Document Type : Original Article
Authors
1
Oral Pathology Department, Faculty of Dentistry, University of Tripoli, Libya
2
Oral Pathology Department, Faculty of Dentistry, Sinai University, Kantra, Egypt
3
Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
4
Department of Pathology, Faculty of Medicine Cairo University, Giza, Egypt
5
Department of Oral Pathology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Abstract
Tumour microenvironments are crucial for cancer progression and metastasis. There are two major routes of spread, one by blood vessels and the other through the lymphatic system. There are limited data regarding the immune cell potential, the role of both lymphatic and blood vessels in oral epithelial dysplasia (OED), and metastatic & non-metastatic oral cancer. This study is designed to determine the role that eosinophil cell and mast cell densities play, along with the role of podoplanin (D2-40) (lymphatic marker), CD105 (vascular marker) and PCNA (proliferative marker), in the different grades of oral squamous cell carcinoma and OED. In this cross-sectional study, paraffin blocks were selected, including 60 cases of OSCC and 10 cases of OED. From each block, 6 sections were prepared for hematoxylin and eosin, special stains (Toluidine blue and congo red) for mast cells and eosinophils, and immunohistochemistry with CD105, D2-40, PCNA. The immunoreactivity of this marker was analyzed by an image analysis program. The study revealed a significant increase in lymphovascular density (LVD), microvascular density (MVD) and PCNA in OSCC when compared to OED. Metastatic OSCC demonstrated an increase in LVD, and MVD when compared to non-metastatic OSCC. On the other hand, the degree of differentiation of the infiltrated immune cells revealed that eosinophils and mast cells reduce when OSCC's grade is advanced. In addition, non-metastatic cases showed higher counts of immunological cells than metastatic cases. Tumour cell proliferation, lymphangiogenesis and angiogenesis are important phenomena of cancer cell spreading and are correlated with poor prognosis. The large number of immunological cells in OSCC when compared to dysplastic groups confirms that they have a critical role in stromal invasion. Additionally, the non-metastatic group demonstrated a significantly higher mean count of tumour-associated tissue eosinophils and mast cells than the metastatic group. Thus, we concluded that increased infiltration of eosinophil and mast cells in OSCC is directly related to favourable prognosis and indicates their potential protective role against tumour metastasis.
Keywords
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