Cell Cannibalism in Oral Precancerous Lesions and Squamous Cell Carcinoma

Cellular cannibalism is defined as a process of non-apoptotic cell death. This phenomenon has been indicated to be associated with aggressiveness, anaplasia, invasiveness, and metastatic potential of various malignancies. The Aim of this study is the evaluation of cell cannibalism in oral dysplastic lesions and oral cancer.

A total of 31 cases of squamous cell carcinoma (SCC), 30 epithelial dysplasia, and 36 hyperkeratosis (HK) were enrolled in this Cross-sectional study. All hematoxylin and eosin tissue sections were examined in 10 high-power fields for tumor cell cannibalism. Data were analyzed using the Kruskal-Wallis and Fisher's exact test.

Cell cannibalism was found in all cases of SCC, 58.3% of dysplastic lesions, and 3.7% of HK cases. The mean number of cells with cannibalism was 19.48± 4.94 in SCC patients, 1.03± 1.25 in dysplastic lesions, and 0.03± 0.18in HK with a significant difference (P<0.001). High grades dysplastic and cancerous lesions exhibited more cannibalistic cells (P=0.01, P= 0.27, respectively).

In addition to oral SCC, cell cannibalism was found in oral epithelial dysplasia; which was significantly more in SCC. This phenomenon was in association with grades of differentiation and might be considered a potential criterion for malignant transformation and high-grade lesions.