Assessment of Tumor Cell Morphology and Peri-Tumoral Stromal Changes in Oral Squamous Cell Carcinoma

Background: Oral squamous cell carcinomas are tumors with dissimilar behavioural patterns. Several cellular and extracellular changes take place throughout the process of carcinogenesis, which convey diagnostic and prognostic significance. This is an attempt to recognize significant indicators that convey the impending course of the tumor.Aims: To evaluate the alteration in the morphology of tumor cells and the stromal changes occurring in OSCC. To correlate these features with clinicopathological variables of each case Material and Methods: A total of 47 cases were included in the study. Oral squamous cell carcinomas (n=27), Leukoplakia with dysplasia (n=10), oral submucous fibrosis (n=10) cases were selected. 3 morphometrical parameters were assessed namely nuclear area (NA), cell area (CA) and their ratio (NA/CA). In addition, the birefringence patterns of collagen fibers in the peritumoralstromawere assessedResults: Nuclear area (P=.014) and nuclear to cell area ratio (P<.0001)showed statistically significant increase from dysplasia to increasing grades of OSCC. Collagen fibres showed a higher preponderance of the orange red (OR) birefringence in the well (66.6%) and moderately differentiated (77.7%) OSCC cases.Among the poorly differentiated OSCC cases, green yellow (GY) birefringence predominated.Follow up analysis was done.Conclusion: Substantial nuclear and cellular morphometric alterations occur in tumor cells and in the peritumoralstroma during the advancing grades of oral squamous cell carcinoma. Morphometrical analysis of nuclear area and nuclear to cell area in association with birefringence patterns of stromal collagen fibres,can serve as an adjunct for more efficient prognostication of OSCC.