Sains Malaysiana 45(2)(2016): 201–205

Microvessel Density in Different Grades of Oral Squamous Cell Carcinoma

and its Relationship with Keratin Pearl

(Kepadatan Saluran Mikro dalam Gred Berbeza Karsinoma Sel Skuamus Mulut

dan Hubungannya dengan Mutiara Keratin)

Zeng Zhou Tan¹, Mohammad Zakir Hossain*², Md Shahidul Ahsan¹, Yew Choy Chew³, Swe Swe Win⁴ & Suan Phaik Khoo¹

¹School of Dentistry, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Wilayah Persekutuan, Malaysia

²Department of Oral Biology & Biomedical Sciences, Faculty of Dentistry, University of Malaya

50603 Kuala Lumpur, Wilayah Persekutuan, Malaysia

³School of Science, Monash University, 47500 Bandar Sunway, Selangor Darul Ehsan, Malaysia

⁴University of Dental Medicine, Thingangyun 11071, Yangon, Yangon Division, Myanmar

Received: 20 March 2015/Accepted: 8 July 2015

ABSTRACT

Angiogenesis has an important role in the invasion, metastasis and growth of tumors. Increased microvessel density (MVD) has been described in oral squamous cell carcinoma (OSCC) compared to oral dysplasia and normal oral tissue. A morphometric study was designed to evaluate the MVD and to evaluate the presence of any association between MVD and keratin pearl in the three histopathological grades of OSCC (as defined in Bryne’s grading system). Forty-five samples of OSCC were graded into well differentiated (WDSCC), moderately differentiated (MDSCC) and poorly-differentiated (PDSCC) oral squamous cell carcinoma. Morphometric analysis showed that MVD was significantly lower in WDSCC compared to MDSCC (p<0.001) and PDSCC (p<0.001). The density in MDSCC was significant lower than PDSCC. The keratin pearl count was significantly higher in WDSCC compared to MDSCC (p<0.001) and PDSCC (p<0.001). Between MDSCC and PDSCC, the keratin pearl count was significantly higher for MDSCC (p=0.001). Pearson correlation test showed a significant negative correlation between keratin pearl and MVD (r=-0.805, p<0.001). The findings suggested that vascularity in OSCC is associated with its cellular differentiation and also associated with keratin pearl formation.

Keywords: Keratin pearl; microvessel density (MVD); oral squamous cell carcinoma (OSCC); tumour grading

ABSTRAK

Angiogenesis mempunyai peranan yang penting dalam penaklukan, perebakan dan juga pertumbuhan tumor. Peningkatan kepada kepadatan saluran mikro (MVD) telah digambarkan di dalam karsinoma sel skuamus mulut (OSCC) jika dibandingkan dengan displasia mulut dan tisu mulut biasa. Suatu kajian morfometri telah direka untuk mengkaji kepadatan saluran mikro (MVD) dan mengkaji kehadiran mana-mana yang berkaitan antara MVD dan mutiara keratin di dalam tiga gred histopatologi terhadap OSCC (seperti yang diterangkan di dalam sistem pengredan Bryne). Empat puluh lima sampel OSCC telah digredkan kepada perbezaan yang sangat baik (WDSCC), perbezaan yang sederhana (MDSCC) dan perbezaan yang kurang atau tiada (PDSCC) bagi karsinoma sel skuamus mulut. Analisis morfometri menunjukkan bahawa MVD adalah jauh lebih rendah di dalam WDSCC berbanding MDSCC (p<0.001) dan juga PDSCC (p<0.001). Manakala ketumpatan saluran mikro di dalam MDSCC adalah lebih rendah berbanding PDSCC. Kiraan mutiara keratin adalah lebih tinggi di dalam WDSCC jika dibandingkan dengan MDSCC (p<0.001) dan PDSCC (p<0.001). Antara MDSCC dan PDSCC, jumlah kiraan mutiara keratin adalah lebih tinggi di dalam MDSCC (p=0.001). Ujian korelasi Pearson menunjukkan hubungan negatif yang signifikan antara mutiara keratin dan MVD (r=-0.805, p<0.001). Hasil kajian menunjukkan bahawa saluran vaskular di dalam OSCC dapat dikaitkan dengan pembezaan sel dan pembentukan mutiara keratin.

Kata kunci: Karsinoma sel skuamus mulut (OSCC); kepadatan saluran mikro (MVD); mutiara keratin; pengredan; tumor

REFERENCES

Astekar, M., Joshi, A. & Metgud, R. 2012. Expression of vascular endothelial growth factor and microvessel density in oral tumorigenesis. J. Oral Maxillofac. Pathol. 16(1): 22-26.

Bryne, M., Koppang, H.S., Lilleng, R. & Kjaerheim, A. 1992. Malignancy grading of the deep invasive margins of oral squamous cell carcinomas has high prognostic value. J. Pathol. 166(4): 375-381.

