Journal of Cancer Research and Treatment

Current Issue» Volume 2, Number 2 (2014)


Study of Immune Effector Cells in Leukoplakia and Oral Cancer

1Immunohistochemistry and Flowcytometry Division, Gujarat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India

Journal of Cancer Research and Treatment. 2014, 2(2), 28-40
DOI: 10.12691/jcrt-2-2-2
Copyright © 2014 Science and Education Publishing

Cite this paper:
Birva V. Brahmbhatt, Hemangini H. Vora. Study of Immune Effector Cells in Leukoplakia and Oral Cancer. Journal of Cancer Research and Treatment. 2014; 2(2):28-40. doi: 10.12691/jcrt-2-2-2.

Correspondence to: Birva  V. Brahmbhatt, Immunohistochemistry and Flowcytometry Division, Gujarat Cancer and Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India. Email:


Aim: Immunosuppresion in oral squamous cell carcinoma (OSCC) is related to high degree of recurrence and believed to develop from premalignant lesion. Leukocytes especially T cell subsets are important in immune surveillance during malignant transformation. This study has been planned to observe changes in systemic immune response in premalignant and malignant oral lesions. Method: The proportions of Neutrophils, Monocytes, Lymphocytes, total T cells, T cell subsets including αβ/γδ T cells, Cytotoxic T cells, Helper T cells, Naive/ Effector/Memory T cells, Regulatory T cells and NK-T subpopulations were analysed in peripheral circulation of healthy donors (N= 49), Leukoplakia (N=20) and OSCC patients (N=100) by flowcytometry. Results: In comparison with healthy donors, decreased Lymphocytes, Naive Helper cells, NK T subpopulations and increased Effector cells were observed in Leukoplakia patients. Similarly, decreased Lymphocytes, NK T subpopulations and increased Neutrophils, Monocytes, Helper and Regulatory T cells were observed in OSCC patients as compared to healthy controls. Moreover, Lymphocytes were decreased and Regulatory T cells were increaed during the progression of Leukoplakia to OSCC. Further, in relation with clinicopathological parameters, Cytotoxic cells were found to be reduced with increasing histological grade. Also, Helper cells were found to be decreased in patients with tobacco and alcohol habit and also with increasing tumor size. Further, in univariate survival analysis, increased incidence of relapse was observed in patients with low γδ and NK T cells. In multivariate survival analysis, low γδ T cells emerged as poor prognosticator for disease free survival and high Regulatory T cells emerged as poor prognosticator for predicting overall survival. Conclusion: Altered systemic immune response was seen during malignant transformation and also found to be associated with patient’s survival. Thus, investigation of circulating Leukocyte and T cell subsets seems to be useful for predicting patient’s survival and to identify immunosuppressed patients who may be benefited with immunotherapy.



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Quantitative DNA Assay (Ploidy), Koilocytotic Changes and AgNOR Expression for Risk Estimation in Oral Leukoplakia

1Department of Pathology and Cancer Screening, Chittaranjan National Cancer Institute, Kolkata, India

2Department of Pharmaceutical Sciences, Birla Institute of Technology, Mesra, Ranchi, India

3Department of Pharmaceutical Technology, Jadavpur University, Kolkata, India

4Department of Pathology, Hospital Wing, Chittaranjan National Cancer Institute, Kolkata, India

Journal of Cancer Research and Treatment. 2014, 2(2), 22-27
DOI: 10.12691/jcrt-2-2-1
Copyright © 2014 Science and Education Publishing

Cite this paper:
Asoke Roy, Satyendra Prasad Bhatnagar, Malay Chatterjee, Goutam Mandal, Dipanwita Ghosh. Quantitative DNA Assay (Ploidy), Koilocytotic Changes and AgNOR Expression for Risk Estimation in Oral Leukoplakia. Journal of Cancer Research and Treatment. 2014; 2(2):22-27. doi: 10.12691/jcrt-2-2-1.

Correspondence to: Asoke  Roy, Department of Pathology and Cancer Screening, Chittaranjan National Cancer Institute, Kolkata, India. Email:


In this study, quantitative DNA estimation (DNA ploidy), AgNORs and koilocytotic changes were assessed in oral leukoplakia for risk categorization. Materials and methods: 50 cases of oral leukoplakias along with adequate controls were selected for the study. Quantitative DNA analysis was done by FACS scan. AgNORs were studied by silver staining method, koilocytotic changes and histopathology were studied in HE stained tissue sections. Results: Out of 50 cases, 45 cases (90%) were linked to traditional addiction of various forms and 5 cases (10%) were non-addicts. Histologically, there were 52% non dysplastic and 48% dysplastic cases. Out of these 50 cases, there were diploid, tetrapoid and aneuploid population including hypodiploid DNA content. The DNA index (DI), among these cases, were ranged from 0.22 (hypodiploid) to 2.12 (tetrapoid) (co-efficient of variation ranged from 0.39 to 18.43). The mean AgNOR count for smokers were 3.5 ± 2.058 whereas the mean AgNOR count for the betel quid group was 2.85 ± 1.47 and for khaini- gutka group was 3.67 ± 2.21. Less than 50% cases showed positivity for koilocytotic changes (20 out of 50 cases). Conclusion: The quantitative DNA (ploidy) study along with AgNORs can be considered dually as a prospective prognostic marker for cancer risk prediction in cases of oral leukoplakia. But koilocytotic changes for the HPV association as a marker for risk prediction in cases of oral leukoplakia is controversial and needs to be investigated on a large scale basis and follow up for a longer duration.



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