口腔鳞癌血管生成中MMP-2与巨噬细胞的关系

目的:探讨人类口腔鳞状细胞癌(OSCC)中基质金属蛋白酶-2(MMP-2)的表达并与肿瘤相关巨噬细胞(TAMs)以及微血管密度(MVD)间的关系。方法:采用免疫组化SABC法分别检测在42例口腔鳞癌和10例口腔正常组织中MMP-2的表达情况和CD68标记的巨噬细胞及CD34标记的MVD值。结果:口腔鳞癌中MMP-2的表达与淋巴结转移、TNM分期有关(P<0.05);MMP-2的表达与MVD值之间存在相关性(r=0.641,P<0.001),同时也与肿瘤内浸润的巨噬细胞相关(r=0.433,P<0.01)。结论:OSCC中的TAMs与MMP-2密切相关,TAMs可能通过MMP-2发挥促血管生成作用,促进肿瘤生长、发展和转移。     

Expression of immunoregulatory molecules PD-L1 and PD-1 in oral cancer and precancerous lesions: A cohort study of Japanese patients

Objective

An association of the programmed cell death-1 (PD-1) and its ligand PD-L1 with various types of malignant tumors has been established. This study aimed to investigate the role of the PD-L1/PD-1 pathway in oral squamous cell carcinoma (OSCC) and oral epithelial precursor lesions (OEPL).

Significant association of increased PD-L1 and PD-1 expression with nodal metastasis and a poor prognosis in oral squamous cell carcinoma

Programmed cell death ligand 1 (PD-L1) and its receptor PD-1 are immune checkpoint molecules that attenuate the immune response. Blockade of PD-L1 enhances the immune response in a variety of tumours and thus serves as an effective anti-cancer treatment. However, the biological and prognostic roles of PD-L1/PD-1 signalling in oral squamous cell carcinoma (OSCC) remain to be elucidated. The purpose of this study was to examine the correlation of PD-L1/PD-1 signalling with the prognosis of OSCC patients to assess its potential therapeutic relevance. The expression of PD-L1 and of PD-1 was determined immunohistochemically in 97 patients with OSCC and the association of this expression with clinicopathological characteristics was examined. Increased expression of PD-L1 was found in 64.9% of OSCC cases and increased expression of PD-1 was found in 61.9%. Univariate and multivariate analysis revealed that increased expression of PD-L1 and PD-1 positively correlated with cervical lymph node metastasis. The expression of CD25, an activated T-cell marker, was negatively correlated with the labelling index of PD-L1 and PD-1. Moreover, the patient group with PD-L1-positive and PD-1-positive expression showed a more unfavourable prognosis than the group with PD-L1-negative and PD-1-negative expression. These data suggest that increased PD-L1 and PD-1 expression is predictive of nodal metastasis and a poor prognosis and is possibly involved in cancer progression via attenuating the immune response.     

Regulatory T cells and M2-polarized tumour-associated macrophages are associated with the oncogenesis and progression of oral squamous cell carcinoma

Regulatory T cells (Tregs) and tumour-associated macrophages (TAMs) contribute to the tumour microenvironment by inhibiting anti-tumour immune responses. This study was performed to investigate the roles of Tregs and TAMs in oral squamous cell carcinoma (OSCC) and oral epithelial precursor lesions (OEPL). The expression of Treg markers CD25 and FoxP3 and TAM markers CD163 and CD204 was investigated in 82 OSCC and 45 OEPL specimens, and their associations with clinicopathological parameters were analyzed. Correlations were found among CD25, FoxP3, CD163, and CD204 levels (P < 0.001), and these targets were up-regulated in OSCC compared to OEPL (P < 0.001). In OSCC, infiltration of Tregs and/or M2 TAMs was associated with sex and clinicopathological features, such as tumour size, nodal metastasis, tissue differentiation, stromal reaction, invasive behaviour, and invasive depth. In OEPL, CD25, FoxP3, CD163, and CD204 immunoreactivities were significantly associated with sex, postoperative recurrence, and cancerization to OSCC. This study is novel in showing that the infiltration of Tregs and M2 TAMs is significantly associated with the progression of premalignant lesions to OSCC. This suggests that these cells represent prognostic biomarkers for premalignant lesion progression and that immunotherapeutic approaches to control Treg/M2 TAM numbers could protect against progression to malignancy.     

