Useful histological findings in incisional biopsies of oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancers.

The aim of this study was to investigate the histopathological features of OSCC specimens obtained from incisional biopsies and to alert clinicians to the importance of more representative biopsies.

Forty-eight OSCC samples were obtained from incisional biopsies and classified by Bryne’s score. The following morphological features were analyzed: invasive front, invasiveness, apoptotic cells, atypical mitosis, giant cells, acantholysis, ulceration, necrosis, calcification, surface epithelium, granulation tissue, desmoplasia, tissue invasions, inflammatory infiltrate and tumor thickness.

Ten (21%) cases were classified as high grade malignancies and 38 (79%) as low grade. Apoptotic cells (n = 26), atypical mitosis (1–2/20×; n = 38), giant cells (n = 8), acantholysis (n = 5), necrosis (n = 5), calcification (n = 1), granulation tissue (n = 32), desmoplasia (n = 4), perineural invasion (n = 2), muscular invasion (n = 8), invasion of salivary gland tissue (n = 3), vascular invasion (n = 10), and chronic inflammation (n = 33) were observed. Vascular invasion (p = 0.04, Pearson’s χ2 test) and necrosis (p = 0.04, Pearson’s χ2 test) were significantly associated with cases of high-grade malignant tumors. Atypical mitosis was associated with a greatest tumor thickness (p = 0.04, Fischer’s exact test).

This study suggests that incisional biopsies may be useful and significant as they can show histopathological variables that are important to classify oral squamous cell carcinomas into low grade and high grade according to Bryne’s score, which was used in this study. Thus, more representative biopsies might be useful to achieve this and allow a more accurate planning.