Clinical Case Reports

Biography

Biography: Umanath Nayak

Abstract

Oral squamous cell carcinoma represents a major health problem in India. Two common sites for oral cancers are the gingivo-buccal complex and oral tongue. Gingivo-buccal cancer has been clinically and epidemiologically proved to be related to the wide-spread habit of tobacco chewing prevalent in the country. Though squamous cell carcinoma of the tongue (SCCT) is also believed to be associated with tobacco use similar to other HNSCC subtypes, an increased incidence in the young and in individuals with no history of smoking/tobacco chewing and alcohol consumption gives rise to the speculation that genetic factors may have a role to play in their causation. In addition, young patients with SCCT have frequent loco-regional recurrence and the disease appears to be more aggressive with respect to its clinical and biological behavior and is known to exhibit skip metastasis. Despite advances in therapy, the SCCT five year survival rate has not improved in the last few decades. All these factors make SCCT a unique HNSCC subtype and yet molecular genetic studies designed specifically for SCCT have been rare; most studies have been restricted to a single prognostic marker and/or a small cohort of patients. We have conducted comprehensive molecular genetic and clinico-pathological analyses for one hundred and twenty one SCCT samples; results revealed significant association of p53 stabilization with age of onset, FHIT loss and poor survival. Younger age (≤45 years) and FHIT loss were significantly associated with p53 nuclear stabilization especially in patients with no history of tobacco use. More importantly, samples harboring mutation in p53 DNA binding domain or exhibiting p53 nuclear stabilization, were significantly associated with poor survival. Our study has therefore identified distinct features in SCCT tumorigenesis with respect to age and tobacco exposure and revealed possible prognostic utility of p53