Abdulmajeed Ahmad A, Dalley Andrew J, Farah Camile S
The University of Queensland, UQ Centre for Clinical Research, Herston, Qld, Australia; The University of Queensland, School of Dentistry, Brisbane, Qld, Australia.
J Oral Pathol Med. 2013 Nov;42(10):755-60. doi: 10.1111/jop.12073. Epub 2013 Apr 25.
Multifactorial conditions underlie progression of potentially malignant oral lesions (PMOL) to oral squamous cell carcinoma (OSCC) and there is currently need for better prediction of malignant transformation. The hypothesised existence of cancer stem cells in dysplastic oral tissues provides the potential for more informed assessment of PMOL progression. Semi-quantitative immunohistochemical assessment of four putative cancer stem cell markers (CD24, CD44, CD271 and ALDH1) was conducted with a training cohort of 107 patient biopsies to establish clinically applicable score threshold values that were subsequently applied to a blind diagnosis in an independent validation cohort of 278 biopsies. Stain intensity scores for ALDH1, CD24 and CD44, but not CD271 were greater for OSCC than normal tissues. The intensity of ALDH1 and CD24 immunostaining correlated with increased oral epithelial disease severity, and CD24 was effective in distinguishing OSCC from non-malignant tissues, correctly diagnosing 71% of OSCC cases in the validation cohort. Importantly, CD24 immunostaining was effective in diagnosing the presence of dysplasia, correctly discriminating 69% of dysplasia tissues from normal tissues, although no distinction between mild and severe grades of dysplasia was achieved. The results highlight CD24 immunostain intensity as an effective marker of oral dysplasia and OSCC. In conclusion, CD24 immunostain intensity scoring may serve as a helpful technique to assist with the histological recognition of dysplasia in oral biopsies, but not for distinguishing between grades of dysplasia.
多因素情况是潜在恶性口腔病变（PMOL）进展为口腔鳞状细胞癌（OSCC）的基础，目前需要更好地预测恶性转化。发育异常的口腔组织中癌症干细胞的假设存在为更明智地评估PMOL进展提供了可能性。对107例患者活检的训练队列进行了四种假定的癌症干细胞标志物（CD24、CD44、CD271和ALDH1）的半定量免疫组织化学评估，以建立临床适用的评分阈值，随后将其应用于278例活检的独立验证队列中的盲法诊断。与正常组织相比，OSCC中ALDH1、CD24和CD44的染色强度评分更高，但CD271并非如此。ALDH1和CD24免疫染色的强度与口腔上皮疾病严重程度的增加相关，并且CD24可有效区分OSCC与非恶性组织，在验证队列中正确诊断了71%的OSCC病例。重要的是，CD24免疫染色可有效诊断发育异常的存在，正确区分69%的发育异常组织与正常组织，尽管未实现轻度和重度发育异常之间的区分。结果突出了CD24免疫染色强度作为口腔发育异常和OSCC的有效标志物。总之，CD24免疫染色强度评分可能是一种有用的技术，有助于在口腔活检中对发育异常进行组织学识别，但不能用于区分发育异常的等级。
