Immunohistochemical Approach to Evaluate and Compare the Expression of CD44 in Oral Premalignant Disorders and Oral Squamous Cell Carcinoma - A Retrospective Study

Objective: Oral squamous cell carcinoma (OSCC) is the most prevalent kind of head and neck cancer. Oral premalignant diseases (OPMD) such as oral submucous fibrosis (OSMF) and oral lichen planus (OLP), have a higher risk of developing into OSCC. Due to the cellular milieu created by exposure to smoking, alcohol, betel nuts, or the human papillomavirus, the stratified squamous epithelium that covers the oral cavity is extremely sensitive and vulnerable to carcinogenic damage. This can further lead to the formation of dysplastic or hyperkeratotic epithelium, which further transforms to OPMDs. Recently, it has been shown that cancer cells display the cell surface glycoprotein cluster of differentiation 44 (CD44), which may be cleaved at the ectodomain to produce soluble CD44. The aim of the present study is to evaluate and compare CD44 expression as a prognostic marker for OPMD-related cancer development using immunohistochemistry (IHC).
Materials and Methods: The expression of CD44 was assessed by IHC in 80 paraffin-embedded tissues [20 normal mucosa (control), 20 OLP cases, 20 OSMF cases, and 20 OSCC patients] in this retrospective investigation. The one-way analysis of variance (ANOVA) and an independent student’s t-test were used to conduct the statistical analysis.
Results: Using an independent sample t-test, comparisons between the control vs OLP, control vs. OSMF, control vs. OSCC, OLP vs. OSCC, and OSMF vs. OSCC all demonstrated statistical significance with p-values of <0.001, <0.001, <0.001, 0.001, and 0.001, respectively. However, a statistical analysis of the comparison between OLP and OSMF with a p-value of 0.894 revealed no statistical significance.
Conclusion: Thus, it has been concluded that CD44 can be employed as a diagnostic marker for the change from healthy mucosa to premalignant and malignant tissue based on the level of expression using IHC.