Head and neck squamous cell carcinoma is diagnosed at late stages. The prevalence of metastatic lesions directly correlates with poor patient outcome. The progression to metastatic disease requires changes in the tumor microenvironment. Within the microenvironment, infiltrating immune cells facilitate the spread of tumor cells. Tumor-infiltrating lymphocytes play an important role in the response of tumors to therapy. Tumor-associated macrophages are the main cellular component in stroma of many tumors. The goal of cancer treatment is to abolish cell proliferation and to induce aptoptosis. Apoptosis is a key mechanism of tumor cell elimination. The Bcl2 protein itself is a product of a proto-oncogene and has an antiapoptotic action. The study used immunohistochemical staining of CD68, CD3, Bcl2 to measure macrophages, lymphocytes and evaluate apoptosis in 25 included cases; 5 cases of non specific dermatitis, 5 normal skin and 15 head and neck squamous cell carcinoma (HNSCC) graded into 5 well, 5 moderately and 5 poorly differentiated. CD68+ve macrophages were significantly higher in moderately differentiated HNSCC than well differentiated tumors. Poorly differentiated showed significantly lower CD68+ve macrophages than moderately differentiated tumors. CD3 +ve lymphocytes were significantly higher in well differentiated followed by moderate and poorly differentiated. CD3+ve lymphocytes were significantly higher in cases of dermatitis than HNSCC cases. Poorly differentiated SCC showed higher Bcl2 positivity followed by moderately differentiated. Well differentiated SCC showed the least Bcl2 positivity. This difference was significant. Our results showed tumor infiltrating macrophage and lymphocyte can predict the progression and prognosis of HNSCCs and the involvement of Bcl2 in HNSCC tumorigenesis.
Duaa S Helal and Omneya M Wahba
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