Role of inflammation in oral carcinogenesis (Part I): Histological grading of malignancy using a binary system

Abstract

Abstract. The aim of the present study was to assess the suppressant role of the inflammatory infiltrate in oral carcinogenesis through the immunohistochemical expression of CD8 and FOXP3 and to discuss how representative this expression proved, as well as other parameters considered to be of prognostic value. A total of 20 cases of oral epithelial dysplasia and 40 cases of oral squamous cell carcinoma were selected. The criteria suggested by the World Health Organization were used for the histological grading of dysplasia. For carcinoma, a binary method was developed for the present study using parameters such as type of invasion, maturity, presence of epithelial masses and dysmorphism of the masses. Immunohistochemical analysis was performed for assessment of the expression of anti-CD8 and anti-FOXP3 in cases of dysplasia and carcinoma. Although the inflammatory infiltrate was more intense in the majority of carcinomas, it exercised a protective role in the dysplasia cases, as CD8 expression was significantly greater. Although a correlation was found between CD8 and the intensity of the inflammatory infiltrate in the carcinoma cases, CD8 demonstrated >5% expression in only 32.5% of the cases, compared to 80% of the dysplasia cases. Thus, we suggest that the inflammatory infiltrate should not be used as a parameter in routine examinations, as it plays different roles in the various stages of carcinogenesis. The histological grading system for malignancy employed in the present study is indicated for the assessment of oral squamous cell carcinoma.

The prognostic value of histopathological grading systems in oral squamous cell carcinomas

“…This inconsistency might be explained by the subjectiveness attributed to some parameters of this grading system, which result in high intra‐ and interexaminer variability (Sawair et al , ). Moreover, immaturity cannot be used for the assessment of cellular pleomorphism, as suggested in Bryne's grading system, as it is manifest in the course of the differentiation process and most cells are immature at the invasive front (Piva et al , ). The results of this study revealed no association between the MG system and outcome of OSCC patients, similar to previously reported findings (Silveira et al , ; Lindenblatt et al , ).…”

“…LHR is considered to be an attempt by the organism to eradicate tumor cells, in other words, it has an anti‐tumoral effect, and indeed evading immune destruction is considered to be one of the hallmarks of the cancer (Hanahan and Weinberg, ). However, evidences have shown that immune and inflammatory cells might have protumoral effects (Piva et al , ; Dayan et al , ; Salo et al , ). This was particularly exemplified by subpopulations of CD4 T cells, which express CD25 and the transcription factor Foxp3 (CD4+CD25+Foxp3+) and are termed regulatory T cells (Treg), which plays important roles in suppression of tumor‐specific immunity and in promotion of tumor development (Chaudhary et al , ).…”

Role of inflammation in oral carcinogenesis (Part II): CD8, FOXP3, TNF-α, TGF-β and NF-κB expression

“…The criteria of the World Health Organization (WHO) were used for the histological grading of the dysplasia (17). Carcinomas were classified as stage I (low-grade) or stage II (high-grade) according to the method proposed by Piva et al (18). …”

Oral squamous cell carcinoma in a South African sample: Race/ethnicity, age, gender, and degree of histopathological differentiation

“…[31,33] As the histopathological features vary between different regions within the same OSCC, and as histopathological grading is subjective with low reproducibility, the information gained from a single biopsy, particularly if it has been taken from a superficial part of the tumor cannot be used as a reliable indicator of the future clinical behavior of the tumor. [32,34] However, it has become clear that the histopathological information gained from multiple biopsies taken from different parts of the invasive front of the cancer has a more significant prognostic value.…”