Tumor Microenvironment & Its Role In prognosis Of Oral Squamous Cell Carcinoma----A Clinico-pathologic study
Tumor Microenvironment, Extracellular Matrix, Tumor islands, Tumor Associated Fibroblasts
Abstract
Background: Tumor micro-environment consists of many different cell populations, such as cancer-associated fibroblasts and various immune cells. The surrounding stroma can function as both positive and negative regulators of cancer development. These different regulators are: ability to evadeapoptosis, neo-angiogenesis, deregulation of the energy metabolism and resistance to the immune detection.These different phases can lead to activation of invasion and thus metastasis. As the tumor advances, stromal changes facilitate the movement of tumor cells within the matrix, leading to metastasis. Solid tumors, such as oral squamous cell carcinoma (OSCC), consist of tumor islands and a modified extracellular matrix (ECM). Throughout tumor progression, the ECM undergoes numerous morphological and architectural alterations. The changes in extracellular matrix are indicative of early invasive changes.The challenges in evaluating oral squamous cell carcinoma primarily arise from its diverse histologic patterns. This variability is considered one of the reasons influencing prognosis. Special stains, including PAS, Masson's Trichrome (MT), and Mucicarmine, are used to study changes in the epithelium, lamina propria, ECM, and other tissues of the maxillofacial region. Alcian blue and Mucicarmine are used to study mucin expression in tissues. Although many IHC studies have been done to detect changes of MUC 1 & MUC 2 glycoproteins, the expression of mucin a in tumor microenvironment of OSCC has not been clearly delineated. Objectives: To investigate the role of mucin expression by mucicarmine stain in different grades of oral carcinoma. Methodology: A total of 150 cases were subjected to mucicarmine staining. The staining patterns were observed in the stroma, extracellular matrix, and in areas surrounding tumor islands. Result: Bright staining was more prominent in poorly differentiated oral squamous cell carcinoma than in moderately and well-differentiated cases. Statistically significant differences were observed among three grades of OSCC. Conclusion: The pattern of mucicarmine staining varies among different grades of oral carcinoma, and less mucin expression relates to better prognosis.
Keywords: Cancer Associated fibroblasts (CAFs), Extracellular matrix, H&E Stain, Metastasis, Mucicarmine stain, Special stain, Tumor Microenvironment.
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