Apoptosis: A Prognostic Marker in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma

Introduction: Oral cancer is a major health problem especially in India. In cancer, the equilibrium between proliferation and apoptosis is disturbed. The defect in apoptotic pathway allows cells to proliferate with genetic abnormalities. Thus, the aim of this study is to assess the significance of apoptotic index (AI) as a putative prognostic marker in oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). Materials and Methods: Study constituted of 60 previously histopathologically confirmed cases, 30 cases of OED and 30 cases of OSCC of different histopathological grades. A uniform section of 3-4 μm thickness was cut from all the blocks and was then stained using hematoxylin and eosin stains. AI was assessed using a binocular research light microscope. The results were sent for statistical analysis using Student’s t-test. Results: The mean AI increased progressively with increasing grades of OED and decreased with increasing grades of OSCC. A maximum mean AI was reported in well-differentiated squamous cell carcinoma (WDSCC) 0.7600. The results observed were significant (P < 0.001) on comparing WDSCC with moderately differentiated SCC (MDSCC) and with poorly differentiated SCC (PDSCC) but were insignificant on comparing MDSCC with PDSCC. Conclusion: This suggest tumors that exhibit less apoptosis tend to show aggressive behavior, hence AI can offer an idea about the nature and course of the lesion. Thereby helping in prognosis and predicting its outcome.