Loss of heterozygosity in oral cancer

The development and progression of oral squamous cell carcinoma (OSCC) is a multistep process, which involves many genetic factors. Among them, loss of heterozygosity (LOH) studies have been used to identify regions on chromosomes that may contain putative tumor suppressor genes (TSGs). Here, we searched PubMed for relevant publications including our previous studies and compared results of LOH in OSCCs from the articles. LOHs in OSCCs were observed at various loci on almost all chromosomes, except X and Y. In this review, the LOH in patients with OSCC and the interrelationship between TSGs and OSCC initiation and progression are discussed.     

程序性死亡分子1及其配体在口腔鳞状细胞癌患者外周血中的表达及临床意义

目的 检测口腔鳞状细胞癌患者外周血中程序性死亡分子1（PD-1）及其配体（PD-L1）的表达水平,探讨其生物学及临床意义。方法 选取82例口腔鳞状细胞癌患者（口腔鳞癌组）和25例健康对照者（对照组）为研究对象,收集研究对象的外周血,采用流式细胞术检测外周血T淋巴细胞表面PD-1、PD-L1的表达及T淋巴细胞亚群计数,采用酶联免疫吸附方法检测血清中可溶性PD-1（sPD-1）和可溶性PD-L1（sPD-L1）的表达水平。采用SPSS 17.0软件对数据进行检验和相关性分析。结果 口腔鳞癌组外周血CD8+ T淋巴细胞百分数明显高于对照组（P<0.05）,而CD3+、CD4+T淋巴细胞百分数及CD4+/CD8+T亚群百分数比值均低于对照组（P<0.05）。口腔鳞癌组外周血CD4+、CD8+ T淋巴细胞表面PD-1、PD-L1的阳性表达率均高于对照组（P<0.01）。口腔鳞癌组血清sPD-L1水平高于对照组（P<0.05）,而sPD-1水平二者差异无统计学意义（P>0.05）。sPD-L1的表达与临床分期、肿瘤分化程度及淋巴结转移状态相关（P<0.05）,与性别、年龄、肿瘤部位及大小无关。结论 口腔鳞状细胞癌患者外周血T淋巴细胞亚群存在不同程度的免疫功能抑制,CD4+和CD8+ T淋巴细胞表面PD-1及PD-L1表达显著升高。异常升高的sPD-L1可能与口腔鳞状细胞癌的发生发展有关。     

Immunohistochemical detection of Ki‐67 is not associated with tumor‐infiltrating macrophages and cyclooxygenase‐2 in oral squamous cell carcinoma

J Oral Pathol Med (2010) 39 : 565–570 Background: An inflammatory component consisting of cells and chemical mediators may influence the proliferation and dissemination of the oral squamous cell carcinoma (OSCC). In the present study, we evaluated the possible relationship between Ki‐67, tumor‐associated macrophages (TAMs), and COX‐2 in OSCCs. In addition, the immunodetection of these proteins was associated with different histological grades of malignancy, including invasive and in situ tumors. Methods: Twenty‐seven OSCC cases were examined by light microscopy using criteria adopted WHO, and immunohistochemistry for Ki‐67, CD68, and COX‐2 using EnVision System in invasive and in situ lesions. Immunohistochemical detection of these proteins was assessed and scored for COX‐2, and results were compared with their histological grades of malignancy. Results: A correlation between Ki‐67, COX‐2, and CD68 was not found. Histological grade of malignancy (HDM) was associated with the Ki‐67 immunostaining (P = 0.00), but this was not observed regarding both CD68 (P = 0.51) and COX‐2 (P = 0.89). Furthermore, there was a COX‐2 overexpression in 62.96% of the sample, and a high density of TAMs in both OSCCs and in situ carcinomas. Conclusions: Imunolabeling for Ki‐67 was directly correlated with less‐differentiated tumors, suggesting that this marker may contribute to understand the biological behavior of OSCC, and help to distinguish risk groups of OSCC. Furthermore, the lack of correlation between Ki‐67, COX‐2, and CD68 indicates that the latter two markers may play a pivotal role in oral carcinogenesis. However, further studies are needed to clarify their contribution for cell proliferation and tumor differentiation.     

