Immunohistochemical Investigation of Predictive Biomarkers for Mandibular Bone Invasion in Oral Squamous Cell Carcinoma
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ORIGINAL ARTICLE
Immunohistochemical Investigation of Predictive Biomarkers for Mandibular Bone Invasion in Oral Squamous Cell Carcinoma Takahiko Gibo 1 & Shin-ichi Yamada 1 & Makiko Kawamoto 1 & Takeshi Uehara 2 & Hiroshi Kurita 1 Received: 20 April 2020 / Accepted: 19 May 2020 # Arányi Lajos Foundation 2020
Abstract The accurate preoperative determination of the extent of mandibular resection remains a challenge for the surgeons. The purpose of the present study was to immunohistochemically investigate predictive markers for histological bone invasion of oral squamous cell carcinoma (OSCC). The medical records of primary OSCC patients with mandibular bone contact in preoperative computed tomography scans between January 2003 and December 2017 were retrospectively reviewed and an immunohistochemical investigation was performed. Forty-five OSCC patients with mandibular bone contact radiographically were included in this study. Histopathologically, infiltrative bone invasion was observed in 19 patients (42.2%) and compressive bone invasion in 15 (33.3%). A correlation was noted between the histological pattern of bone invasion and mode of invasion (chi-squared test, p < 0.05). At the tumor surface, a correlation was observed between the expression of IL-6 and bone invasion (the Wilcoxon test, p < 0.05), although the expression was so weak. At the bone contact area, the expression of both ɑ-SMA and OPG correlated with infiltrative bone invasion (ɑ-SMA; the Wilcoxon test, p < 0.05, OPG; p < 0.05). These results suggest that predictive markers for aggressive (infiltrative) bone invasion in OSCC patients with a higher mode of invasion are the expression of ɑ-SMA and OPG. Keywords Oral squamous cell carcinoma . Mandible . Bone invasion . ɑ-SMA . Predictive marker
Introduction Oral squamous cell carcinoma (OSCC) is the most common malignant neoplasm among head and neck malignancies, and squamous cell carcinoma accounts for more than 90% of oral cancers [1]. Recent advances in treatment modalities for OSCC have improved the treatment outcomes of OSCC patients. However, standard radical therapy, including the wider resection of lesions often results in a decline in functions and quality of life (QOL) in OSCC patients [2]. As one of the anatomical characteristics of the oral cavity, the oral mucosa is close to the jaw bones, and OSCC sometimes easily and directly invades the maxillary and mandibular bones. The prevalence rate of mandibular invasion was
* Shin-ichi Yamada [email protected] 1
Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan
2
Department of Laboratory Medicine, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto 390-8621, Japan
reported to be 42% in tongue OSCC, 48% in the retromolar region, and 62% in the oral floor [3]. Larger or more deeply invading OSCC was shown to more likely invade the mandiblar bone3. The bone invasion of OSCC is associated with a poor prognosis, upgrades the primary tumor stage, and cause
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