Clinicopathological Correlation of Cd44 Expression and Carcinoma Associated Fibroblasts at the Invasive Tumour Front of Oral Squamous Cell Carcinoma- A Preliminary Study

Abstract

BACKGROUND AND AIM: Oral squamous cell carcinoma is one of the most prevalent malignant cancers in India. Invasive tumour front of OSCC shows lower degree of differentiation and higher grade of cellular dissociation when compared to other parts of tumour. Integral prognostic information about the invasiveness of tumour and its metastatic capacity can be deduced from ITF. This study is aimed to evaluate the expression of CD44 and Cancer Associated Fibroblasts at the Invasive Tumour Front of Oral Squamous Cell Carcinoma and to analyze the association between histopathological parameters and the expression of CD44 and CAF. This study also analyses the correlation between the  expression of CD44 and the amount of CAF.

MATERIALS AND METHODS:  20 samples of histopathologically confirmed cases of OSCC were chosen and subjected to immunohistochemical Analysis using two antibodies Alpha smooth muscle actin (SMA) and CD44. The CD44 expression and CAFs were analyzed and   correlated with the histopathological prognostic factors by using univariate and multivariate analysis using IBM SPSS Statistics 23 software.

RESULTS: Higher expression of CD44 and presence of more CAFs at the invasive front was associated with an increased depth of Invasion >5mm. This was found to be statistically significant in univariate analysis with p value=0.000 for CD44 expression and p value= 0.017  for CAF distribution respectively. High expression of CD44 was observed with the presence of more CAF at the invasive tumour front of OSCC cases selected (Chi square test-p value=0.025). 50% and 66.7% of the lymph node infiltrated cases showed high distribution of CAF and high expression of CD44 respectively.

CONCLUSION: In the present study, we found that both  high expression of CD44 and high distribution of CAF were associated with increased depth of invasion in OSCC, which is a very important prognostic factor. These factors can be used as markers for predicting invasiveness and can be used as targets in molecular cancer therapy.