A recent trend in cancer control programmes is the development of early detection strategies and chemoprevention of premalignant lesions. The present study evaluates the potential of selected markers in the biological staging of tumor progression in oral mucosa for better management of the disease. The expression patterns of various cytokeratin protein types such as 10/11, 13 & 16, 19, 18, 14 and pancytokeratin, involucrin, ras p21, epidermal growth factor (EGF) and its receptor (EGFR) were assessed immunohistochemically in various stages of tumor progression in oral mucosa. Statistical analyses such as the Kruskal-Wallis one-way ANOVA, Spearman's rank correlation and multiple regression analysis were carried out to see which proteins have a significant association with tumor progression in oral mucosa. Statistical analysis showed that the expression patterns of cytokeratin types 10/11, 14 and 19, involucrin and epidermal growth factor were significantly correlated with tumor progression in oral mucosa in both univariate and multivariate analysis. Thus the biological stage of a lesion can be calculated from the multiple regression equation derived for these proteins, which could be more useful in assessing the stage of tumor progression in oral mucosa than histopathological grading.
SankaranarayananR.Oral cancer in India: an epidemiologic and clinical review. Oral Surg Oral Med Oral Path1990; 69: 325–30.
2.
JayanthK., NotaniM.Epidemiology of oral cancer. In: RaoR.S., DesaiP.B., eds. Oral cancer.Bombay: Professional Education Division, Tata Memorial Hospital1991; 1–7.
3.
SankaranarayananR., NairM.K., MathewB., BalaramP., SebastianP., DuttS.C.Recent results of oral cancer research in Kerala, India. Head & Neck1992; 14: 107–12.
4.
NairM.K., SankaranarayananR., KrishnanE., PadmanabhanT.K., MayadeviS., MathewA.Independent predictors of response and disease-free survival in oral cancer treated with radical radiation therapy. Cancer1992; 69: 2221–6.
5.
HensonD.E.Future directions for the American Joint Committee on Cancer. Cancer1992; 69: 1639–44.
6.
Fenoglio-PreiserC.M.Selection of appropriate cellular and molecular biologic diagnostic tests in the evaluation of cancer. Cancer1992; 69: 1607–32.
7.
MeyskensF.L.Jr.. Biology and intervention of the premalignant process. Cancer Bull1991; 43: 475–80.
8.
ChandranG.J., BalaramP., KannanS., PillaiM.R., NalinakumariK.R., NairM.K.Immunohistochemical localization of epidermal growth factor and its receptor in normal, premalignant and malignant oral mucosa. Int J Oncol1994; 4: 503–8.
9.
KannanS., BalaramP., PillaiR., ChandranG.J., NairM.K.Immunohistochemical analysis of ras p21 expression in normal, premalignant and malignant oral mucosa. Int J Cancer1993; 55: 700–2.
10.
KannanS., BalaramP., ChandranG.J.Alterations in expression of basement membrane proteins during tumour progression in oral mucosa. Histopath1994; 24: 531–7.
11.
KannanS., BalaramP., ChandranG.J., PillaiM.R., MathewB., NairM.K.Co-expression of ras p21 and epidermal growth factor receptor during various stages of tumor progression in oral mucosa. Tumor Biol1994; 15: 73–81.
12.
KannanS., BalaramP., ChandranG.J.Alterations in expression of terminal differentiation markers of keratinocytes during oral carcinogenesis. Pathobiol1994; 62: 127–33.
13.
KannanS., BalaramP., ChandranG.J.Differential expression of cytokeratin proteins during tumor progression in oral mucosa. Epith Cell Biol1994; 3: 61–9.
14.
WahiP.N., CohenB., LuthraU.K., TorloniH.Histological typing of oral and oropharyngeal tumors. International Histological Classification of Tumours No. 4.Geneva: World Health Organisation, 1971.
15.
WHO Collaborating Centre for Oral Precancerous Lesions.Definition of leukoplakia and related lesions: an aid to studies on oral precancer. Oral Surg1978; 46: 518–39.
16.
SternbergerL.A.Immunocytochemistry.New York: John Wiley and Sons Inc, 1979.
17.
RoinM.P.Genetic and proliferation markers in clinical studies of the premalignant process. Cancer Bull1991; 43: 507–14.
18.
BoydN.M., ReadeP.C.Differences between preneoplastic cells, neoplastic cells and their normal counterparts. J Oral Pathol1988; 17: 257–62.
19.
MorganP.R., ShirlawP.J., JohnsonN.W., LeighI.M., LaneE.B.Potential applications of anti-keratin antibodies in oral diagnosis. J Oral Pathol1987; 16: 212–22.
20.
MorganP.R., SuL.Intermediate filaments in oral neoplasia. I. Oral cancer and epithelial dysplasia. Oral Oncol, Eur J Cancer1994; 308: 160–6.
21.
VigneswaranN., PetersK.P., HornsteinO.P., HanekeE.Comparison of cytokeratin, filaggrin and involucrin profiles in oral leukoplakias and squamous cell carcinomas. J Oral Pathol Med1989; 18: 377–90.
22.
OgdenG.R., ChisholmD.M., AdiM., LaneE.B.Cytokeratin expression in oral cancer and its relationship to tumor differentiation. J Oral Pathol Med1993; 22: 82–6.
23.
CrossM., DexterT.M.Growth factors in development, transformation, and tumorigenesis. Cell1991; 64: 271–80.
24.
ShirasunaK., HayashidoY., SugiyamaM., YoshiokaH., MatsuyaT.Immunohistochemical localization of epidermal growth factor (EGF) and EGF receptor in human oral mucosa and its malignancy. Vichows Arch A Pathol Anat Histopathol1991; 418: 349–53.
BishopJ.M.Molecular themes in oncogenesis. Cell1991; 64: 235–48.
27.
RenanM.J.Cancer genes: current status, future prospects, and applications in radiotherapy/oncology. Radiother Oncol1990; 19: 197–218.
28.
BarbacidM.Ras oncogenes: their role in neoplasia. Eur J Clin Invest1990; 20: 225–35.
29.
TsujiT., SaskaiH., HiraokaF., ShiznozakiF.The immunohistochemical detection of ras p21 and its correlation with differentiation in oral cancers. J Tumor Markers Oncol1989; 4: 415–9.
30.
FieldJ.K.The role of oncogenes and tumor–suppressor genes in the aetiology of oral, head and neck squamous cell carcinoma. J R Soc Med1995; 88: 35P–9P.
31.
RumsbyG., CarterR.L., GustersonB.A.Low incidence ras oncogene activation in human squamous cell carcinoma. Br J Cancer1990; 61: 365–8.
32.
McKenzieS.J.Diagnostic utility of oncogenes and their products in human cancer. BBA1991; 1072: 193–214.
33.
WorthA.J., GallagherR.P., ElwoodJ.M.Pathologic prognostic factors for cutaneous malignant melanoma: the Western Canada melanoma study. Int J Cancer1989; 43: 370–5.
34.
KamuraT., TsukamotoN., TsuruchiI.N.Multivariate analysis of the histopathologic prognostic factors of cervical cancer in patients undergoing radical hysterectomy. Cancer1992; 69: 181–6.
35.
JarosE., PerryR.H., AdamL.Prognostic implications of p53 protein, epidermal growth factor receptor and Ki-67 labelling in brain tumours. Br J Cancer1992; 66: 373–85.
