Clinicopathologic evaluation of Pro- and antiapoptotic marker expression in oral squamous cell carcinoma

BACKGROUND : Apopotosis is determined by the balance between the pro- and anti- apoptotic regulators in a cell. Bcl2 is the principal anti apoptotic regulator and bax is the principal pro- apoptotic factor that heterodimerizes with bcl2 and counteracts its function. The ratio of bcl2/bax is known to influence the prognosis of OSCC and it differs between the histological differentiation types of OSCC. AIM : Is to determine whether the ratio of bax and bcl2 expression have any significance with regard to clinicopathological parameters. OBJECTIVE OF THE STUDY ; To evaluate the immunohistochemical expression of Bcl 2 and Bax genes in oral squamous cell carcinoma. MATERIALS AND METHODS : This is a prospective study involving 60 cases of histologically proven OSCC, collected between January 2012 and June 2012. The paraffin tissue blocks were prepared, cut and were stained immunohistochemically for bcl2 and bax. Their immunopositivity were then semiquantitatively analysed by giving scores to the percentage of cells stained. The bcl2/bax is then mathematically calculated. This ratio is then statistically analyzed for any significance in relation to age, sex, site, habit and clinical stage of the patient. RESULTS : The bcl2/bax ratios for tongue cases were significantly higher than that of the other sites. Also within the tongue cases, the ratios for cases which had trauma as the etiological factor had significantly higher values. CONCLUSION : OSCC of tongue is known to have poor prognosis than the other subsites of oral cavity as proved by other studies. Higher Bcl2/bax ratio than the rest of the subsites may be one of the reasons for this. Trauma causes a higher bcl2/bax ratio among the various etiologies causing tongue OSCC