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P177. Cancer stem cell immunophenotypes and hypoxia-inducible factor-1alfa influences on oral squamous cell carcinoma
Abstracts / Oral Oncology 47 (2011) S74–S156
these clinico-pathological factors on the locoregional recurrence rate was analyzed with the Kaplan–Meier method and log-rank test. Multivariate analysis was assessed with Cox’s regression model. Results: There were 236 males and 108 females in the study group. The patients were in the age group 26–84 years and the mean age was 58 years. Maximum follow up period was for 68 months and the median follow up time was 20 months. One hundred and twenty-four patients were in the stages I and II and 220 patients were in the stages III and IV. Fifty-two patients developed recurrences either at the primary site or at the regional lymph nodes. On univariate analysis, the predictors of recurrence were perineural infiltration, pathological nodal stage and the extracapsular spread. The 5-year disease free survival rate for all patients at 3 years and 5 years were 80.6% and 74.4%, respectively. For patients with pathological stages I, II, III and IV disease, the 5year disease free survival rates were 86.3%, 84.3%, 72.6% and 64%, respectively. On multivariate analysis, the pathological nodal stage and the extracapsular spread were independently the important prognostic factors affecting the disease free survival. Conclusion: Perineural invasion, pathological nodal stage and the extracapsular spread were the most important predictors for recurrence in carcinoma of the buccal mucosa.
doi:10.1016/j.oraloncology.2011.06.419
P177. Cancer stem cell immunophenotypes and hypoxia-inducible factor-1alfa influences on oral squamous cell carcinoma L.R. Oliveira *,a, J.P. Oliveira-Costa a, D.F. Soave a, F.A. Soares b, S. Zucoloto a, A. Ribeiro-Silva a a
Department of Pathology, Ribeirão Preto Medical School, University of São Paulo, Brazil b Department of Pathology Anatomy, A.C. Camargo Cancer Hospital, Brazil Introduction: Recent experimental and clinical evidences support the hypothesis that cancers can arise from mutations in normal adult stem cells, originating the cancer stem cells (CSC). The identification of CSC antigens can be evidenced in some human tumors by phenotypic analysis through immunohistochemistry. Hypoxia is an essential environmental regulator of tumor angiogenesis and growth, and consequently, of therapeutical response. This study aims to identify a putative CSC immunophenotype and the effects of hypoxia in oral squamous cell carcinomas (OSCC) according these immunophenotypes, determining their influences on prognosis. Methods: The following data were retrieved from 150 patients: age, gender, primary anatomic site, smoking and alcohol intake, recurrence, metastases, histologic classification, treatment, diseasefree survival (DFS), and overall survival (OS). An immunohistochemical study for CD44, CD24, and HIF-1alfa was performed in a tissue microarray of 150 paraffin blocks of OSCC. Results: Immunoexpression for CD44, CD24, and HIF-1alfa was found in 100 (66.7%), 83 (55.3%), and 40 (26.7%) of OSCC cases, respectively. In univariate analysis, there were significant influences in relation to OS for treatment, as well as for the CD44 positive immunophenotypes with simultaneous HIF-1alfa immunostaining. The multivariate test confirmed the significant effect of CD44 and HIF-1alfa immunoexpression in OSCC (CD44 = HR 0.317 [95% confidence interval, 0.070–0.664], P = 0.033 and HIF-1alfa = HR 1.170 [95% confidence interval, 0.792–1.441], P = 0.029; respectively). Discussion: Based on our initial and unprecedented results, the concomitant CD44 and HIF-1alfa immunostaining could be used in combination with other classical clinicopathological relevant infor-
S131
mations to improve the assessment of prognosis and treatment in OSCC. doi:10.1016/j.oraloncology.2011.06.420
P178. Assessment of tissue eosinophilia in head and neck squamous cell carcinoma by Luna staining S. Rahrotaban *,a, A. Khatibi b, A. Allami c a
Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Qazvin University of Medical Sciences, Iran b Faculty of Dentistry, Qazvin University of Medical, Iran c Department of Community Medicine and Health, Qazvin University of Medical Science, Qazvin, Iran Introduction: Tumor associated tissue eosinophilia (TATE) has been described in a variety of neoplasms, but its role in tumors has not yet been defined, SCC is the most common malignancy of the head and head. The aim of this study was to evaluate the association between TATE and histopathologic grading in HNSCC with Luna staining. Method: Out of 83 cases 67 paraffin blocked of HNSCC were selected. Hematoxylin and eosin stained sections were reviewed for histopathologic grading according to Broder’s system and divided to three groups: well, moderate, and poor differentiated. Sections (4 lm) were stained with Luna for detection of eosinophilic infiltration within the tumor. A blind pathologist counted eosinophils in 10HPF in each slide and categorized as: none (0), low (1–4), medium (5–19), high (P20). Clinicopathologic factors including age, sex, location, and histopathologic grading were tested statistically. Results: TATE was negative in one (1.5%) case, which was moderately differentiated and was positive in 66(98.5%) cases including low 3(4.5%) cases, two were poor and one was moderately differentiated. Medium 14(20.9%) cases, four were well and five were moderate and five were poorly differentiated. High 49(73.1%) cases, 21 were well and 23 were mod and five were poorly differentiated. There was no correlation between TATE and age, sex, location, and histopathologic grading (P > 0.05). Conclusion: TATE has no correlation with histopathologic factors, but TATE was lower in poorly differentiated group than two others. doi:10.1016/j.oraloncology.2011.06.421
P179. Vascular endothelial growth factor (VEGF) expression and inflammatory cells infiltration in well-differentiated squamous cell carcinoma of tongue N. Jalayer Naderi *,a, F. Tirgari b, F. Esmaili c a
Shahed University, Faculty of Dentistry, Iran Tehran University of Medical Sciences, Institute Cancer, Iran c Graduate Student of Faculty of Dentistry, Shahed University, Iran b
Introduction: VEGF is a cytokine that play an important role in angiogenesis and inflammation. It was shown that inflammatory cells activated in microenvironment of tumors. The purpose of this study was to investigate the impact of VEGF expression and inflammatory infiltration in tongue squamous cell carcinoma. The correlation between VEGF expression and inflammatory infiltration was determined. Methods: Twenty-four formalin-fixed, paraffin-embedded biopsy from well-differentiated squamous cell carcinoma of tongue was detected immunohistochemically for VEGF expression. The labeling
these clinico-pathological factors on the locoregional recurrence rate was analyzed with the Kaplan–Meier method and log-rank test. Multivariate analysis was assessed with Cox’s regression model. Results: There were 236 males and 108 females in the study group. The patients were in the age group 26–84 years and the mean age was 58 years. Maximum follow up period was for 68 months and the median follow up time was 20 months. One hundred and twenty-four patients were in the stages I and II and 220 patients were in the stages III and IV. Fifty-two patients developed recurrences either at the primary site or at the regional lymph nodes. On univariate analysis, the predictors of recurrence were perineural infiltration, pathological nodal stage and the extracapsular spread. The 5-year disease free survival rate for all patients at 3 years and 5 years were 80.6% and 74.4%, respectively. For patients with pathological stages I, II, III and IV disease, the 5year disease free survival rates were 86.3%, 84.3%, 72.6% and 64%, respectively. On multivariate analysis, the pathological nodal stage and the extracapsular spread were independently the important prognostic factors affecting the disease free survival. Conclusion: Perineural invasion, pathological nodal stage and the extracapsular spread were the most important predictors for recurrence in carcinoma of the buccal mucosa.
