Significance of pathohistological findings and the expression of Bcl-2 in diagnosis and treatment of oral planocellular carcinoma

Abstract

Background/Aim. Numerous studies were aimed to detect and characterize various tumor markers in patients with oral planocellular carcinoma in order to reduce moratlity and mobidity rates of these patients, as well as to establish the correlation between the expression of specific tumor marker and prognostic outcome. The aim of this study was to determine patohistological characteristics of tumor and peritumor tissue in patients with oral planocellular carcinoma, with special regard to the expression of Bcl-2, as well as to point out the significance of clinicomorphological correlations for clinical use. Methods. Sixty-two patients with oral planocellular carcinoma, stage II and III, were examined. The patients were surgically treated for this condition at the Clinic for Maxillofacial Surgery, Military Medical Academy, Belgrade. Surgical specimens were obtained from both tumor and peritumoral tissues. Patohistologic degree of tumor differentiation and the immunohistochemical expression of Bcl-2 were determinated for each specimens. Results. Twenty-four (39%) patients had tumor dimension T1, while six (9%) and thirty-two (52%) patients had tumor dimension T2 and T3, respectively. Patohistologic analysis of peritumor connective, fat, muscle and bone tissue samples confirmed the presence of tumor infiltration. The expression of Bcl-2 in peritumor tissue samples correlated significantly with tumor's histologic grade (ς = 0.468; p lt 0.001), nuclear grade (ς = 0.430; p lt 0.001) and nucleocytoplasmic ratio (ς = 0.410; p = 0.001). Conclusion. This results suggest that the expression of Bcl-2 in combination with patohistologic findings could have a prognostic value in patients with oral planocellular carcinoma.

Uvod/Cilj. Mnogobrojna istraživanja usmerena su na detekciju i karakterizaciju različitih tumorskih markera kod oralnog planocelularnog karcinoma sa ciljem da se smanji morbiditet i mortalitet, kao i uspostavi korelacija između stepena ekspresije određenog markera i prognoze bolesti. Cilj ovog rada bio je da se utvrde patohistološke karakteristike tumorskog i peritumorskog tkiva bolesnika sa oralnim planocelularnik karcinomom, posebno stepen ekspresije markera Bcl-2, da se ukaže na značaj korelacije kliničkomorfoloških parametara, kao i na mogućnost primene ovih rezultata u kliničkoj praksi. Metode. Studija je obuhvatila 62 bolesnika u II i III stadijumu oralnog planocelularnog karcinoma, operisana u Klinici za maksiofacijalnu hirurgiju Vojnomedicinske akademije u Beogradu. Kod svih bolesnika određivani su stadijum bolesti, patohistološki stepen diferentovanosti tumora, a imunohistohemijskom metodom praćena je ekspresija markera Bcl-2 u peritumorskom tkivu. Rezultati. U analiziranoj grupi bila su 24 (39%) bolesnika sa tumorom veličine T1, 6 (9%) bolesnika sa tumorom veličine T2, a 32 (52%) bolesnika sa primarnim tumorom veličine T3. Infiltracija tumora u peritumorskom tkivu verifikovana je patohistološkom analizom okolnog vezivnog, masnog, mišićnog tkiva i kosti, koji su bili zahvaćeni resekcijom. Utvrđena je statistički visokoznačajna pozitivna korelacija između stepena ekspresije proteina Bcl-2 u peritumorskom tkivu, sa jedne strane, i histološkog gradusa tumora (ς=0,468; p lt 0,001), nukleusnog gradusa tumora (ς=0,430; p lt 0,001) i nukleocitoplazmatskog odnosa u tumorskim ćelijama (ς=0,410; p = 0,001). Zaključak. Ekspresija Bcl-2 u kombinaciji sa patohistološkim parametrima može biti značajan prognostički faktor, pa mu treba posvetiti više pažnje u okviru multidisciplinarnog istraživanja prognoze oralnog planocelularnog karcinoma.