A Study of Distribution of P53, Cyclin D1 and CD44 in Oral Squamous Cell Carcinoma and its Correlation with Grading and Nodal Metastases.

Squamous Cell Carcinoma (SCC) Of The Mouth Constitutes The Sixth Most Common Cancer Worldwide But The Third Most Common In Developing Countries.1 There Is Evidence Of An Increase In Incidence Rate And Mortality As A Result Of This Disease In Recent Years, Particularly In Young Adults In Central Europe.2 Despite Advances In Treatment Modalities, The Prognosis Of This Cancer Is Still Very Poor And Has Not Changed Over The Past Few Decades. Biological Phenotypes Of Cancer Greatly Affect The Clinical Outcomes Of Patients With The Disease. If Such Biological Characteristics Of Cancer Could Be Predicted Before Treatment, It Would Be Possible To Select More Effective And Suitable Treatment For Each Cancer. Recent Studies Have Clarified That A Variety Of Molecular Events Play Extremely Important Roles In Not Only Tumor Development But Also Tumor Progression. Consequently, Special Attention Has Turned To Molecular Markers As A Possible Means For Obtaining Useful Information To Predict Aggressive Phenotypes Of Tumors.3 Since The Current TNM Staging System Is Also Inadequate To Accurately Classify The Patients Of Oral SCC In Terms Of Prognosis, It Is Important To Look For New Biological Prognostic Markers That Might Add Information About The Aggressiveness Of The Tumors And Treatment Response. So, The Interest Lies In Studying The Molecular Markers Involved In Cell Cycle Regulation Of Tumor Cells P53 And Cyclin D1. The P53 Tumor-Suppressor Gene Regulates Cell Cycle Progression Through Induction Of Apoptosis At The G1/S Checkpoint.4,5 Immunohistochemical P53 Protein Expression Is Based On The Prolonged Half-Life Of The Mutant Protein Compared To The Wild-Type.6 Cyclin D1 Plays A Central Role In The G1/S Cell Cycle Transition And Responses To Cytotoxic Stimuli.7, 8 We Were Also Interested In The Expression Of CD44 Molecule That Has Been Correlated To Carcinogenesis And Aggressive Biological Behavior Of Several Malignant Tumors. CD44 Is A Polymorphic Family Of Cell Surface Proteoglycans And Glycoproteins Implicated In Cell-Cell And Cell-Matrix Adhesion Interactions, Lymphocyte Activation And Homing, Cell Migration And Tumor Metastasis. In View Of The Prospective Impact Of Multiple Molecular Marker Accumulation On Tumor Progression, Multiple-Marker Testing Could Provide Us With More Useful Information For Our Definition Of The Biological Behavior Than Single Marker Expression. So, In Our Study We Have Analyzed The Expression Of Cell Cycle Regulatory Proteins P53 And Cyclin D1, Cell Adhesion Molecule CD44 Using Immunohistochemistry In Oral Squamous Cell Carcinoma And Its Variant Verrucous Carcinoma. We Also Studied The Impact Of Expression Of These Markers On Clinico-Pathological Features Like Histological Grading Of The Tumor And Cervical Node Metastasis