Jayaraj G, Sherlin H J, Ramani P, Premkumar P, Natesan A
Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India.
Indian J Cancer. 2015 Jan-Mar;52(1):87-92. doi: 10.4103/0019-509X.175580.
Concurrent with the progression of a non- diseased epithelium to the pre-cancerous epithelium to carcinoma, the stroma also undergoes modifications. Myofibroblasts are important stromal cells that play a crucial role in carcinogenesis. The current study investigated the presence of myofibroblasts in healthy oral mucosa, potentially malignant disorders (PMDs) and squamous cell carcinoma (SCC).
The study material consisted of a total of 106 samples categorized into three groups, namely, Group I - Oral SCC (OSCC) (n = 42), Group II - PMDs (n = 32) and Group III - Oral healthy mucosa (n = 32) subjected to immunohistochemical analysis using alpha Smooth Muscle Actin.
Among the 42 cases of OSCC, the staining index was negative in 23 cases (54.7%), low in 9 cases(21.4%) and moderate in 10 cases (23.8%). The stroma of cases of verrucous carcinoma, cases of Hyperkeratosis with epithelial dysplasia, 77.5% of the cases of oral Submucous Fibrosis (OSMF) and healthy oral mucosa were devoid of myofibroblasts resulting in a grade of "0" in all cases.Two of the cases of OSMF (12.5%) showed low staining index for myofibroblast. There was a significant difference in the myofibroblasts expression between the Groups (Kruskal-Wallis test P<0.001).
The findings of the current study justify "myofibroblast" as one among the key stromal element in tumor progression. Future studies involving a larger sample size along with follow up of patients with PMDs are essential to identify the exact stage in which they emerge in the stroma of these lesions.
随着非病变上皮发展为癌前上皮再到癌，基质也会发生改变。肌成纤维细胞是重要的基质细胞，在致癌过程中起关键作用。本研究调查了健康口腔黏膜、潜在恶性疾病（PMDs）和鳞状细胞癌（SCC）中肌成纤维细胞的存在情况。
研究材料共106个样本，分为三组，即第一组——口腔鳞状细胞癌（OSCC）（n = 42），第二组——PMDs（n = 32），第三组——口腔健康黏膜（n = 32），使用α平滑肌肌动蛋白进行免疫组织化学分析。
在42例OSCC病例中，23例（54.7%）染色指数为阴性，9例（21.4%）为低表达，10例（23.8%）为中等表达。疣状癌、伴有上皮发育异常的角化过度病例、77.5%的口腔黏膜下纤维化（OSMF）病例和健康口腔黏膜的基质中均无肌成纤维细胞，所有病例的分级均为“0”。2例OSMF病例（12.5%）肌成纤维细胞染色指数低。各组间肌成纤维细胞表达存在显著差异（Kruskal-Wallis检验P<0.001）。
本研究结果证明“肌成纤维细胞”是肿瘤进展中的关键基质成分之一。未来涉及更大样本量以及对PMDs患者进行随访的研究对于确定它们在这些病变基质中出现的确切阶段至关重要。
