance was set at P < 0.05. Results: On comparison of MVD in Group I and II, statistically significant difference was found in MVD (8.88 ± 3.41, 16.13 ± 5.86, P = 0.0001). The HIF1-α expression was less in Group I (6.85 ± 2.62) as compare to Group II (7.22 ± 3.08) but the difference was statistically nonsignificant (P = 0.35). Conclusions: The OSCC with OSMF is not only clinicopathologically distinct entity of OSCC but also diverse in its molecular pathogenesis as explicited by distinct expression of HIF-1 α and CD105.

The effectiveness of enamel matrix protein (Emdogain(®)) in combination with coronally advanced flap in the treatment of multiple marginal tissue recession: A clinical study.

BACKGROUND: Gingival recession resulting in root exposure is a common problem faced by clinicians. This clinical study compared the results obtained by treating gingival recession using enamel matrix derivative (Emdogain gel(®)) along with coronally positioned flap and coronally positioned flap alone. MATERIALS AND METHODS: Twenty patients with a total of 46 gingival recession defects, each patient with a minimum of two recession defects, were included in the study. The test group, which consisted of 10 patients with 22 recession defects, was treated by enamel matrix derivatives (Emdogain gel) in combination with a coronally positioned flap, while the control group, which consisted of 10 patients with 24 gingival recession defects, was treated with 24% ethylenediaminetetraacetic acid (EDTA; Prefgel(®)) in combination with coronally positioned flap. RESULTS: Student's paired and unpaired t-test was used for statistical analysis. If the probability value (P) was less than 0.05, it was considered significant. Data from this study demonstrated that application of (EMD) Emdogain gel resulted in a statistically significant increase in root coverage, gain in the clinical attachment level (CAL), and probing pocket depth (PPD) reduction when compared with coronally advanced flap (CAF) alone, but there was no statistically significant difference in the width of keratinized gingiva (WKG) between the two groups.

Correlation of serum levels of vascular endothelial growth factor with TNM staging, histopathologic grading, and surgical therapy for oral squamous cell carcinoma.

OBJECTIVE: This study aimed to assess the serum levels of vascular endothelial growth factor in oral squamous cell carcinoma patients before and after surgical therapy, to compare these values with those of healthy individuals using ELISA, and to evaluate if any correlation existed between vascular endothelial growth factor levels and TNM stage or histolopathologic grade of the tumor. METHOD AND MATERIALS: The study included three groups: group A1 consisted of 31 oral squamous cell carcinoma patients who had not received any prior treatment; group A2 consisted of the same 31 oral squamous cell carcinoma patients who had undergone radical surgical excision 1 month prior but no adjuvant therapy; and group B (control group) consisted of 16 healthy individuals. The serum vascular endothelial growth factor levels were assessed using the ELISA kit. RESULTS: The vascular endothelial growth factor levels of preoperative oral squamous cell carcinoma patients were found to be three times higher than those of controls, and this difference was found to be statistically significant. The postoperative vascular endothelial growth factor levels had decreased 1 month after surgery but did not decrease to baseline levels. The vascular endothelial growth factor levels increased progressively with the TNM stage and histologic grade of tumor, but no definite correlation between the two could be found. CONCLUSION: Vascular endothelial growth factor is an important marker of angiogenesis, as the vascular endothelial growth factor levels of the oral squamous cell carcinoma groups remained significantly elevated compared to that of controls. Though no significant difference was found between the pre- and postoperative oral squamous cell carcinoma groups, it can be suggested that successful treatment may reduce serum vascular endothelial growth factor levels if the time period of postoperative sample collection is increased. Only then can the utility of vascular endothelial growth factor as marker for assessing the effectiveness of surgical therapy or as a prognostic indicator be commented upon.