The importance of tumor markers in oral pathology. II. Cell membrane and cytoplasmic antigens as tumour markers

The secretor status of blood group antigens in the saliva in people with oral cancers: a systematic review

BACKGROUND

Human ABO blood group type and the antigenic secretor status are hypothesized to associate with oral diseases including oral cancer. Secretor status is the ability of individuals to secrete blood group antigens into body fluids. This study aimed to evaluate the secretor status of ABO antigens of saliva in patients with oral cancers or oral potentially malignant disorders (OPMDs) relative to healthy adults.

METHODS

A systematic and comprehensive online search from inception to April 28, 2022, was carried out in MEDLINE, Embase, PsycInfo, and Emcare. The language was limited to English. Yielded records were screened by two independent reviewers at the title and abstract phase and at full-text screening. Studies investigating adults (≥ 18 years) with oral cancers or oral potentially malignant disorders compared to adults free of oral cancer were included in this study. Data were extracted according to the planned objectives. Methodological quality was assessed, and the findings were analyzed narratively. Meta-analyses were conducted to pool the odds of the non-secretor status of oral cancers and OPMDs compared to healthy adults.

RESULTS

The search included a total of 34 studies from three databases. Nine duplicates were removed. During the title and abstract screening, 11 irrelevant studies were excluded. Twelve studies were screened during the full-text screening, and eight articles were eligible to be included in the final analysis. A pooled odds ratio (OR) of 3.80 (95%CI, 1.53-9.44) was estimated when pooled 1254 oral cancers and oral potentially malignant disorders patients compared to 666 healthy adults.

DISCUSSION AND CONCLUSION

The odds of being a non-secretor appear to be approximately 3.8 times higher in patients with oral cancers and oral potentially malignant disorders compared to healthy adults. The lack of ABO blood group antigens in body fluids of non-secretors is more exposed to exogenous antigens than secretors. The host-parasite interactions of secretors and non-secretors underlying oral cancer and other diseases may be evidence to support or refuse them. Clinicians may use the secretor status as a detection test during their regular oral check-ups for high-risk populations for oral cancers. Non-secretors can be given more attention considering them as high-risk groups, and in terms of prognosis, differences between these two groups may be expected.

Reactivity of monoclonal antibodies 17.13 and 63.12 with oral epithelial dysplasia and hyperkeratosis

Monoclonal antibodies (MAbs) 17.13 and 63.12 exhibit characteristic reactivity patterns in normal stratified squamous epithelium, as well as highly sensitive and specific altered reactivity patterns in squamous cell carcinoma. The purpose of this study was to critically evaluate the patterns of reactivity of MAbs 17.13 and 63.12 in 43 biopsies of clinical oral leukoplakia or erythroleukoplakia with microscopic diagnoses of hyperkeratosis or epithelial dysplasia. Altered carcinoma-like reactivity patterns were seen in 72% of hyperkeratoses and in all cases of epithelial dysplasia, but varied in the level of epithelial strata exhibiting altered reactivity. Increased frequency of altered reactivity within the epithelial strata was associated with the presence, but not the grade of, epithelial dysplasia, as well as with the presence, intensity; and pattern of submucosal inflammation. The results of this study suggest that altered reactivity patterns of MAb 17.13 are associated with epithelial dysplasia and may be of assistance in detecting precancerous changes in hyperkeratoses before morphologically identifiable epithelial dysplasia. The association of submucosal inflammation with altered MAbs 17.13 and 63.12 reactivity may indicate either a decrease in specificity of these antibodies for precancerous change or an increased significance of inflammation in precancerous lesions.

Immunohistochemical localization of metal binding proteins in thyroid tissues and tumors

Positive immunohistochemical staining for three metal binding proteins, ceruloplasmin, lactoferrin, and transferrin, has been suggested to be a reliable diagnostic marker of malignant but not benign thyroid neoplasms. We tested this hypothesis on a series of 9 nodular hyperplasias, 17 follicular adenomas, 54 papillary carcinomas, 20 follicular carcinomas, and 3 anaplastic carcinomas of thyroid using formalin-fixed paraffin-embedded tissues. We found focal staining for ceruloplasmin and lactoferrin in approximately 25% of follicular adenomas examined; focal ceruloplasmin positivity was also seen in nonneoplastic tissues surrounding thyroid neoplasms. No staining for these markers was found in malignant neoplasms or hyperplasias. Transferrin was found in 55% of papillary carcinomas, but more follicular adenomas (20%) than follicular carcinomas (11%) were positive using this antiserum. These findings show that immunostaining for these antigens is not a reliable method to distinguish benign from malignant thyroid lesions of follicular cell origin.

Reactivity of monoclonal antibodies 17.13 and 63.12 with 141 oral mucosal lesions

We studied the reactivity of monoclonal antibodies (MAbs) 17.13 and 63.12 with normal and diseased human oral mucosa by means of the immunoperoxidase technique. The specimens included: 22 normal oral tissues, 20 benign tumors, 17 lichen planus, 23 focal keratosis and epithelial hyperplasias, 18 proliferative verrucous leukoplakias, 20 dysplasias, and 21 squamous cell carcinomas. In most cases of normal mucosa and benign lesions, MAb 17.13 stained basal epithelial cells only, whereas MAb 63.12 stained all cell layers above the basal cells. In the premalignant and malignant lesions MAb 17.13 stained above the basal cells and MAb 63.12 either stained areas not stained by MAb 17.13 or the staining was absent. Based on the different staining patterns observed, there appears to be a potential value of these new reagents in diagnostic histopathology regarding specimens with equivocal cellular morphology.

