A Study on Cancer-Associated Fibroblast Using Alpha-Smooth Muscle Actin Immunohistochemistry in Oral Squamous Cell...

Area of Science:

• Oncology
• Pathology
• Cancer Biology

Background:

• Oral squamous cell carcinoma (OSCC) is a major global health concern with complex tumor microenvironment interactions.
• Cancer-associated fibroblasts (CAFs), marked by alpha-smooth muscle actin (α-SMA), are key players in OSCC progression, invasion, and metastasis.
• The prognostic significance of CAF expression patterns in OSCC requires further characterization.

Purpose of the Study:

• To detect CAFs using α-SMA immunohistochemistry in OSCC.
• To evaluate the association between CAF expression patterns and lymph node metastasis (LNM) and pathological tumor-node-metastasis (pTNM) staging.
• To identify potential new prognostic markers for OSCC clinical management.

Main Methods:

• Laboratory-based analytical study of 88 histopathologically confirmed OSCC cases.
• α-SMA immunohistochemistry was used to detect and quantify CAFs, assessing their distribution patterns (focal, network, spindle).
• Analysis included correlation with clinicopathological parameters such as LNM, pTNM staging, tumor-stroma ratio (TSR), worst pattern of invasion (WPOI), tumor budding (TB), and tumor-infiltrating lymphocytes (TILs).

Main Results:

• No significant association was found between CAF scores (quantity) and LNM (p=0.758).
• CAF distribution patterns showed a significant association with pTNM staging (p=0.001), with advanced stages exhibiting network and spindle patterns.
• Significant correlations were observed between TSR and CAF score (p<0.0001), TB and CAF score (p=0.021), and TB and LNM (p=0.047).

Conclusions:

• While CAF quantity alone did not predict LNM, CAF architectural patterns are significantly associated with pathological staging in OSCC.
• The correlations between CAF distribution, TB, and invasion patterns suggest CAF architecture as a potential prognostic indicator.
• Evaluating CAF distribution patterns can serve as an adjunctive histopathological parameter for risk stratification in OSCC patients.