Cancer-associated fibroblasts and CD163-positive macrophages in oral squamous cell carcinoma: their clinicopathological and prognostic significance

J Oral Pathol Med (2012) 41 : 444–451 Background: Stromal cells are believed to affect cancer invasion and metastasis. The purpose of this study was to evaluate the distribution of cancer‐associated fibroblasts (CAFs) and the incidence of tumor‐associated macrophages (TAMs) in oral squamous cell carcinoma (OSCC), focusing on clinicopathological factors and patient prognosis, as well as cancer invasion. Methods: The study included 108 patients with OSCC. Anti‐α‐smooth muscle actin, CD68, and CD163 antibodies were used to identify CAFs and TAMs. CAFs were divided into 4 grades on the basis of staining intensity: negative (0), scanty (1), focal (2), and abundant (3). The most intensive areas of macrophage concentration in each tumor invasive stroma were also evaluated. Results: The cancer specimens were divided into Grade 0/1, Grade 2, and Grade 3 on the basis of CAF grade. In addition, they were divided into low‐ and high‐grade groups on the basis of the number of CD68‐positive and CD163‐positive macrophages. The latter were significantly increased in the Grade 2 CAF group compared to the Grade 0/1 group (P = 0.009). Kaplan–Meier and multivariate survival analyses revealed that Grade 2 CAFs (P = 0.003) and high CD163‐positive macrophage levels (P = 0.007) significantly correlated with a poor outcome in patients with OSCC, and that a high CD163‐positive macrophage level was a significant and an independent prognostic factor (P = 0.045). Conclusions: Cancer‐associated fibroblasts and CD163‐positive macrophages may be potential prognostic predictors of OSCC.     

Increased tumor-infiltrating plasmacytoid dendritic cells predicts poor prognosis in oral squamous cell carcinoma

ObjectiveAccumulating evidence suggests that plasmacytoid dendritic cells (pDC) have a dual role not only in initiating anti-tumor immune responses but also in inducing immune tolerance to facilitate cancer development. The aim of this study was to investigate the distribution and function of tumor-infiltrating pDCs in primary oral squamous cell carcinoma (OSCC) and their relation to patient outcome.MethodsThe distribution of pDCs in 10 normal oral mucosa and 60 OSCC tissues was detected by immunohistochemistry. The population of pDCs in six OSCC patients and six healthy donors was evaluated by flow cytometry. The relationship between tumor-infiltrating pDCs and clinicopathological data and patient outcome was analyzed accordingly. The capacity of pDCs to produce cytokines, such as IFN-α, IL-6, IL-8 and TNF-α in response to TLR-9 ligands (CpG-ODN) was measured by ELISA.ResultPDCs were detected at high levels in 38.3% of the OSCC tissues, primarily in the stroma, but were absent in normal oral mucosa. The frequency of pDCs in OSCC tissue was significantly higher than that observed in normal oral mucosa. However, the distribution and population of circulating pDCs was similar between healthy donors and OSCC patients. Kaplan-Meier analysis revealed a significant association of increasing number of tumor-infiltrating pDCs with lymph node metastasis and overall survival. Multivariate analysis confirmed that high levels of tumor-infiltrating pDCs was an independent prognostic factor. Further cytokine analysis revealed a decreased secretion of IFN-α, IL-6 and TNF-α, which indicated an impaired function of tumor-infiltrating pDCs.ConclusionsThe increased number of tumor-infiltrating pDCs correlates with an adverse outcome in primary OSCC patients. This finding is not only suggestive of the contribution of pDCs in the progression of oral cancer but also presents an opportunity and a new target for OSCC immune therapy in oral cancer management.     

