Robin Pupo, Neda Qosja, Mohammad Tehseen, Omer Farooq, Arif Jamshaid, Fatima K. Rehman
Dr. Fatima Rehman | College of Arts and Sciences | Department of Biology
Introduction: Excessive use of cigarettes cigars/ pipe as well as smokeless tobacco is one of the most common cause of oral cancer. In Shaukat Khanum Memorial Center Hospital and Research Center (SKMCH&RC) in Pakistan, Squamous Cell Carcinoma of Tongue (SCCOT) is the second most common head and neck malignancy. Approximately 20-30% of patients with early oral tongue carcinoma will have occult neck nodal modal metastasis. Presently, elective neck dissection remains the only reliable way to predict regional and or distant metastasis. There is a pressing need to find reliable biomarkers and non-invasive predictors of metastasis and patient response in early squamous cell carcinoma of oral tongue.Retrospective analysis was performed in a double-blind manner on tissues microarray (5 cores/patient) created from paraffin-embedded specimens from 50 patients with well documented clinical history of the disease. A subset of 20 different proteins were elected as potential biomarkers of metastasis based on published literature on SCCOT and analyzed through immunohistochemistry. Four proteins, E-cadherin, Podoplanin, Microglobulin and Interleukin-8 were found as possible predicators of metastasis. These findings were validated using Aperio image analysis software. Digital analysis using Aperio confirmed results for two of the four proteins; E-cadherin and Podoplanin while Microglobulin and Interleukin-8 were found to have non-significant results. Specifically, Podoplanin was found to be upregulated while E-cadherin was downregulated in metastatic patients. Computer-aided image analysis provides a powerful tool to support clinical decisions while reducing inter-and intra-observer variability. Based on the results from Aperio, Podoplanin and E-cadherin may be used as potential biomarkers to predict nodal metastasis in early tongue cancer. Further studies are required to confirm these findings and to quantify the levels of these proteins in tissue and plasma of patients with cancer compared to non-tumoral controls.