Periodic acid-schiff stain and p53 marker: reducing interobserver variability in microinvasive oral squamous cell
Syeda Areeba Rehan1, Bushra Parveen2, Nighat Ara1
1Department of Oral Pathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan.
Objective:
To assess the effectiveness of periodic acid-Schiff stain and p53 immunohistochemical marker in reducing interobserver variability for diagnosing microinvasive oral squamous cell carcinoma cases.
Methods:
The cross-sectional study was conducted at a tertiary care diagnostic hospital in Rawalpindi, Pakistan, from March 31 to July 31, 2023, and comprised diagnostically challenging biopsy specimens. The specimens were subjected first to haematoxylin and eosin stain, and then with periodic acid-Schiff stain and tumour protein p53 immunohistochemistry simultaneously. A preliminary diagnosis on routine staining alone and a final diagnosis with the two adjuncts were reported by two observers who were both blinded to the prior diagnosis. Data was analysed using SPSS 25.
Results:
Of the 30 specimens diagnosed, 21 (70%) belonged to males and 9 (30%) to females. The mean age of the patients was 60.47±11.78 years. Periodic acid-Schiff staining and tumour protein p53 immunohistochemistry demonstrated a significant decrease in interobserver variability in the diagnosis of microinvasive oral squamous cell carcinoma, exhibiting enhanced visualisation in basement membrane breach and identifying the invading cells within the lamina propria that were masked on routine staining (p<0.05).
Conclusion:
Periodic acid-Schiff stain and tumour protein p53 immunohistochemistry could assist in reducing interobserver variability in the diagnosis of microinvasive oral squamous cell carcinoma.
Insights
Periodic acid-Schiff stain and p53 immunohistochemistry significantly reduce diagnostic variability in microinvasive oral squamous cell carcinoma. These methods improve visualization of basement membrane breaches, aiding accurate diagnosis.
Area of Science:
- Oral Pathology
- Oncology
- Diagnostic Histopathology
Background:
- Microinvasive oral squamous cell carcinoma (MI-OSCC) diagnosis can be challenging.
- Interobserver variability in diagnosing MI-OSCC can impact patient management.
Purpose of the Study:
- To evaluate the effectiveness of periodic acid-Schiff (PAS) stain and p53 immunohistochemistry (IHC) in reducing interobserver variability for MI-OSCC diagnosis.
- To assess the utility of PAS and p53 IHC in visualizing basement membrane breaches and invading cells.
Main Methods:
- A cross-sectional study involving diagnostically challenging biopsy specimens.
- Specimens were stained with Hematoxylin and Eosin, PAS, and p53 IHC.
- Two blinded observers provided preliminary and final diagnoses.
Main Results:
- PAS staining and p53 IHC significantly decreased interobserver variability in MI-OSCC diagnosis (p<0.05).
- These adjunct stains enhanced visualization of basement membrane breaches.
- Invading cells within the lamina propria, masked by routine staining, were identified.
Conclusions:
- Periodic acid-Schiff stain and p53 immunohistochemistry can assist in reducing interobserver variability for MI-OSCC diagnosis.
- These techniques improve the accuracy and consistency of MI-OSCC diagnosis.
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