口腔鳞状细胞癌巨噬细胞浸润与VEGF表达关系的研究

目的探讨口腔鳞状细胞癌中肿瘤相关巨噬细胞（TAMS）与血管内皮生长因子（VEGF）表达之间的关系。方法采用免疫组织化学SP法检测10例口腔正常粘膜，40例口腔鳞状细胞癌标本中CD68及VEGF的表达。结果口腔鳞状细胞癌巨噬细胞计数与VEGF表达明显高于正常口腔粘膜（P〈0.01）；VEGF表达与TNM分期及淋巴结转移显著相关（P〈0.05）；巨噬细胞计数与淋巴结转移显著相关（P〈0.05）；巨噬细胞计数与VEGF表达之间呈正相关（r=0.439，P〈0.01）。结论口腔鳞状细胞癌中TAMS和VEGF表达均与肿瘤的生长和转移有关，且二者之间存在正相关关系。     

Association of macrophages with angiogenesis in oral verrucous and squamous cell carcinomas

J Oral Pathol Med (2010) 39 : 559–564 Background: Tumor‐associated macrophages (TAMs) are a major cellular component of human cancers, yet there is still no consensus as to their role in cancer growth and angiogenesis. Methods: The association between TAMs and angiogenesis was investigated in formalin‐fixed, paraffin‐embedded archival material of oral squamous cell carcinoma (OSCC) and oral verrucous carcinoma (OVC). TAMs shown by immunohistochemistry for CD68 and microvessels demonstrated by immunohistochemistry for CD31 were quantified using an image analyzer computer system. Results: TAMs were observed in all studied specimens. The area percentage of CD68 immunoreactivity and microvessel density (MVD) were significantly lower in OVC compared with the different grades of OSCC (P = 0.0009), (P = 0.0045). Both parameters increased in high‐grade malignancy of OSCC. Linear regression analysis revealed a positive correlation between the area percentage of CD68 immunoreactivity and the MVD in the studied tumors. Conclusions: Increased TAMs is associated with angiogenesis and higher histopathological grades in oral cancer.     

口腔鳞癌中肿瘤相关巨噬细胞(TAMs)和血管生成与淋巴结转移的关系

目的 了解口腔鳞癌中肿瘤相关巨噬细胞（TAMs)和血管生成与淋巴结转移的关系。方法 采用免疫组织化学方法观察巨噬细胞侵入及血管生成。结果 巨噬细胞记数及微血管记数在淋巴结转移组较无转移组增多（P＜0.05)；随病理分级的增加，巨噬细胞的侵入增加（P＜0.05)，微血管记数虽稍有增加但无统计学意义（P＞0.05)。结论 本研究表明在口腔鳞癌中TAMs在淋巴结转移中可能起重要的作用。     

Expression of hepatocyte growth factor and c-met protein is significantly associated with the progression of oral squamous cell carcinoma in Taiwan

BACKGROUND: Hepatocyte growth factor (HGF) is a pleotropic growth factor that regulates cell proliferation, migration, survival, tumor angiogenesis, and tumor cell invasion and metastasis. Its diverse biological effects are mediated through its interaction with its receptor, c-met protein. METHODS: In this study, we examined the expression of HGF and c-met protein in 93 specimens of oral squamous cell carcinoma (OSCC), 10 specimens of oral epithelial dysplasia (OED), 14 specimens of oral epithelial hyperkeratosis (OEH), and 16 specimens of normal oral mucosa (NOM) by immunohistochemistry. The HGF and c-met labeling indices (LIs) in OSCC, OED, OEH, and NOM groups were calculated and compared between groups. The correlation between the expression of HGF or c-met in OSCCs and clinicopathological parameters, or survival of OSCC patients was analyzed statistically to investigate the possible influence of HGF or c-met on the progression and prognosis of OSCCs in Taiwan. RESULTS: Positive HGF or c-met staining was mainly cytoplasmic. The mean HGF LI increased significantly from NOM (3.1 +/- 5.1%) through OEH (32.5 +/- 19.8%) and OED (52.0 +/- 19.3%) to OSCC (71.9 +/- 28.6%; P = 0.000). The mean c-met LI also increased significantly from NOM (25.8 +/- 30.8%) and OEH (34.4 +/- 19.3%) through OED (53.0 +/- 20.0%) to OSCC (73.0 +/- 29.4%; P = 0.000). Statistical analysis showed that the c-met LI in either the tumor center or invasion front was significantly associated with T status, N status, and clinical staging of OSCC. However, only the HGF LI in the tumor invasion front was significantly correlated with N status and clinical staging of OSCC. CONCLUSION: Our results suggest that the expression of HGF and c-met protein is an early event in oral carcinogenesis in Taiwan. The HGF LI in the tumor invasion front and the c-met LI in either the tumor center or invasion front can predict the progression of OSCCs in Taiwan.     

