Valor prognóstico da imunoexpressão de α-SMA em carcinoma espinocelular de língua e assoalho bucal

Abstract

Oral squamous cell carcinoma (OSCC) is a relevant public health problem, with a still gloomy prognosis (survival rate below 50% in 5 years) and has no specific markers capable of predicting an assertive prognosis. In order to increase the knowledge about biological events related to oral carcinogenesis, as well as to evaluate the role of markers that may contribute to the prognosis and treatment of patients with this tumor, this study aims to verify the prognostic value of carcinoma-associated fibroblast density (CAF) by immunostaining the α smooth muscle actin (α-SMA) isoform at the invasion front and tumor stroma in 91 tongue and floor OSCC samples (surgical specimens) diagnosed and treated at the Bom Pastor Hospital, Varginha / MG, from 1998 to 2012. The results of the clinical and epidemiological analysis revealed a predominance of male patients (74.7%), smokers (71.4%). and alcoholics (52.7%). Most cases were in advanced stage III and IV (57.1%). Survival analyzes showed that 65% of patients were alive and 75% of patients were free of recurrence after 5 years. The results also revealed a significant correlation between α-SMA immunostaining and patient survival rate, with abundant α-SMA expression significantly interfering with disease-specific survival (risk of death) (p = 0.005; OR: 3.94; 95% CI: 1.50-10.34) of patients on both invasion front and tumor stroma, resisting (p = 0.04) multivariate Cox analysis after adjustment for other prognostic factors. When analyzing α-SMA immunostaining and AJCC T stage classifications (7th and 8th edition), no significant difference was observed (p = 0.36 and p = 0.40), the same was observed when associating stage classifications AJCC T (7th and 8th edition) and survival (p = 0.36 and p = 0.40). Thus, the results of this study demonstrated that the density of CAFs can be a useful tool to determine the prognosis of OSCC of the tongue and floor, both in the invasion front and in the tumor stroma. In addition, further studies need to be encouraged to improve category T in the AJCC specifications (7th and 8th edition), especially considering the appropriate point for cutting the internship and the best way of measuring the DOI