Kapila Supriya Nikita, Natarajan Srikant, Boaz Karen
Lecturer, Department of Oral Pathology, Kathmandu Medical College-Dental College and Hospital, Kathmandu, Nepal.
Professor, Department of Oral Pathology, Manipal College of Dental Sciences, Mangalore, Manipal University Mangalore, Karnataka, India.
J Clin Diagn Res. 2017 Sep;11(9):ZC46-ZC50. doi: 10.7860/JCDR/2017/27828.10600. Epub 2017 Sep 1.
Recent times have revealed an increase in incidence of Oral Squamous Cell Carcinoma (OSCC) in young adults including those who lack association with typical risk factors such as tobacco. There are reported variations in clinical behaviour of tumours in young and older individuals.
Present study evaluated differences in clinicopathological characteristics between two groups of OSCC, below and above 40 years of age.
An analytical study was performed on two groups of OSCC patients, below and above 40 years of age. Clinicopathological parameters of site distribution, type of habit, histological grade, nodal metastasis, margin status, mitotic index and Argyrophilic Nucleolar Organizing Regions (AgNOR) count were compared. Chi-square test and Students t- test were applied for statistical analysis.
Present study revealed that mean AgNOR count was significantly higher in older group (6.38) than younger group (4.27). However, no significant differences were noted in site distribution, tobacco habit, histological grade, mitotic index, nodal metastasis and status of resected surgical margins between the two age groups. A trend for increased metastasis and poor histological differentiation was also observed in the older and younger age group respectively. Most common site was buccal mucosa followed by tongue in both groups.
Reasons for documented variability in tumour characteristics between young and older patients are currently unclear. Difference in AgNOR count found in present study is suggestive of variability in proliferative and ploidy characteristics between different age groups and supports the hypothesis of genetic and epigenetic influences in development of oral cancer.
近年来,包括那些与烟草等典型风险因素无关的年轻人在内,口腔鳞状细胞癌(OSCC)的发病率有所上升。据报道,年轻人和老年人肿瘤的临床行为存在差异。
本研究评估了两组年龄在40岁以下和40岁以上的OSCC患者临床病理特征的差异。
对两组年龄在40岁以下和40岁以上的OSCC患者进行了分析研究。比较了部位分布、习惯类型、组织学分级、淋巴结转移、切缘状态、有丝分裂指数和嗜银核仁组织区(AgNOR)计数等临床病理参数。采用卡方检验和学生t检验进行统计分析。
本研究显示,老年组(6.38)的平均AgNOR计数显著高于年轻组(4.27)。然而,两组在部位分布、吸烟习惯、组织学分级、有丝分裂指数、淋巴结转移和手术切缘状态方面未发现显著差异。在老年组和年轻组中分别观察到转移增加和组织学分化不良的趋势。两组中最常见的部位是颊黏膜,其次是舌。
目前尚不清楚年轻患者和老年患者肿瘤特征存在差异的原因。本研究中发现的AgNOR计数差异提示不同年龄组之间增殖和倍体特征存在差异,并支持遗传和表观遗传因素对口腔癌发生影响的假说。