Chen, Y.K., Huse, S.S. & Lin, L.M. 2004. Differential expression of p53, p63 and p73 protein and mRNA for DMBA-induced hamster buccal-pouch squamous-cell carcinomas. Int. J. Exp. Pathol. 85(2): 97-104.

Deschler, D.G. & Day, T. 2008. Pocket Guide to TNM Staging of Head and Neck Cancer and Neck Dissection Classification. 3rd ed. Alexandria, VA: American Academy of Otolaryngology - Head and Neck Surgery Foundation Inc.

Doshi, N.P., Shah, S.A. & Patel, J.F. 2011. Histological grading of oral cancer: A comparison of different systems and their relation to lymph node metastasis. National Journal of Community Medicine 2: 136-143.

Elpek, G., Gelen, T., Aksoy, N., Erdoğan, A., Dertsiz, L. & Demircan, A. & Keles, N. 2001. The prognostic relevance of angiogenesis and mast cells in squamous cell carcinoma of the oesophagus. J. Clint. Pathol. 54(12): 940-944.

Hanahan, D. & Weinberg, R.A. 2000. The hallmarks of cancer. Cell 100(1): 57-70.

Kyzas, P.A., Stefanou, D., Batistatou, A. & Agnantis, N.J. 2005. Prognostic significance of VEGF immunohistochemical expression and tumor angiogenesis in head and neck squamous cell carcinoma. J. Cancer Res. Clin. Oncol. 131(9): 624-630.

Li, C., Shintani, S., Terakado, N., Klosek, S.K., Ishikawa, T., Nakashiro, K. & Hamakawa, H. 2005. Microvessel density and expression of vascular endothelial growth factor, basic fibroblast growth factor, and platelet-derived endothelial growth factor in oral squamous cell carcinomas. International Journal of Oral and Maxillofacial Surgery 34(5): 559-565.

Linder, S., Blåsjö, M., von Rosen, A., Parrado, C., Falkmer, U.G. & Falkmer, S. 2001. Pattern of distribution and prognostic value of angiogenesis in pancreatic duct carcinoma: A semiquantitative immunohistochemical study of 45 patients. Pancreas 22: 240-247.

Lopez-Graniel, C.M., Tamez de Leon, D., Meneses-Garcia, A., Gomez-Ruiz, C., Frias-Mendivil, M., Granados-Garcia, M. & Barrera-Franco, J.L. 2001. Tumor angiogenesis as a prognostic factor in oral cavity carcinomas. J. Exp. Clin. Cancer Res. 20: 463-468.

Macluskey, M., Chandrachud, L.M., Pazouki, S., Green, M., Chisholm, D.M., Ogden, G.R., Schor, S.L. & Schor, A.M. 2000. Apoptosis, proliferation, and angiogenesis in oral tissues. Possible relevance to tumour progression. J. Pathol. 191(4): 368-375.

Piffko, J. & Bankfalvi, A. 1997. Standardized AgNOR analysis of the invasive tumour front in oral squamous cell carcinomas. Journal of Pathology 182: 450-456.

Snehal, G.P. & Jatin, P.S. 2005. TNM staging of cancers of the head and neck: Striving for uniformity among diversity. CA Cancer J. Clin. 55: 242-258.

Tanigawa, N., Amaya, H., Matsumura, M. & Shimomatsuya, T. 1997 Correlation between expression of vascular endothelial growth factor and tumor vascularity, and patient outcome in human gastric carcinoma. J. Clin. Oncol. 15(2): 826-832.

Tannapfel, A. & Weber, A. 2001. Tumor markers in squamous cell carcinoma of the head and neck: Clinical effectiveness and prognostic value. Eur. Arch. Otorhinolaryngol. 258(2): 83-88.

Torres-Rendon, A., Roy, S., Craig, G.T. & Speight, P.M. 2009. Expression of Mcm2, geminin and Ki67 in normal oral mucosa, oral epithelial dysplasias and their corresponding squamous-cell carcinomas. Br. J. Cancer 100(7): 1128-1134.

Warnakulasuriya, S. 2009. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol. 45: 309-316.

Xiangming, C., Hokita, S., Natsugoe, S., Tanabe, G., Baba, M., Takao, S., Kuroshima, K. & Aikou, T. 1998. Angiogenesis as an unfavorable factor related to lymph node metastasis in early gastric cancer. Ann. Surg. Oncol. 5(7): 585-589.

Yoshij, H., Gomez, D.E., Shibuya, M. & Thorgeirsson, U.P. 1996. Expression of vascular endothelial growth factor, its receptor, and other angiogenic factors in human breast cancer. Cancer Res. 56(9): 2013-2016.

*Corresponding author; email: zakir@um.edu.my