背景:口腔鳞状细胞癌是全球最常见的恶性肿瘤。口腔癌前病变和恶性病变的发病机制主要归因于调节细胞凋亡和细胞增殖的分子机制的改变。B细胞淋巴瘤基因2(Bcl-2)是通过抑制细胞凋亡延长细胞存活的抗凋亡基因,并且与恶性肿瘤的侵袭行为相关。该研究的目的是评估Bcl-2在口腔鳞状细胞癌和口腔发育不良性病变中的表达,并将其表达与各种等级的异型增生和癌进行比较。
方法:对在ShriBMPatil医学院病理科和研究中心接受的80例临床怀疑的发育不良和恶性口腔病变的病例进行了基于医院的横断面研究,Vijaypura,卡纳塔克邦.在80个案例中,40个是鳞状细胞癌,40例为口腔发育不良病变。对于每种情况,制备测量4μm厚度的两个部分。在一个切片上进行苏木精和伊红染色,另外进行Bcl-2的IHC染色。对口腔上皮异型增生和鳞状细胞癌的每一例进行Bcl-2表达评估。
结果:40例鳞状细胞癌,15个分化良好,22人中等分化,三人分化差。在高分化的口腔鳞状细胞癌中,Bcl-2阳性在66.7%的病例中为0级,在33.3%的病例中为1级。在中分化口腔鳞状细胞癌中,Bcl-2阳性在63.6%的病例中为1级,在36.4%的病例中为2级。在低分化口腔鳞状细胞癌中,Bcl-2阳性在33.3%的病例中为1级,在66.7%的病例中为2级。在40例发育不良病变中,11例表现为重度发育不良,中度异型增生11例,轻度异型增生18例。在72.7%的重度不典型增生病例和63.6%的中度不典型增生病例中发现2级阳性.在轻度发育不良中,所有病例均显示0级Bcl-2表达。
结论:低分化口腔鳞状细胞癌中Bcl-2阳性高,高分化口腔鳞状细胞癌中Bcl-2阳性低。与中度发育不良相比,重度发育不良中的Bcl-2表达更高,这可能表明肿瘤在低分化口腔鳞状细胞癌和严重发育不良中的侵袭行为。
BACKGROUND: Squamous cell carcinoma of the oral cavity is the most common malignancy noted globally.Pathogenesis of premalignant and malignant oral lesions is mainly attributed to the alteration in the molecular mechanisms that regulate apoptosis and cell proliferation. B-cell lymphoma gene 2 (Bcl-2) is the anti-apoptotic gene that prolongs cell survival by inhibiting apoptosis and is associated with the aggressive behaviour of malignant tumours. The aim of the study was to evaluate Bcl-2 expression in oral squamous cell carcinoma and dysplastic lesions of the oral cavity and to compare its expression with various grades of dysplasia and carcinoma.
METHODS: A hospital-based cross-sectional study was done on 80 clinically suspected cases of dysplastic and malignant oral cavity lesions received in the histopathology section of the Department of Pathology of Shri BM Patil Medical College Hospital and Research Center, Vijaypura, Karnataka. Out of 80 cases, 40 were squamous cell carcinoma, and 40 were dysplastic lesions of the oral cavity. For each case, two sections measuring 4 μm thickness were prepared. Hematoxylin and eosin staining was performed on one section, and Bcl-2 IHC staining was performed on another. Bcl-2 expression evaluation was done for each case of oral epithelial dysplasia and squamous cell carcinoma.
RESULTS: Out of 40 cases of squamous cell carcinoma, 15 were well-differentiated, 22 were moderately differentiated, and three were poorly differentiated. In well-differentiated oral squamous cell carcinoma, Bcl-2 positivity was grade 0 in 66.7% of cases and grade 1 in 33.3% of cases. In moderately differentiated oral squamous cell carcinoma, Bcl-2 positivity was grade 1 in 63.6% of cases and grade 2 in 36.4% of cases. In poorly differentiated oral squamous cell carcinoma, Bcl-2 positivity was grade 1 in 33.3% and grade 2 in 66.7% of cases. Out of 40 cases of dysplastic lesions, 11 cases showed severe dysplasia, 11 cases showed moderate dysplasia and 18 cases showed mild dysplasia. grade 2 positivity was seen in 72.7% of cases of severe dysplasia and 63.6 % of cases of moderate dysplasia. In mild dysplasia, all of the cases showed grade 0 Bcl-2 expression.
CONCLUSIONS: In poorly differentiated oral squamous cell carcinoma Bcl-2 positivity was high and low in well-differentiated oral squamous cell carcinoma. Bcl-2 expression was higher in severe dysplasia compared to moderate dysplasia, which may indicate aggressive behaviour of tumour in poorly differentiated oral squamous cell carcinoma and severe dysplasia.