Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
BMC Oral Health. 2022 May 6;22(1):165. doi: 10.1186/s12903-022-02188-0.
Morphological evaluation of oral mucosal biopsy is sometimes inconclusive, which may delay the diagnosis and treatment of oral squamous malignancy. Immunohistochemical biomarkers denoting oral squamous malignancy would be clinically helpful in such scenario.
We first studied the expression patterns of four potential biomarkers (cytokeratin 13, cytokeratin 17, Ki-67 and laminin 5 gamma 2 chain) in an exploratory cohort containing 54 surgical specimens from confirmed oral squamous malignancies. A pattern score was assigned to each specific expression pattern of these four biomarkers. A total score from each specimen was then calculated by summing up the four pattern scores. A cut-off value of total score denoting oral squamous malignancy was then determined. Another 34 oral squamous malignancies that were misdiagnosed as non-malignant lesions on their pre-treatment biopsies were used as a validation cohort to test the clinical utility of this scoring system.
In the exploratory cohort, fifty-two (96%) of the 54 confirmed oral squamous malignancies had a total score of 9 and above. In the validation cohort, thirty-one (91%) of the 34 pre-treatment oral biopsy specimens also had a total score of 9 or above, supporting the feasibility of using this scoring system to predict immediate risk of oral squamous malignancy.
Our four-biomarker "oral squamous malignancy scoring system" provides reliable prediction for immediate risk of oral squamous malignancy on pre-treatment oral biopsies.
口腔黏膜活检的形态学评估有时并不明确，这可能会延误口腔鳞状恶性肿瘤的诊断和治疗。标记口腔鳞状恶性肿瘤的免疫组织化学生物标志物在这种情况下将具有临床帮助。
我们首先在包含 54 例经手术证实的口腔鳞状恶性肿瘤的探索性队列中研究了四个潜在生物标志物（细胞角蛋白 13、细胞角蛋白 17、Ki-67 和层粘连蛋白 5γ2 链）的表达模式。为这四个生物标志物的每种特定表达模式分配一个模式评分。然后通过将四个模式评分相加来计算每个标本的总评分。然后确定总评分表示口腔鳞状恶性肿瘤的截止值。另外 34 例术前活检误诊为非恶性病变的口腔鳞状恶性肿瘤被用作验证队列，以检验该评分系统的临床实用性。
在探索性队列中，54 例经证实的口腔鳞状恶性肿瘤中有 52 例（96%）总分为 9 分及以上。在验证队列中，34 例术前口腔活检标本中有 31 例（91%）总分为 9 分或以上，支持使用该评分系统预测口腔鳞状恶性肿瘤即刻风险的可行性。
我们的四标志物“口腔鳞状恶性肿瘤评分系统”为术前口腔活检提供了对口腔鳞状恶性肿瘤即刻风险的可靠预测。
