University of Oulu

Almangush, A., Mäkitie, A.A., Hagström, J. et al. Cell-in-cell phenomenon associates with aggressive characteristics and cancer-related mortality in early oral tongue cancer. BMC Cancer 20, 843 (2020). https://doi.org/10.1186/s12885-020-07342-x

Cell-in-cell phenomenon associates with aggressive characteristics and cancer-related mortality in early oral tongue cancer

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Author: Almangush, Alhadi1,2,3,4,5; Mäkitie, Antti A.2,6,7; Hagström, Jaana1,8,9;
Organizations: 1Department of Pathology, University of Helsinki, Haartmaninkatu 3 (P.O. Box 21), FIN-00014, Helsinki, Finland
2Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
3Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
4Institute of Biomedicine, Pathology, University of Turku, Turku, Finland
5Faculty of Dentistry, University of Misurata, Misurata, Libya
6Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
7Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
8Department of Oral Pathology and Radiology, University of Turku, Turku, Finland
9Research Programs Unit, Translational Cancer Medicine, University of Helsinki, Helsinki, Finland
10Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
11Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
12Department of Head and Neck Surgery, University of Sao Paulo Medical School, São Paulo, SP, Brazil
13Medical Informatics and Data Analysis Research Group, University of Oulu, Oulu, Finland
14Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
15Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe20201214100636
Language: English
Published: Springer Nature, 2020
Publish Date: 2020-12-14
Description:

Abstract

Background: Cell-in-cell structures (caused by cell cannibalistic activity) have been related to prognosis of many cancers. This is the first multi-institutional study to assess the prognostic impact of cell-in-cell structures in a large cohort of early oral tongue squamous cell carcinomas (OTSCC).

Methods: A total of 308 cases from five Finnish University Hospitals and from the A.C. Camargo Cancer Center, São Paulo, Brazil, were included in this study. Cell-in-cell structures were evaluated on surgical postoperative sections that stained with hematoxylin and eosin staining.

Results: We found that cell-in-cell structures associated with cancer-related mortality in univariable analysis with a hazard ratio (HR) of 2.99 (95%CI 1.52–5.88; P = 0.001). This association was confirmed in multivariable analysis (HR 2.22, 95%CI 1.12–4.44; P = 0.024). In addition, statistically significant associations were observed between the cell-in-cell structures and other adverse histopathologic characteristics including deep invasion (P <  0.001), high index of tumor budding (P = 0.007), worst pattern of invasion (P <  0.001), perineural invasion (P = 0.01), and stroma-rich pattern (P = 0.001).

Conclusions: Our findings demonstrate a significant relationship between cell-in-cell formation and aggressive characteristics of early OTSCC. Cell-in-cell structures have a distinct impact as a novel prognostic indicator in early OTSCC and they can be easily assessed during routine pathology practice.

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Series: BMC cancer
ISSN: 1471-2407
ISSN-E: 1471-2407
ISSN-L: 1471-2407
Volume: 20
Issue: 1
Article number: 843
DOI: 10.1186/s12885-020-07342-x
OADOI: https://oadoi.org/10.1186/s12885-020-07342-x
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Subjects:
Funding: This study was funded by Turku University Hospital Fund, Helsinki University Hospital Research Fund, the Finnish Dental Society (Apollonia), the Finnish Cancer Society, Finska Läkaresällskapet, and the Maritza and Reino Salonen Foundation. The funders took no part in the design or performance of the study. Funding consists of academic grants without any engagements considering the research project.
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