Esakki Amba, Poothakulath Krishnan Reshma, Pandiar Deepak, Ramani Pratibha, Jayaraman Selvaraj
Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Sep 21;16(9):e69830. doi: 10.7759/cureus.69830. eCollection 2024 Sep.
Background and objective Oral submucous fibrosis (OSMF) is a common and potentially malignant disorder with a high risk of malignant transformation to oral squamous cell carcinoma (OSCC). Tumor budding is a scattered pattern of invasion and is related to the aggressive behavior of malignant tumors, increased depth of invasion, higher clinical staging, size, and grade of the tumor. The present study aimed to evaluate tumor budding in OSCC arising in the background of OSMF. Materials and methods A total of 120 patients with OSCC (30 each of OSCC arising in the background of OSMF, well-differentiated, moderately differentiated, and poorly differentiated OSCC) were included in the study. Hematoxylin and eosin (H&E)-stained sections were evaluated for the presence of tumor buds at the invasive front of the tumor. Kappa statistics and chi-square tests were employed to statistically compare the results by using IBM SPSS Statistics 23 software (IBM Corp., Armonk, NY). A p-value of less than or equal to 0.05 was considered statistically significant. Results The mean age of the occurrence of OSCC arising in the background of OSMF was 45.3 ±7.62 years. A progressive increase in the tumor buds was noted in OSCC arising in the background of OSMF, well-differentiated squamous cell carcinoma (WDSCC), moderately differentiated squamous cell carcinoma (WDSCC), and poorly differentiated squamous cell carcinoma (PDSCC). The chi-square test showed no significant difference between OSCC in the setting of OSMF and WDSCC (p=0.604) groups; however, a significant difference was noted with MDSCC (p=0.001) and PDSCC (p=0.000) groups. Conclusions OSCC arising in the background of OSMF shows lower tumor budding at the invasive front of the tumor. This histopathological parameter can be easily identified in the H&E sections and is fairly reproducible. Hence, reporting the presence of tumor budding will help in predicting the prognosis of these patients.
背景与目的 口腔黏膜下纤维化（OSMF）是一种常见的、具有恶变潜能的疾病，恶变风险高，可发展为口腔鳞状细胞癌（OSCC）。肿瘤芽生是一种散在的浸润模式，与恶性肿瘤的侵袭性行为、浸润深度增加、临床分期较高、肿瘤大小及分级有关。本研究旨在评估在OSMF背景下发生的OSCC中的肿瘤芽生情况。
材料与方法 本研究共纳入120例OSCC患者（其中30例为OSMF背景下发生的OSCC，30例为高分化OSCC，30例为中分化OSCC，30例为低分化OSCC）。苏木精-伊红（H&E）染色切片用于评估肿瘤浸润前沿是否存在肿瘤芽。使用IBM SPSS Statistics 23软件（IBM公司，纽约州阿蒙克）进行kappa统计和卡方检验，以对结果进行统计学比较。p值小于或等于0.05被认为具有统计学意义。
结果 在OSMF背景下发生的OSCC的平均发病年龄为45.3±7.62岁。在OSMF背景下发生的OSCC、高分化鳞状细胞癌（WDSCC）、中分化鳞状细胞癌（WDSCC）和低分化鳞状细胞癌（PDSCC）中，肿瘤芽数量呈逐渐增加趋势。卡方检验显示，OSMF背景下的OSCC与WDSCC组之间无显著差异（p = 0.604）；然而，与MDSCC组（p = 0.001）和PDSCC组（p = 0.000）存在显著差异。
结论 在OSMF背景下发生的OSCC在肿瘤浸润前沿显示出较低的肿瘤芽生。这一组织病理学参数在H&E切片中易于识别且具有相当高的可重复性。因此，报告肿瘤芽生的存在将有助于预测这些患者的预后。
