Correlation of Histopathological Metastatic Invasive Prognosticators with Five Years Survival of Oral Squamous Cell Carcinoma

Background: OSCC is the 3rd widespread malignancy in India followed by cervical and breast cancer. Histopathological findings in the tumor are the most prominent factors identified for OSCC progression. Clinical and histopathological prognosis in OSCC like perineural invasion, vascular invasion, lymph node invasion have been studied extensively by many researchers separately or in combination since many years. Bone invasion, muscle invasion and salivary gland invasion are explored less. In order to collectively correlate the role of all prognosticators with 5 years survival, the later prognosticators are included in our study in isolation which may predict accurately the probability of 5 year survival of OSCC. Also we have to search role of the prognosticator which is most commonly affecting 5 years survival of OSCC cases so that it may modify the potential consequence of management of OSCC. Objectives: The aim of this study is to assess the relevance of histopathological invasive prognosticators on 5 years survival of oral squamous cell carcinoma (OSCC) patients visiting Sharad Pawar Dental College and Hospital, Sawangi, Wardha (MS). Methodology: Departmental reports will be screened and specimen mounted slides of histopathologically diagnosed 200 OSCC patients, who undergone surgical resection will be observed under binocular microscope. Data of dead and survived OSCC patients undergone surgery 5 years back will be collected by telecommunication. Histopathological invasive prognosticators will be analyzed and correlated with 5-years survival after treatment. Expected Results: Collectively correlating the role of histopathological invasive prognosticators in our study may predict the probability of 5 years survival of OSCC cases more accurately. Discovering diversed histopathological patterns of all metastatic prognosticators and their correlation with 5 years survival. Identification of most effective histopathological invasive prognosticator predicting 5 year survival. Conclusion: The most commonly found prognosticators in OSCC patients who died within 5 years versus others who survived for 5 years will be discovered. In addition the most common histopathological pattern related to dead and survived patients after 5 years will be found which can modify the potential consequence of management of OSCC.

Multi-Site Tumour Sampling Improves the Detection of Intra-Tumour Heterogeneity in Oral and Oropharyngeal Squamous Cell Carcinoma

Background: Oral squamous cell carcinoma (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC) are very common in head and neck malignancy. Intratumour heterogeneity (ITH) may hamper their responses to treatment. Hence, novel tumour sampling methods that reflect ITH are required. In this study, we investigated the clinical significance of multi-site tumour sampling (MSTS) to detect ITH in OSCC and OPSCC.Methods: One hundred eighty-two paired specimens were sampled by routine sampling (RS) or MSTS, respectively. Histologically, tumour grade, peri-tumoural vascular and lymphatic growth, perineural permeation, tumour necrosis, and muscle invasion were assessed. Immunohistochemically, the positive and average detection rates of P53(mutant), ki67 and CyclinD1 were detected. The exon 9 and exon 20 mutations of PIK3CA gene and the methylation status of the CDKN2A promoter were analysed.Results: Microscopically, the detection rate of perineural permeation, the detection density of peri-tumoural vascular and lymphatic growth, necrosis and muscle invasion in MSTS were significantly more frequent than those in RP (P < 0.05, P < 0.05, P < 0.01, P < 0.01). MSTS resulted in a higher detection rate of P53 (mutant), ki67, and CyclinD1 expression than did RS, but the difference was not significant. MSTS's detection rates in PIK3CA gene mutation and gene methylation sequencing in CDKN2A gene promoter region were both higher than RP (P < 0.05, P < 0.01). To be emphasised, the hotspot mutation H1047Rwas detected in one MSTS specimen (case 24M5) but in no RS specimens.Conclusions: This study verified that MSTS's advantage in the reflection of morphological and molecular characteristics of OSCC and OPSCC. MSTS was more representative than RP. Therefore, MSTS can compensate the RP limitations in ITH detection especially in large tumours.