Joshi Priya, Pol Jaydeep, Chougule Madhuri, Jadhav Kiran, Patil Sangeeta, Patil Swapnita
Department of Oral Pathology and Microbiology, Vasantdada Patil Dental College and Hospital, Sangli, Maharashtra, India.
Department of Oncopathology, Mahatma Gandhi Cancer Hospital, Miraj, Maharashtra, India.
J Oral Maxillofac Pathol. 2020 Sep-Dec;24(3):587. doi: 10.4103/jomfp.JOMFP_74_20. Epub 2021 Jan 9.
The majority of the head and neck squamous cell carcinomas (HNSCC) occur in the oral cavity. Even with advances in cancer therapy only minor improvements in the survival of HNSCC patients have taken place and approximately 350,000 patients die annually of HNSCC worldwide. Tumor budding (TB) is a novel and promising histo-morphological parameter that has been studied in many cancers. The presence of TB is associated with lymph node and distant metastasis as well as poor survival, independently of the applied scoring system. The depth of tumor invasion (D) measured from the surface of the tumor to the deepest point of invasion is also an important prognostic parameter for oral squamous cell carcinoma (OSCC) with a cutoff point of 4 mm. Both taken together constitute BD model and it has also been found to be an independent prognostic factor for patients with OSCC. Therefore, it would be highly beneficial to evaluate TB and BD model in routine histopathological reporting.
This study aims to compare the detection of TB in hematoxylin-eosin and pan-cytokeratin stained immune-histochemical sections of OSCC and also to evaluate whether BD score can serve as a reliable prognostic indicator for OSCC.
A total of 30 formalin-fixed, paraffin-embedded tissue blocks of clinically and histopathologically diagnosed cases of OSCC were retrieved. One section was stained with hematoxylin and eosin and the other was processed for pancytokeratin immunohistochemistry to evaluate tumor buds. Depth of invasion (D) was also evaluated to achieve the BD score.
Statistical significance ( < 0.001) was noted between TB score evaluated in hematoxylin and eosin (H&E) and pancytokeratin stained sections. There was no statistical significance between age, gender, site of lesion, clinical staging, survival and BD score.
Immunohistochemical analysis of TB is superior to H&E staining in detection of tumor buds at the tumor invasive front.
大多数头颈部鳞状细胞癌（HNSCC）发生于口腔。即便癌症治疗取得进展，HNSCC患者的生存率仅有微小改善，全球每年约有35万患者死于HNSCC。肿瘤芽生（TB）是一种已在多种癌症中得到研究的新型且有前景的组织形态学参数。TB的存在与淋巴结及远处转移以及较差的生存率相关，与所应用的评分系统无关。从肿瘤表面至最深浸润点测量的肿瘤浸润深度（D）也是口腔鳞状细胞癌（OSCC）的一个重要预后参数，临界值为4毫米。两者共同构成BD模型，并且已发现其也是OSCC患者的一个独立预后因素。因此，在常规组织病理学报告中评估TB和BD模型将非常有益。
本研究旨在比较苏木精 - 伊红染色及全细胞角蛋白染色的免疫组织化学切片中OSCC肿瘤芽生的检测情况，并评估BD评分是否可作为OSCC可靠的预后指标。
总共检索了30个经临床和组织病理学诊断为OSCC的福尔马林固定、石蜡包埋组织块。一张切片用苏木精和伊红染色，另一张进行全细胞角蛋白免疫组织化学处理以评估肿瘤芽。还评估了浸润深度（D）以获得BD评分。
在苏木精 - 伊红（H&E）染色切片和全细胞角蛋白染色切片中评估的TB评分之间存在统计学显著性（<0.001）。年龄、性别、病变部位、临床分期、生存率和BD评分之间无统计学显著性。
在肿瘤浸润前沿检测肿瘤芽时，TB的免疫组织化学分析优于H&E染色。
