Emmprin (CD147) expression in oral submucous fibrosis and in oral squamous cell carcinoma-A potential predictor.

Abstract

Introduction: Oral squamous cell carcinoma arising from oral submucous fibrosis (OSMF) is highly invasive with metastasis and high recurrence rate. WHO has categorized oral carcinoma as 6^th most common cancer in male and 10^th most common cancer in female. It is estimated that there are 7-13% chances of malignant transformation of OSMF, with 60% of cases fall under well-differentiated OSCC. CD147 also called as EMMPRIN (Basigin) is a transmembrane glycoprotein and found to be highly expressed by active cells like tumour cells and lymphocytes.

Aims and objectives: This study aims at evaluating the expression of EMMPRIN (CD147) in both OSMF and in oral squamous cell carcinoma through immunohistochemical technique, to use EMMPRIN as a marker for disease progression and prognosis.

Materials and method: In this study, we have taken 12 samples of OSMF and 12 samples of OSCC along with 5 normal tissue blocks as control. The tissue samples were all retrieved and taken from the Department of Oral Pathology and Microbiology which were reconfirmed by histopathological diagnosis. All the samples were poly-HRP (horse radish peroxidase) and PolyExcel Stunn substrate and chromogen. The staining was scored and analysed statistically.

Results: There was a significantly good expression in OSMF with 83.3% of cases, that is, 10 out of 12 show positive staining. Weak positive cases and moderately positive cases were 4 each, and strong positive cases were 2. This indicates that the staining increases as the stage advances. In OSCC, the number of cases showing positive staining was 5, which makes up to 41.7%. As the stage of OSCC increases, the expression of EMMPRIN (CD147) is expected to increase as it is a component important in both angiogenesis and metastasis.

Conclusion: The 42% positive CD147 (EMMPRIN) expression in OSCC indicates that it may progress to the next stage of invasion and metastasis, whereas the 83% of positive cases of OSMF indicate that it is likely to transform into OSCC as early as possible. But further study with large sample size and proper distribution of samples in each stage of OSMF and OSCC can help in better analysis of the marker CD147 (EMMPRIN) as a predictor of prognosis.