Background: The grading of oral squamous cell carcinoma can be useful along with TNM staging in determining treatment plan. The aim is to evaluate the prognostic value of histopathological grading of oral squamous cell carcinoma and to find its importance in setting appropriate treatment plan.Methods: The study includes 60 oral squamous cell carcinoma cases surgically operated during January 2012 to December 2018. From the archival paraffin blocks and available resected specimens of each case, the histological parameters used in Bryne’s invasive grading system and Almangush BD model were evaluated and compared to their prognosis.Results: The parameters used in BD model-tumor budding and depth of invasion were found to be statistically significant with prognosis of the disease. Except for nuclear polymorphism, the parameters used in Bryne’s invasive front grading system do not correlate with prognosis.Conclusion: Based on the prognostic significance, tumor budding ≥5 buds in the invasive front area and depth of invasion ≥4mm can be used as risk factors in prospective clinical trials by considering them in early stage disparity cases for multimodality treatment approach and elective neck dissection.

The incidence of HPV associated Head and Neck Squamous Cell Carcinoma (HNSCC) is increasing over the past 30 years. It is a growing public health concern. It has been reported that tissues of HPV associated HNSCCs over express p16INK4a. Therefore p16INK4a is used as a surrogate marker to detect HPV associated HNSCC. Immunohistochemical detection of p16INK4a is an easy and simple technique than molecular detection of HPVs. Hence we investigated the presence of p16INK4a in Oral and Oropharyngeal Squamous Cell Carcinoma (OPSCC). Aims: The objectives of our study are (1)To study the association of p16INK4a expression with OPSCC, thus with the HPV. (2) To compare the p16INK4a expression in oral cavity and oropharyngeal SCC. (3) To correlate the level of p16INK4a expression with different grades of OPSCC. Methods: A total sample of 35 cases were analysed during the period of June 2014 to August 2015. We performed IHC in sections of formalin fixed paraffin embedded tissue of OPSCC cases and correlated the various patterns of p16INK4a positivity with respect to histopathological diagnosis. Results: In the present study, 71.43% of the OPSCC cases were above 50 years of age. OPSCC was more common in males with male to female ratio of 8:1. 94.29% of OPSCC cases were positive for p16INK4a, of which the most common pattern was diffuse nuclear and cytoplasmic staining (37.14%). Conclusion: In the present study, increased number of OPSCC cases were seen over expressing p16INK4a (94.29%). Oropharynx was the commonest site for p16INK4a positivity (94.44%). Among the oral cavity SCC cases, tongue was the most common site involved (64%). Of the OPSCC cases, most cases (37.14%) had diffuse pattern of p16INK4a over expression. However, DNA detection based studies are needed to validate the utility of IHC detection of p16INK4a as a surrogate marker for HPV associated HNSCC.