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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2018.07.17    [Epub ahead of print]
An Immunohistochemical and Polarizing Microscopic Study of the Tumor Microenvironment in Varying Grades of Oral Squamous Cell Carcinoma
Aeman Khalid1, Safia Siddiqui2, Bharadwaj Bordoloi2, Nafis Faizi3, Fahad Samadi4, Noora Saeed1
1Department of Pathology, Jawahar Lal Nehru Medical College, Aligarh, UP(India)
2Department of Oral Pathology and Microbiology, Sardar Patel Post Graduate Institute of Dental & Medical Sciences, Lucknow, UP(India)
3Department of Community Medicine, Jawahar Lal Nehru Medical College, AMU, Aligarh, UP(India)
4Department of Oral Pathology and Microbiology, King George Medical University, Lucknow, UP(India)
Corresponding Author: Safia Siddiqui ,Tel: +91-9838778650, Email: safiasidd4@gmail.com
Received: June 7, 2018;  Revised: July 15, 2018  Accepted: July 17, 2018.  Published online: July 27, 2018.
ABSTRACT

Background:
Invasion of epithelial cells into the connective tissue brings about massive morphological and architectural changes in the underlying stroma. Myofibroblasts reorganize the stroma to facilitate the movement of tumor cells leading to metastasis. The aim of this study was to determine the number and pattern of distribution of myofibroblasts and the qualitative and quantitative change that they cause in the collagen present in the stroma in various grades of oral squamous cell carcinoma (OSCC).
Methods:
The study was divided into two groups with Group I (test group, 65 cases) consisting of 29 cases of well-differentiated squamous cell carcinoma (WDSCC), 25 moderately differentiated SCC (MDSCC), and 11 poorly differentiated SCC (PDSCC), and Group II (control group) consisting of 11 cases of normal mucosa. Sections from each sample were stained with anti-ɑ-smooth muscle actin (ɑ-SMA) antibodies, hematoxylin and eosin (H&E), and Picrosirius red (PSR). Several additional sections from each grade of OSCC were stained with Masson’s trichrome (MT) to observe the changes in collagen. For the statistical analysis, Fisher’s exact test, Tukey’s post hoc honest significant difference (HSD) test, ANOVA, and the chi-square test were used, and p<0.05 was considered statistically significant. Result: As the tumor stage progressed, an increase in the intensity ɑ-SMA expression was seen, and the network pattern dominated in more dedifferentiated carcinomas. The collagen fibers became thin, loosely packed, and haphazardly aligned with progressing cancer. Additionally, the mean area fraction decreased, and the fibers attained a greenish yellow hue and a weak birefringence when observed using polarizing light microscopy.
Conclusion:
Myofibroblasts bring about numerous changes in collagen. As cancer progresses, there is increase in pathological collagen, which enhances the movement of cells within the stroma.
Key Words: Myofibroblast, Collagen, Oral squamous cell carcinoma, α-Smooth muscle actin, Picrosirius red, Polarizing microscope