Open AccessCharacterization of immune cell infiltrate in tumor stroma and epithelial compartments in oral squamous cell carcinomas of Sudanese patients
Author(s) -
Gaafar Nuha Mohamed,
Osman Tarig AlHadi,
Ahmed Israa Abdulrahman,
Elsheikh Mariam,
Dongre Harsh,
Jacobsen Martha Rolland,
Mohamed Nazar Gafar,
Fromreide Siren,
Suleiman Ahmed Mohamed,
Johannessen Anne Christine,
Nginamau Elisabeth Sivy,
Costea Daniela Elena
Publication year - 2022
Publication title -
clinical and experimental dental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.464
H-Index - 9
ISSN - 2057-4347
DOI - 10.1002/cre2.501
Subject(s) - foxp3 , stromal cell , immune system , stroma , pathology , immunohistochemistry , tumor microenvironment , infiltration (hvac) , medicine , intraepithelial lymphocyte , lymph node , cancer research , epithelium , immunology , physics , thermodynamics
Background Tumor immune infiltrate has been explored in oral squamous cell carcinoma (OSCC), but studies on simultaneous characterization of multiple immune cell subtypes separately in stromal and intraepithelial tumor compartments are limited. Objectives We aimed to investigate the immune cell infiltrate in OSCC by using immunohistochemistry (IHC) for a panel of inflammatory cells in stromal and epithelial tumor compartments for a better characterization of the tumors. Methods Thirty‐six OSCC lesions and nine normal oral mucosa (NOM) samples from patients attending Khartoum Dental Teaching Hospital, Sudan were investigated for presence of tumor infiltrating lymphocytes, tumor‐associated macrophages, tumor‐associated neutrophils, and PD‐L1 positive cells in the inflammatory infiltrate by single and double IHC. Digital quantitative analysis (Aperio Technologies Inc.) was performed separately for stromal and epithelial compartments. Results OSCC cases displayed a higher inflammatory infiltrate in the associated stroma, but not in the epithelial compartment when compared to NOM. The immunosuppressive type of inflammatory infiltrate, that is, T regulatory cells (FoxP3 + cells) was identified to be significantly higher in the epithelial compartment of tumors with advanced clinical state. An immunoscore developed by combining intraepithelial FoxP3 + and CD4 + cells was found significantly higher in lesions from elderly patients, localized at toombak dipping‐related sites, poorly differentiated OSCCs, or with loco‐regional lymph node spreading. Conclusions Despite heavy immune cell infiltration in tumor‐associated stroma, the majority of OSCCs in this cohort displayed a low intraepithelial immune infiltration. An immunoscore based on combined CD4 and FoxP3 intraepithelial expression may serve as an indicator of advanced tumor progression and should be further investigated for its use as potential prognostic biomarker in OSCC.