Role of maspin expression in oral squamous cell carcinoma

Saraanya, K (2018) Role of maspin expression in oral squamous cell carcinoma. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Oral cancers broadly includes neoplasms arising from buccal mucosa, tongue, lips, hard palate, soft palate, oropharynx, larynx, hypopharynx except the neoplasm arising from salaivary gland. Among this 90% comprises squamous cell carcinoma. Oral cancer is the most common cancer in India among men (11.28% of all cancer) and fifth among women (4.3% of all cancers) and 3rd most frequently occurring cancer in India among both men and women. Oral SCC is the 6th leading cause of cancer worldwide. AIMS AND OBJECTIVES: 1. To study the incidence of oral SCC in patients admitted in Govt. Stanley Medical College, Chennai during the period of January 2016 to December 2016. 2. To identify the incidence of oral SCC in various sites. 3. To study the clinicopathological features and various prognostic factors of oral SCC including age, sex, risk factors, histological grade, tumour staging and nodal metastasis. 4. To determine the immunohistochemical expression of MASPIN. 5. To evaluate the level of MASPIN expression in various grades of oral SCC. 6. To compare the overall MASPIN expression (OME) with various prognostic factors. MATERIALS AND METHODS: Study Design: Retrospective and comparative study. Source of Data: Incisional biopsy / Excision biopsy specimen of oral cavity lesion was obtained from Department of Oto Rhinolaryngology and Surgery and reported by Department Of Pathology, Govt Stanely Medical College, Chennai. Study Period: This study was from January 2016 to December 2016. Pilot Study: Done with 5 specimens in September 2015 submitted to institutional ethical committe in October 2016 and approval obtained. Sample size estimation: Level of expression of maspin and intensity of staining in malignant cells was considered as the primary variable in calculating the sample size. Total Sample Size: 88. Study Groups: Group 1: Specimen diagnosed as malignant by Histopatholgical Examinantion – Well Differentiated SCC. Group 2: Specimen diagnosed as malignant by Histopatholgical Examinantion – Moderately Differentiated. Group 3: Specimen diagnosed as malignant by Histopatholgical Examinantion – Poorly Differentiated. Random Selection: All cases were selected by simple randomisation . Out of all specimens reported during January 2016to December 2016; 36 were Well Differentiated Squamous Cell Carcinoma 36 were Moderately Differentiated Squamous Cell Carcinoma; 16 were Poorly Differentiated Squamous Cell Carcinoma. Inclusion Criteria: All Histopathological variants of Oral Squamous Cell Carcinoma reported in Department Of Pathology ,Stanley Medical College during the period of January 2016 to December 2016 sent from Department Of Surgery and Otorhinolaryngology. Exclusion Criteria : 1. Benign neoplasm arising from the oral mucosa will not be included in this study. 2. Primary malignancies of oral cavity other than Squamous Cell Carcinoma will not be included in this study. 3. Recurrence and Metastatic tumours of the oral cavity. SUMMARY: This study was a retrospective and comparative study conducted in the Department of Pathology, Govt. Stanley Medical College during the period of January 2016 to December 2016. The total number of specimens received in Govt. Stanley Medical College were 9374 out of which 246 were from oral cavity and upper respiratory tract. 153 cases were documented as malignant out of the 9374 cases. Most common age group of occurrence of OSCC was noted in the 5th decade with mean age of presentation at 53.55yrs. Males were commonly affected by OSCC with an incidence of 82.95% than females which accounted to 17.05%. Tongue was the most common site for oral SCC accounting to 39.59% followed by buccal mucosa accounting to 23.86 %. In this study we noted that Well differentiated SCC (36 cases) and Moderately differentiated SCC (36 cases) were reported in equal proportion and Poorly differentiated SCC in 16 cases. In this study 36.36% of cases presented with nodal metastasis and 63.64% of cases presented without nodal metastasis. In our study Oral SCC presented predominantly as stage I with an incidence of 36.36%. Among Well Differentiated SCC, Maspin was strongly expressed in 50% of cases and weakly expressed in 19.44% of cases .The intensity of staining score was score 3 in 27.7% of cases and score 0 in 8.33% of cases. In Moderately Differentiated SCC, Maspin was strongly expressed in 13.88% of cases and was negative in 27.77% of cases. The intensity of staining score was score 3 in 13.88 % of cases and score 0 in 5.555% of cases. In Poorly Differentiated SCC, none of the cases showed strong expression and 18.75 % of cases showed weak expression while 68.75 % of cases showed negative expression.The intensity of staining score 3 was not seen in any of the cases , score 1 was in 50 % of cases and score 0 in 43.75%.cases. Cases with absent nodal metastasis showed strong maspin expression accounting to 41.07 % and negative in 7.142 %. None of the Cases with nodal metastasis showed strong maspin expression while 75 % of cases showed negative expression. Thus in this study the overall maspin expression was highest in well differentiated squamous cell carcinoma and lowest in poorly differentiated squamous cell carcinoma. Overall maspin expression was highest in nodal negative cases than nodal positive cases. Nodal positive cases showed a deceased maspin expression. Thus Maspin is considered as a prognostic marker, where loss of its expression indicates a bad prognosis with increased incidence of metastatic potential of such tumours. CONCLUSION: This study showed the increased prevalence of Oral SCC among the general population. Because of its aggressive nature, invasiveness and metastatic potential and its increasing trend in younger individuals, it is necessary to understand the carcinogenesis at molecular level. In this study we attempted to evaluate the correlation between Maspin expression and various prognostic factors such as stage and grades of tumours . This study also evaluates the level of maspin expression in tumours presented with and without nodal metastasis. This study showed a statistically significant association in the form of inverse correlation between the subcellular localization, histological grades ,stages of tumour and also with lymphnodal status. However because of non availability of patient follow up details and outcome, the current study does not provide the idea about the Maspin expression with patient outcome and treatment effect. Thus in future maspin can be consider as a prognostic marker for early diagnosis of metastasis and its potential for progression of the tumor. Since it is a prognostic marker it can be considered for targeted therapy for a better survival and outcome of the patients with SCC.

Item Type: Thesis (Masters)
Uncontrolled Keywords: maspin expression ; oral squamous cell carcinoma.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 19 Aug 2018 02:13
Last Modified: 19 Aug 2018 02:13

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