口腔疣状癌中LRIG1的表达及其抑癌作用的初步研究

目的:探讨富含亮氨酸重复序列和免疫球蛋白样多肽1(LRIG1)在口腔疣状癌中的表达及其抑癌作用的机制.方法:收集口腔疣状癌(n=15)、口腔鳞状细胞癌(n=30)及对应癌旁组织石蜡标本共90例,以15例外伤患者的正常黏膜组织作为对照;免疫组织化学染色技术(SP法)检测其中LRIG1和Bcl-2的表达,并用皮尔森分析二者相关性.结果:LRIG1在正常黏膜、口腔疣状癌、口腔鳞状细胞癌组织中的表达依次下降(P＜0.05)并伴随Bcl-2的表达依次升高(P＜0.05);并且,LRIG1与Bcl-2表达呈负相关.结论:LRIG1可能通过抑制Bcl-2的表达抑制口腔疣状癌的发生发展.     

Topoisomerase expression in oral squamous cell carcinoma: relationship with cancer stem cells profiles and lymph node metastasis

J Oral Pathol Med (2012) 41 : 762–768 Background: The relationship between predictive proteins and tumors presenting cancer stem cells (CSCs) profiles in oral tumors is still poorly understood. This study aims to identify the relationship between topoisomerases I, IIα, and IIIα and putative CSCs immunophenotype in oral squamous cell carcinoma (OSCC) and determine its influence on prognosis. Methods: The following data were retrieved from 127 patients: age, gender, primary anatomic site, smoking and alcohol intake, recurrence, metastases, histologic classification, treatment, and survival. An immunohistochemical study for topoisomerases I, IIα, and IIIα was performed in a tissue microarray containing 127 paraffin blocks of OSCCs. Results: In univariate analysis, topoisomerases expression showed significant differences according to CSCs profiles and p53 immunoexpression, but not with survival. Topoisomerases IIα and IIIα also showed significant relationship with lymph node metastasis. The multivariate test confirmed these associations. Conclusions: The results that all topoisomerases correlates with OSCC CSCs may indicate a role for topoisomerases in head and neck carcinogenesis. Notwithstanding, it is plausible that other members of topoisomerases family could represent novel therapeutical targets in oral squamous cell carcinoma.     

Association of fibrin and interleukin 8 in human oral squamous cell carcinoma

OBJECTIVE: We have recently demonstrated that fibrin induces a specific, dose- and time-dependent upregulation of the angiogenic factor interleukin 8 (IL-8) from human oral squamous cell carcinoma (OSCC) cells in vitro. In this study we begin to test the hypothesis that fibrin induces IL-8 expression from tumor cells in vivo by studying their in vivo association in OSCC. STUDY DESIGN: The presence of fibrin(ogen) was initially evaluated in 20 archival human OSCCs by means of immunohistochemistry with a polyclonal antibody. The presence of fibrin and IL-8 was then studied in 19 sections from 8 different patients' head and neck tumors (including 6 OSCCs) by means of immunohistochemistry with a monoclonal antibody against fibrin. These 8 tumors had been treated with inhibitors of new fibrin formation and degradation immediately after surgical removal. RESULTS: Fibrin staining was found in 100% of the tumor sections tested. IL-8 staining was found in the cytoplasm of tumor cells in 100% of the studied tumors, including areas adjacent to fibrin. CONCLUSIONS: These data demonstrate an in vivo association between fibrin and IL-8 in OSCC. These studies support our hypothesis that fibrin induces expression of protumorigenic factors such as IL-8 from tumor cells in vivo.     

