Diagnostic And Prognostic Relevance Of Histopathological Features In Oral Cancer

Abstract

Background: OSCC is a common malignant neoplasm which accounts for high mortality and morbidity worldwide primarily because of late diagnosis of the disease and erratic tumor biology. By evaluating the histopathological characteristics of OSCC patients, the prognosis and management of the disease are determined.

Objectives:  The two study objectives therefore, are: To determine the diagnostic implications of major histopathological parameters in 150 OSCC patients To determine the prognostic implications of major histopathological parameters in 150 OSCC patients.

Study design: A Cross-Sectional Study

Place and duration of study . Department of Dentistry HBS dental college, Islamabad from jan 2021 to july 2021

Methods :  150 patients diagnosed with OSCC were selected for the retrospective study in regard to tumor grade, lymphovascular invasion, perineural invasion, depth of invasion, and margin status. To compare the means between subgroups a t-test score was used and while testing for association between histopathological features and patient survival, the relation was tested by evaluating its overall ability of the variable with the overall patient survival using a chi-squared p-value.

Results :  we enrolled 150 OSCC patients; mean age 56. 4 ± 9. 8. Among 150 matched patients there were 68 (45%) with well differentiated tumours, 53 (35%) moderately differentiated and 29 (20%) poorly differentiated. Invasion of lymphatic and vascular channels was noted in 45 (30%) patients and peripheral nerve invasion was reported in 38 (25%) of patients. The mean depth of invasion was 6. 8 mm and the SD was ± 2. 5 with some having the carcinoma ascending towards the subcutis. Positive surgical margins were observed in 23 patient (15%). Tumor grade showed a p-value of equal to 0. 03, corresponding to a moderate level of evidence, accompanied by LVI with a slightly higher p-value of 0. 02 or low evidence of VI with p = 0. 03 in the least, peri-neural invasion with p = 0. 01, depth of invasion, with p = 0. 04 and margin status with only p = 0. 03.

Conclusion:  It has been seen that the key histopathological parameters are prognostic in OSCC. Therefore, the study emphasises the significance of performing proper histopathological examination in decisions regarding management and prognosis of oral cancer.