IDENTIFICATION AND STUDY OF PROGNOSTIC BIOMARKERS IN A COHORT OF EARLY-STAGE ORAL SQUAMOUS CELL CARCINOMA PATIENTS FROM ARMENIA

Background Oral squamous cell carcinoma (OSCC) is the sixth leading malignancy worldwide. The incidence of OSCC has increased in recent years. Tumor-associated macrophages have been shown to promote tumor progression by influencing tumor invasion, migration, and angiogenesis. So far, no study investigating different biomarkers in cohorts of patients with OSCC from Armenia has been published. Objective The aim of this study was to evaluate the role of tumor-associated macrophages in the prognosis of OSCC and investigate the association between the expression of Ki67 and p53 biomarkers and its relation with clinicopathologic parameters (tumor stage and grade) in a cohort of patients with OSCC from Armenia. Methods Available samples from patients diagnosed with OSCC in 2017/2018 were collected from Armenian hospitals after ethics approval (n = 13). Immunohistochemistry was performed using Visualization System and EnVision Double stain System (DAKO) for Ki67, p53, and CD163/CD68 biomarkers. Stained tissues were scanned and quantified using Image Scope software (Aperio Technologies Inc.) and QuPath v0.2.0-m9 (OSS for DPI analysis). Data were analyzed using SPSS 25.0. Results Intense nuclear expression of p53 was identified in 69.2% cases but not strongly correlated with a high proliferation index (>50% Ki67 positive cells; P = .125) and M2 type macrophages expression (P = .308). In contrast, M2 type macrophages count was correlated with tumor stage (P = .026). Conclusions This preliminary study identified a positive correlation between increased expression of M2 type macrophages and OSCC stage. This should be further investigated in a larger cohort of patients.