Distribution of tissue markers in acinic cell carcinomas of salivary gland

Eight cases of acinic cell carcinoma of the salivary glands were histologically reclassified and their immunohistochemical expression and distribution for various tissue antigens were examined. The epithelial elements were divided into tubuloglandular components, microcystic patterns and solid nests. The authors' results indicated the following: 1) The duct luminal cells of tubuloglandular components have distinct epithelial features with cytokeratin (KL 1), alpha 1-antichymotrypsin (alpha 1-ACT), transferrin, lactoferrin, IgA, and carcinoembryonic antigen (CEA) positivity. 2) The cyst-lining cells of microcystic pattern expressed immunophenotypes similar to those of the duct luminal cells. 3) The acinic cells in solid nests had positive results for KL 1, alpha 1-antitrypsin (alpha 1-AT), transferrin, lactoferrin and vasoactive intestinal polypeptide (VIP). 4) The clear cells in solid areas had positive results for KL 1, alpha 1-AT, transferrin and VIP. Both the clear cells and the neoplastic acinic cells showed a rather similar pattern of immunoreactivity. Therefore, the clear cells may transform from the neoplastic acinic cells. 5) Secretory products in tubuloglandular and microcystic patterns had positive results for alpha 1-ACT, lactoferrin, IgA and CEA. 6) The basement membrane-like material between the neoplastic islands has distinct positivity for alpha 1-AT. The result suggests that alpha 1-AT is a useful marker of basement membrane-like material.

Immunoprofile of mucoepidermoid carcinomas of minor salivary glands

Because the data on the antigenic phenotype of mucoepidermoid carcinoma (MEC) are incomplete and somewhat disparate, 45 MECs were evaluated immunohistochemically for low- and high-molecular-weight keratins, vimentin, glial fibrillary acidic protein, smooth muscle actin, and S-100 protein. Tumors stained uniformly for keratins and, on occasion, focally for vimentin. Tumors were nonreactive with antibodies to glial fibrillary acidic protein and, with few exceptions, to muscle-specific actins and S-100 protein. Clear cell and papillary histologic variants were seen as potential diagnostic pitfalls. If used with hematoxylin-and-eosin-stained sections, limited potential is seen for this antibody panel in surgical pathology. Myoepithelial cell-associated antigens are expressed to a very limited extent in MECs.

Localization of salivary amylase and epithelial membrane antigen in salivary gland tumours by means of immunoperoxidase and immunogold-silver techniques

A series of 87 salivary glands was examined using an immunogold-silver technique for salivary gland amylase (SGA) and epithelial membrane antigen (EMA) and an indirect immunoperoxidase technique for both antigens. The specimens comprised 21 pleomorphic adenomas, 3 monomorphic adenomas, 25 adenolymphomas, 5 mucoepidermoid carcinomas, 3 acinic cell tumours, 8 adenoid cystic carcinomas, 2 adenocarcinomas and 8 undifferentiated carcinomas. In addition 5 normal salivary glands and 6 salivary glands showing benign lymphoepithelial lesions were included.

Immunohistochemical demonstration of steroid C-21 hydroxylase in normal and neoplastic salivary glands

The presence of steroid C-21 hydroxylase in normal and neoplastic salivary glands was investigated immunohistochemically with the use of antibody against cytochrome P-450 specific for steroid 21-hydroxylation (P-450C21). In normal salivary glands, P-450C21 was exclusively present in the excretory duct system (intercalating, striated and large excretory ducts), and not observed in acini. In salivary gland tumors, P-450C21 was observed in most epithelial cells of duct origin within pleomorphic adenomas including cells of amorphous groups scattered in myxoid areas, and in adenolymphoma. Some mucous cells in mucoepidermoid tumor also were positive for this enzyme. These findings in the normal and neoplastic salivary gland suggest that the expression of P-450C21 is closely related to ductal differentiation.

Immunohistochemical demonstration of ceruloplasmin in follicular adenomas and thyroid carcinomas

The presence of ceruloplasmin in follicular adenomas (15 cases) and thyroid carcinomas (39) and two Hürthle cell tumours was investigated by immunohistochemical methods. Follicular adenomas were all negative whereas Hürthle cell tumours, follicular and papillary carcinomas exhibited various degrees of cytoplasmic positivity for ceruloplasmin. Highly atypical multinucleated cells and incorporated follicular structures observed in anaplastic carcinomas were positively stained; the spindle cell variety of these cancers was always negative for ceruloplasmin. Medullary carcinomas and normal thyroid tissue were constantly unstained. The distribution pattern of ceruloplasmin is the same as that of lactoferrin, a marker recently proposed for the differential diagnosis between follicular adenomas and thyroid carcinomas; these two glycoproteins are structurally related.

Cytokeratin expression in normal salivary glands and in cystadenolymphomas demonstrated by monoclonal antibodies against selective cytokeratin polypeptides

The distribution of selective cytokeratin polypeptides, vimentin, and glial fibrillary protein (GFP) in 5 human cystadenolymphomas of the parotid gland was compared with normal human parotid (n = 5) and submandibular (n = 4) glands using a panel of monoclonal antibodies against diverse and selective cytokeratin polypeptides, vimentin and glial fibrillary protein (GFP). A biotinstreptavidin method was used on cryostat sections. The immunocytochemical finding of identical cytokeratin polypeptides Nos. 7, 8, 18 and 19 and basal cells selectively labeled by the monoclonal antibody KS 8.58, in both the epithelial part of the cystadenolymphomas and in the duct epithelium of the parotid gland, confirms the hypothesis that the epithelial compartment of cystadenolymphomas is derived from the duct system. The triple expression of cytokeratin, vimentin and GFP in myoepithelial cells of the parotid gland is discussed.