DOI: 10.4103/jomfp.jomfp_203_26 ISSN: 0973-029X

Immunohistochemical expression of cancer stem cell markers ALDH1 and SOX2 in oral squamous cell carcinoma and oral verrucous carcinoma

Percy I. Augustine, Thankappan Prasanth, Tharmasagayam I. Joseph, Kaggalipura L. Girish, Muthuswamy P. Rajalekshmi
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Abstract

Background:

Despite significant advancements in the understanding and treatment of oral cancer, survival rates remain low, ranging from 15% to 50%. Many studies demonstrate that cancer stem cells (CSCs) play a central role in the pathogenesis, progression, and recurrence of carcinomas of the head and neck, including oral squamous cell carcinoma (OSCC). This study aims to investigate the expression of the two putative CSC markers aldehyde dehydrogenase 1 ( ALDH1 ) and sex-determining region-Y box 2 ( SOX2 ) in OSCC and oral verrucous carcinoma (OVC), a verrucous variant of OSCC.

Materials and Methods:

The expression of the CSC markers ALDH1 and SOX2 was assessed immunohistochemically in 30 normal mucosa, 30 OSCC, and 30 OVC cases. The staining patterns were semi-quantitatively evaluated and compared between the three groups. One-way analysis of variance followed by Dunnett t -test and unpaired t -test was applied to find the statistical significance between the groups. P value less than 0.05 was considered as statistically significant at a 95% confidence interval.

Results:

The staining patterns of the markers differed among OSCC and OVC cases in which OVC showed both cytoplasmic and nuclear staining of both the markers while OSCC showed cytoplasmic expression of ALDH1 and nuclear staining in case of SOX2 . The comparison of both ALDH1 and SOX2 expression between the three groups was statistically significant with a P value < 0.05. ALDH1 and SOX2 mean scores were higher in OVC cases.

Conclusion:

Our demonstration of the presence of two putative CSC markers within OSCC and OVC adds further insight into the biology of this disease, highlighting a potentially vital role for CSCs in tumour growth and development. A greater understanding of the CSC, by characterizing the subpopulations in these lesions using these same markers, as well as further investigations using a larger cohort of patients and follow-up analysis, may reveal novel therapeutic targets for these aggressive cancer types.

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