口腔癌淋巴管密度检测及其临床意义

目的探讨口腔癌组织中淋巴管密度（LVD）与颈淋巴结转移及其它临床病理参数之间的关系。方法选择56例口腔鳞状细胞癌石蜡组织标本，采用免疫组化方法检测淋巴管内皮标志物D2-40及淋巴管内皮透明质酸受体-1（LYVE-1）在口腔癌中的表达，计算口腔癌中的LVD，并进行统计学分析，观察LVD与颈淋巴结转移及其它临床病理参数（性别、年龄、发病部位、T分期、病理分级、浸润方式）之间的关系。结果LYVE-1染色显示，癌内LVD在淋巴结转移组明显高于无转移组（P〈0．05）。LYVE-1染色和D2-40染色均显示癌内LVD与病理分级呈正相关（P〈0．017）。LVD与性别、年龄、发病部位、T分期及浸润方式均无关。结论对于口腔癌来说，癌内淋巴管在肿瘤的浸润和转移中发挥重要作用。     

HD-DDP+5-FU方案用于口腔鳞癌诱导化疗临床初步观察

目的 对HD-DDP 5-FU方案用于口腔鳞癌术前诱导化疗进行临床观察，为进一步临床应用提供依据。方法 16例患者入院后行切取活组织检查确诊为口腔鳞癌后，予以1个疗程HD-DDP 5-FU方案化疗再行手术切除，对化疗中及化疗后患者肿物局部及全身的变化，以及患者的不良反应进行临床评价。结果 完全缓解1例，13例患者的病灶在不同程度上有缩小并且临床症状有所改善，病变进展2例。结论 HD-DDP 5-FU方案用于口腔鳞癌诱导化疗可以取得一定的临床疗效，不良反应可以使用药物控制。     

VEGF-C的表达与口腔鳞癌淋巴结转移的关系

目的:观察口腔鳞癌中D2-40及VEGF-C的表达特点,探讨VEGF-C在肿瘤淋巴管生成及淋巴结转移中的作用。方法:将43例口腔鳞癌分为淋巴结转移组和无淋巴结转移组,应用免疫组织化学SP法检测D2-40及VEGF-C的表达情况。结果:口腔鳞癌中的淋巴管主要分布在肿瘤边缘区(肿瘤间质)。癌组织中淋巴管密度及VEGF-C的阳性表达率显著高于正常组织(P<0.05),淋巴结转移组癌灶中淋巴管密度及VEGF-C的阳性表达率显著高于无淋巴结转移组(P<0.05)。结论:口腔鳞癌肿瘤边缘区淋巴管与淋巴结转移相关,VEGF-C可能参与口腔鳞癌淋巴管的形成。     

Phospholipase C‐γ1 expression correlated with cancer progression of potentially malignant oral lesions

Background: Phospholipase C‐γ1 (PLCγ1) is required for cellular migration during tumor progression and invasion of oral squamous cell carcinoma (OSCC) cells. The objective of the current study was to determine immunoexpression pattern of PLCγ1 in oral potentially malignant lesions (OPLs) and evaluate PLCγ1 usefulness as a biomarker for predicting clinical behavior in the carcinogenesis of OPL. Methods: In a retrospective follow‐up study, the expression pattern of PLCγ1 protein was determined using immunohistochemistry in samples from 68 patients, including untransformed cases (n = 38) and malignant‐transformed cases (n = 30). The corresponding post‐malignant lesions (OSCCs) were also performed. Results: We observed that elevated expression of PLCγ1 in 40 of 68 (59%) general OPLs and 23 of 30 (77%) OSCCs compared with that in normal oral mucosa. Kaplan–Meier analysis revealed that patients with PLCγ1 positivity had a significantly higher incidence of OSCC than those with PLCγ1 negativity. Cox regression analysis revealed that PLCγ1 expression patterns were significantly associated with increased risk of malignant progression. In addition, the correlation between PLCγ1 expression in pre‐malignant OPL and that in post‐malignant OSCC was significant (P = 0.004). Conclusion: These data indicate that PLCγ1 expression in OPL correlated with oral cancer progression, and PLCγ1 may serve as a useful marker for the identification of high‐risk OPL into OSCC.