Valor prognóstico de sistemas de gradação histopatológica e caracterização de marcadores em carcinoma espinocelular oral

Abstract

Squamous cell carcinoma (SCC) is an important public health problem, with a poor prognosis (reduced survival rate of less than 50% in 5 years) and still does not provide specific markers able to predict your prognosis. In order to better understand the prognostic factors related to oral carcinogenesis, this study aimed to evaluate the prognostic value of histopathological grading systems, based on: budding model and depth of invasion (BD model), histological risk model (HR), model of the World Health Organization (WHO), tumor-stroma ratio (TSR) TSR and associated with the model BD (TSR and MBD). Additionally we evaluated the expression of proteins related to tumorigenesis: oral stanniocalcin 2 (STC2), N-terminal pro-peptide of pro-collagen type I (PINP), eukaryotic translation elongation factor 1 delta (EFF1D), Plectin and Fascin, in 124 samples of SCC tongue and mouth floor from Brazil and Chile. The results in univariate analysis revealed that compromised surgical margins (p=0.05) showed significance for disease-specific survival and type I and II lymphocytic response (p=0.02) was significant for disease-free survival. In relation to the models we observed that high score of BD (p=0.05), WHO (p=0.001) and HR (p=0.05) showed significance for disease-specific survival. More than five budding the front invasion (p=0.03; p=0.01), and high score of association of TRS and MBD (p=0.05; p=0.01), showed significance for specific survival and disease-free. Association of TSR and MBD resisted the multivariate analysis of Cox for the histopathological grading systems, after adjustment for other prognostic factors, considering both specific survival (p=0.03) and free of disease (p=0.03). In relation to the high expression of markers STC2 (p=0.05; p=0.02) revealed significance to specific survival and resisted for survival, disease-free and more than 50% of marked cells in the stroma with PINP (p=0.04) showed significance for disease-free survival. Immunohistochemical markers with TSR and MBD in multivariate Cox analysis, the parameters were resistant surgical margins compromised (p=0.03) for disease-specific survival and multimodality treatment sequence (p=0.02) and high expression of STC2 (p=0.04) for disease-free survival. The association of TSR and MBD revealed an important histological grading system and such a model can be useful as an aid to establish the prognosis for SCC of tongue and mouth floor. In addition, it was noted that STC2 and PINP the usefulness of a potential prognostic factor for the SCC tongue and mouth floor.