A study on histological grading systems of oral squamous cell carcinoma and comparison of their efficacy in determining the nature (clinical and histopathological) and prognosis of oral squamous cell carcinoma

Purpose: Tumour-Node-Metastasis (TNM) staging has been widely used for treatment planning and prognostication of oral cancers; however, TNM staging system alone is insufficient for optimal prognostication. A combined assessment of clinical staging and cytomorphology might serve as a more specific measure for prognostication. The present study attempted to compare the efficacy of histologic grading systems (Jakobbson et al., Anneroth et al. and Bryne et al.) of malignancy in determining the nature and prognosis of oral squamous cell carcinoma (OSCC). Tumour protein (TP53) immunohistochemical marker was used to determine the aggressiveness of OSCC. Materials and Methods: Tissue sections from 24 biopsy-proven cases of OSCC were stained with anti-TP53 antibody. Hundred cells in each case were counted and tabulated. Cases were graded using three histopathological grading systems. Findings were compared and correlated with TP53 immunopositivity and clinical parameters. Results: Positive correlation was observed between TP53 immunostaining and grading scores of each system. Highest correlation was observed with Jakobbson et al. grading system (r2 value = 0.91, P < 0.001). Significant results were observed on comparing grades of Jakobsson et al., Anneroth et al. and Bryne et al. grading system with segregated groups of TP53 immunopositive cases (P = 0.004, P = 0.003, P = 0.001, respectively). No significant results were observed on comparing grades of histopathological systems with clinical parameters. Conclusion: Both, clinical and histopathological grading systems, with immunohistochemistry, should be taken into account during the assessment of OSCC, for treatment planning and better prediction of tumour prognosis.