doi:10.1016/j.oraloncology.2011.06.419
P177. Cancer stem cell immunophenotypes and hypoxia-inducible factor-1alfa influences on oral squamous cell carcinoma L.R. Oliveira *,a, J.P. Oliveira-Costa a, D.F. Soave a, F.A. Soares b, S. Zucoloto a, A. Ribeiro-Silva a a
Department of Pathology, Ribeirão Preto Medical School, University of São Paulo, Brazil b Department of Pathology Anatomy, A.C. Camargo Cancer Hospital, Brazil Introduction: Recent experimental and clinical evidences support the hypothesis that cancers can arise from mutations in normal adult stem cells, originating the cancer stem cells (CSC). The identification of CSC antigens can be evidenced in some human tumors by phenotypic analysis through immunohistochemistry. Hypoxia is an essential environmental regulator of tumor angiogenesis and growth, and consequently, of therapeutical response. This study aims to identify a putative CSC immunophenotype and the effects of hypoxia in oral squamous cell carcinomas (OSCC) according these immunophenotypes, determining their influences on prognosis. Methods: The following data were retrieved from 150 patients: age, gender, primary anatomic site, smoking and alcohol intake, recurrence, metastases, histologic classification, treatment, diseasefree survival (DFS), and overall survival (OS). An immunohistochemical study for CD44, CD24, and HIF-1alfa was performed in a tissue microarray of 150 paraffin blocks of OSCC. Results: Immunoexpression for CD44, CD24, and HIF-1alfa was found in 100 (66.7%), 83 (55.3%), and 40 (26.7%) of OSCC cases, respectively. In univariate analysis, there were significant influences in relation to OS for treatment, as well as for the CD44 positive immunophenotypes with simultaneous HIF-1alfa immunostaining. The multivariate test confirmed the significant effect of CD44 and HIF-1alfa immunoexpression in OSCC (CD44 = HR 0.317 [95% confidence interval, 0.070–0.664], P = 0.033 and HIF-1alfa = HR 1.170 [95% confidence interval, 0.792–1.441], P = 0.029; respectively). Discussion: Based on our initial and unprecedented results, the concomitant CD44 and HIF-1alfa immunostaining could be used in combination with other classical clinicopathological relevant infor-
S131
mations to improve the assessment of prognosis and treatment in OSCC. doi:10.1016/j.oraloncology.2011.06.420
P178. Assessment of tissue eosinophilia in head and neck squamous cell carcinoma by Luna staining S. Rahrotaban *,a, A. Khatibi b, A. Allami c a
Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Qazvin University of Medical Sciences, Iran b Faculty of Dentistry, Qazvin University of Medical, Iran c Department of Community Medicine and Health, Qazvin University of Medical Science, Qazvin, Iran Introduction: Tumor associated tissue eosinophilia (TATE) has been described in a variety of neoplasms, but its role in tumors has not yet been defined, SCC is the most common malignancy of the head and head. The aim of this study was to evaluate the association between TATE and histopathologic grading in HNSCC with Luna staining. Method: Out of 83 cases 67 paraffin blocked of HNSCC were selected. Hematoxylin and eosin stained sections were reviewed for histopathologic grading according to Broder’s system and divided to three groups: well, moderate, and poor differentiated. Sections (4 lm) were stained with Luna for detection of eosinophilic infiltration within the tumor. A blind pathologist counted eosinophils in 10HPF in each slide and categorized as: none (0), low (1–4), medium (5–19), high (P20). Clinicopathologic factors including age, sex, location, and histopathologic grading were tested statistically. Results: TATE was negative in one (1.5%) case, which was moderately differentiated and was positive in 66(98.5%) cases including low 3(4.5%) cases, two were poor and one was moderately differentiated. Medium 14(20.9%) cases, four were well and five were moderate and five were poorly differentiated. High 49(73.1%) cases, 21 were well and 23 were mod and five were poorly differentiated. There was no correlation between TATE and age, sex, location, and histopathologic grading (P > 0.05). Conclusion: TATE has no correlation with histopathologic factors, but TATE was lower in poorly differentiated group than two others. doi:10.1016/j.oraloncology.2011.06.421
P179. Vascular endothelial growth factor (VEGF) expression and inflammatory cells infiltration in well-differentiated squamous cell carcinoma of tongue N. Jalayer Naderi *,a, F. Tirgari b, F. Esmaili c a
Shahed University, Faculty of Dentistry, Iran Tehran University of Medical Sciences, Institute Cancer, Iran c Graduate Student of Faculty of Dentistry, Shahed University, Iran b
Introduction: VEGF is a cytokine that play an important role in angiogenesis and inflammation. It was shown that inflammatory cells activated in microenvironment of tumors. The purpose of this study was to investigate the impact of VEGF expression and inflammatory infiltration in tongue squamous cell carcinoma. The correlation between VEGF expression and inflammatory infiltration was determined. Methods: Twenty-four formalin-fixed, paraffin-embedded biopsy from well-differentiated squamous cell carcinoma of tongue was detected immunohistochemically for VEGF expression. The labeling