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. 2023 Jun 22;15(6):e40836.
doi: 10.7759/cureus.40836. eCollection 2023 Jun.

Altered Presence of Cancer Stem Cell ALDH1/2 in Oral Leukoplakias and Squamous Cell Carcinomas

Vasileios Zisis  1 , Konstantinos Paraskeuopoulos  2 , Poulopoulos Athanasios  1 , Prashanth Panta  3 , Andreadis Dimitrios  1
Affiliations

Altered Presence of Cancer Stem Cell ALDH1/2 in Oral Leukoplakias and Squamous Cell Carcinomas

Vasileios Zisis et al. Cureus. .

Abstract

Introduction: Cancer stem cells (CSCs) are responsible for initiating the process of carcinogenesis by enabling the self-renewal and self-proliferation of the cancer cells. This study aimed to investigate the presence of epithelial cells with cancer stem cells characteristics (ALDH+) in the early stages of oral precancerous lesions (Oral Leukoplakias) and the frequency of these cells in the different stages of oral squamous cell carcinomas (OSCCs).

Materials & methods: The aim of this study was the detection of the immunohistochemical pattern of expression of CSC protein-biomarker ALDH1&2 (sc-166362, Santa Cruz Co, Dallas, Texas, USA) in paraffin-embedded samples of 30 cases of leukoplakia of all degrees of dysplasia and 21 cases of oral squamous cell carcinomas (OSCC) of all degrees of differentiation compared to the histologically normal oral epithelium. The samples were retrieved from 2009-2019 from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece. The samples were evaluated through a three-tier scale (positive cells Ι: 6-35%, ΙΙ: 36-70%, ΙΙΙ: 71-100%). Statistical analysis was performed through SPSS Pearson Chi-square, and the significance level was set at 0.05 (p=0.05). Results: The staining of ALDH1&2 was observed mildly in the cell membrane of cells in the stratum spinosum of the normal epithelium and the cell membrane of cells in the stratum basale of the normal epithelium, characteristically at the interface point with the basal membrane. ALDH1&2 were expressed significantly more in the OSCC than in the leukoplakia (p-value=0.0001) and the normal epithelium (p-value=0.0001). Mainly, ALDH1&2 were expressed significantly more in the severely and moderately dysplastic oral leukoplakia compared to the mildly dysplastic and non-dysplastic leukoplakia (p-value=0.001).

Discussion: The characteristic expression of ALDH in potentially malignant oral and OSCC lesions suggests the presence of CSCs and their possible implication in the early stages of oral tumorigenesis, even at the stage of oral leukoplakia.

Keywords: aldh; cancer stem cells; oral cancers; oral leukoplakia; oscc.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. ALDH pattern of expression in normal oral epithelium, leukoplakia, and cancer
See this image and copyright information in PMC

References

    1. Potentially malignant disorders of the oral and oropharyngeal mucosa; terminology, classification and present concepts of management. van der Waal I. https://pubmed.ncbi.nlm.nih.gov/18674954/ Oral Oncol. 2009;45:317–323. - PubMed
    1. Oral potentially malignant disorders: is malignant transformation predictable and preventable? van der Waal I. Med Oral Patol Oral Cir Bucal. 2014;19:0–90. - PMC - PubMed
    1. Oral epithelial dysplasia: classifications and clinical relevance in risk assessment of oral potentially malignant disorders. Ranganathan K, Kavitha L. J Oral Maxillofac Pathol. 2019;23:19–27. - PMC - PubMed
    1. Oral epithelial dysplasia classification systems: predictive value, utility, weaknesses and scope for improvement. Warnakulasuriya S, Reibel J, Bouquot J, Dabelsteen E. https://pubmed.ncbi.nlm.nih.gov/18251935/ J Oral Pathol Med. 2008;37:127–133. - PubMed
    1. The relevance of uniform reporting in oral leukoplakia: definition, certainty factor and staging based on experience with 275 patients. Brouns ER, Baart JA, Bloemena E, Karagozoglu H, van der Waal I. Med Oral Patol Oral Cir Bucal. 2013;18:0–26. - PMC - PubMed

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