Avaliação do budding tumoral em biópsias incisionais de carcinoma de células escamosas de boca e sua associação com características clínicopatológicas e com a expressão imunoistoquímica das proteínas caderina-e e podoplanina

Abstract

The success of the treatment of oral squamous cell carcinoma (OSCC) depends on the development of effective tools that can help clinicians and surgeons in their decisions about surgical treatment of oral squamous cell carcinoma, especially about the elective limph node dissection. The tumor budding is recognized as the presence of isolated cells or small clusters of cells in the tumor stroma often distributed near the invasive front region and has been associated with more aggressive tumors. E-cadherin is a principal adhesion molecule of epithelial tissue, which is essential for the establishment and maintenance of apical-basal cell polarity and the structural integrity of the epithelium. The loss of E-cadherin is associated with the process of tumor invasion and with a worse prognosis in OSCC. The Podoplanin is also a protein related to the process of invasion of neoplastic epithelial cells, and its overexpression correlates with a poor prognosis. A relationship E-cadherin negative / positive Podoplanin can be considered a predictive factor of development of metastasis to the OSCC. The objective of this study was to evaluate tumor budding in a sample of incisional biopsies of OSCC and additionally verify the association of this feature with clinicopathological characteristics and the immunoreactivity of the proteins E-cadherin and podoplanin. Fifty-six cases of oral squamous cell carcinoma were enrolled in the retrospective study. Parafin embedded specimens and slices were recovered and immunohsitochemical reaction performed. Tumor budding was investigated and the intensity of budding was associated with clinical staging, histological grade of malignancy, invasion mode, development of metastases and immunohistochemical expression of E-cadherin and podoplanin. Tumor budding was associated with the pattern of tumor invasion. None of the other clinicopathologic characteristics evaluated were associated to tumor budding. E-cadherin was lost in the deep areas of the tumor in comparison with the superficial/central areas. In conclusion, in this sample, tumor budding has an association only with the mode of invasion. Further studies are necessaty before recommend budding for routine pathological diagnosis supporting the treatment decision.