A Preliminary Study of the Role of Endothelial-Mesenchymal Transitory Factor SOX 2 and CD147 in the Microvascularization of Oral Squamous Cell Carcinoma

Vasileios Zisis; Pinelopi A Anastasiadou; Athanasios Poulopoulos; Konstantinos Vahtsevanos; Konstantinos Paraskevopoulos; Dimitrios Andreadis

doi:10.7759/cureus.52265

A Preliminary Study of the Role of Endothelial-Mesenchymal Transitory Factor SOX 2 and CD147 in the Microvascularization of Oral Squamous Cell Carcinoma

Cureus. 2024 Jan 14;16(1):e52265. doi: 10.7759/cureus.52265. eCollection 2024 Jan.

Authors

Vasileios Zisis¹, Pinelopi A Anastasiadou¹, Athanasios Poulopoulos¹, Konstantinos Vahtsevanos², Konstantinos Paraskevopoulos², Dimitrios Andreadis¹

Affiliations

¹ Oral Medicine and Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC.
² Oral and Maxillofacial Surgery, Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.

Abstract

Introduction: The aim of this study was to detect the possible endothelial expression of embryonic-type cancer stem cells (CSC) marker SOX2 and the stemness-type CSC marker CD147 in oral potential malignant disorders (OPMDs), oral leukoplakia (OL) in particular, and oral squamous cell carcinoma (OSCC).

Methods: This study focuses on the immunohistochemical pattern of expression of CSC protein-biomarkers SOX2 and CD147 in paraffin-embedded samples of 21 OSCCs of different grades of differentiation and 30 cases of OLs with different grades of dysplasia, compared to normal oral mucosa.

Results: The protein biomarker SOX2 was expressed in the endothelial cells, but without establishing any statistically significant correlation among OSCC, OL, and normal tissue specimens. However, SOX endothelial staining was noticed in 7/30 (23.3%) cases of OL (one non-dysplastic, one mildly dysplastic, one moderately dysplastic, and four severely dysplastic cases) and 5/21 (23.8%) cases of OSCC (two well-differentiated, one moderately differentiated, and two poorly differentiated cases). Although CD147 is expressed in normal oral epithelium, OL, and OSCC neoplastic cells, its vascular-endothelial expression was noticed in only 2/5 (40%) cases of normal oral epithelium, 1/30 (3.3%) cases of OL (one severely dysplastic case), and 4/21 (19%) cases of OSCC (two well-differentiated, one moderately differentiated, and one poorly differentiated case). Therefore, no statistically significant correlation among OSCC, OL, and normal tissue specimens was established.

Conclusion: The endothelial presence of SOX2 both in oral potentially malignant and malignant lesions suggests that SOX2 may be implicated in the microvascularization process and associated with the degree of dysplasia in OL. The expression of CD147 may be attributed both to local inflammation and tumorigenesis. The implementation of CD147 in larger groups of tissue samples will shed some light on its role in cancer and inflammation. The evidence so far supports the need for more studies, which may support the clinical significance of these novel cancer stem cell biomarkers.

Keywords: cancer stem cells; cd147; immunohistochemistry staining; oral cancers; oral leukoplakia; sox 2.