Immunohistochemical Expression of p16 and p53 as Prognostic Indicator in Oral Squamous Cell Carcinoma: A Cross-sectional Study
Introduction: Head and Neck Squamous Cell Carcinoma (HNSCC) is the sixth most common cancer globally and the seventh most common cause of cancer-related mortality. Tobacco use, alcohol consumption, and Human Papillomavirus (HPV) infection are prominent risk factors for HNSCC. HPVpositive Oral Sq...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18408/64769_CE[Ra1]_F(IS_SS)_QC(SD_IS)_PF1(AKA_SS_RDW_OM)_PFA(AKA_KM)_PN(KM).pdf |
| Summary: | Introduction: Head and Neck Squamous Cell Carcinoma
(HNSCC) is the sixth most common cancer globally and the
seventh most common cause of cancer-related mortality.
Tobacco use, alcohol consumption, and Human Papillomavirus
(HPV) infection are prominent risk factors for HNSCC. HPVpositive Oral Squamous Cell Carcinoma (OSCC) differs from
HPV-negative OSCC in terms of risk factors, preferential site
of origin, age, histomorphological features, molecular genetic
alterations, and prognosis. The prominent basaloid morphology
and lobular growth of OSCCs are associated with p16 positivity
and p53 negativity, respectively.
Aim: To establish the immunohistochemical expression of p16
(p16INK4a) and p53 in OSCC and to assess their relationship with
specific histomorphological features, in the form of solid growth
of cells in a lobular configuration, small crowded cells with scant
cytoplasm, dark hyperchromatic nuclei without nucleoli.
Materials and Methods: The cross-sectional study involved
fifty cases of OSCC over a two-year period from January 2017
to January 2019 at Army Hospital (R and R) Delhi Cantt. The
intensity of p16 and p53 protein expression was graded as
follows: no staining (0), weak staining (1), moderate staining (2),
and strong staining (3). The proportion/percentage of staining
for p16 and p53 protein expression was calculated as follows:
1-4% (1), 5-19% (2), 20-39% (3), 40-59% (4), 60-79% (5), and
80-100% (6) cells stained. A quick score of 0-1 (negative), 2-3
(weak positive), 4-5 (moderate positive), and >6 (strong positive)
was assessed. Cross tables were generated and the Chi-square
test was used for testing associations. The Statistical Software
for Data Science (STATA)-14 was used for statistical analysis.
Results: A total of 50 cases of OSCC were analysed for
histomorphological features and immunohistochemical patterns
of p16 and p53. The age distribution showed that 8 (16%), 9
(18%), 18 (36%), 13 (26%), and 2 (4%) of the patients were in
the age groups of 31-40 years, 41-50 years, 51-60 years, 61-70
years, and above 70 years, respectively. The gender distribution
noted 42 (84%) males and 8 (16%) females. Genital and nongenital mucosa are usually involved by HPV subtypes 6, 11,
16, 18, and 16, 18, 11, 13, 2, respectively. HPV-16 has been
demonstrated in 90-95% of all HPV-positive HNSCC cases,
followed by HPV-18, HPV-31, and HPV-33. p53 is considered
the guardian of the genome and controls the expression and
activity of proteins involved in cell cycle regulation, DNA repair,
cellular senescence, and apoptosis. More than 50% of all
primary HNSCC exhibit p53 mutation.
Conclusion: A significant correlation was observed between
age, dysplasia, keratinisation, basaloid morphology versus
p16 expression, and lobular growth, histological grade versus
p53. An inverse relationship between p16 and p53 expressions
was observed. The immunohistochemical expression of p16
as an immunohistochemical marker of HPV, along with p53, is
recommended. Due to the constraint of the study period, the
survival of the patients could not be assessed in correlation with
p16 and p53 expression. |
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| ISSN: | 2249-782X 0973-709X |