Apoptosis in premalignant and malignant squamous cell lesions of the oral cavity: a light microscopic study

Oral cancers are a major health problem in India. Recently, parameters of cell proliferation and cell death have emerged as important diagnostic and prognostic tools.

The aim was to study apoptosis in premalignant and malignant squamous cell lesions of the oral cavity and to evaluate its prognostic role in oral cancers.

The study included 175 patients presenting with oral lesions. Evaluation of apoptotic index (AI) (using light microscopy) was performed on hematoxylin and eosin-stained sections.

Student's t test was performed.

The mean AI increased progressively with increasing dysplasia, with the maximum AI in well-differentiated (WD) squamous cell carcinoma, and a fall was noted with progression toward higher grades. The difference between WD SCC and poorly-differentiated SCC was significant (P < 0.05). Cases with lymph node metastasis had significantly (P < 0.05) lower mean AI values.

Apoptosis can be fairly accurately assessed using light microscopy. Tumors that exhibit less apoptosis tend to show aggressive behavior and have a greater potential for metastasis.