Gingival squamous cell carcinoma: an epidemiologic, histopathologic, and immunohistochemical study of 419 cases

Abstract

Objectives: This study describes observable trends in the epidemiological, histopathologic, and immunohistochemical characteristics of gingival SCCs.

Study design: A retrospective review was performed of the Texas A&M University's Oral Pathology Biopsy Service database (2010-2020), yielding clinical and histopathologic information on 419 cases of gingival SCC. Fifteen cases were randomly selected for immunohistochemical studies using CK1/10 and CK19 to assess cellular origin.

Results: An increase in incidence of gingival SCC was observed over 10 years (R² = 0.51), although this increase was less significant when adjusted for total biopsy volume (R² = 0.29). The average age of diagnosis was 69.8 years, with the posterior mandibular gingiva being the most frequently affected site. The provisional diagnosis of SCC was given for 61% of cases. Among cases with available risk factor data, 62% reported a prior or current smoking history. Immunohistochemical staining revealed heterogeneous expression patterns with CK1/10 and CK19.

Conclusions: Gingival SCCs demonstrate a diverse clinical and histopathologic appearance and may be omitted in the clinical differential diagnosis in favor of reactive and inflammatory pathology. An increased awareness of the rising incidence of gingival SCCs may promote early clinical recognition and prevent potential delays in diagnosis and treatment.