The prognostic role of clinical, morphological and molecular markers in oral squamous cell tumors -: Minireview

Despite of considerable advances in the diagnostic and therapeutic possibilities, the prognosis of epithelial tumors in the oral cavity is still very poor. A knowledge of the prognostic factors at the begining of treatment is therefore indispensable for determination of the appropriate therapy for the given patient. These factors may be linked to the patient (e.g. age, sex, general condition and immunological parameters) or to the tumor (localization, TNM stage, histoAbbreviations: AgNOR argyrophylic nucleolar organizer regions; AI - apoptotic index; Bcl-2 - protein which regulates the apoptosis; Cyclin-D1 protein which regulates the cell cycle; EGF - epidermal growth factor; EGFR - epidermal growth factor receptor; ErbB-1-a gene coding the EGF; FSH - follicle-stimulating hormon; Ki67 - nuclear antigen; MI - mitotic index; MMP - matrix metalloproteinase; MVD - capillary-density (micro vessel density); NK - natural killer; P53 - nuclear protein; PCNA - proliferating cell nuclear antigen; TGF- - transforming growth factor-; TE - testosteron; VEGF - vascular endothelial growth factor.logical features, DNA content distribution, or immunhistochemical and other parameters). A survey of the literature reveals that the TNM stage, the grade, the mode of invasion and the depth of the tumor infiltration are generally the most important factors influencing the fate of the patient. The prognosis depends primarily on the clinicopathological parameters, though even if they are known, it is not possible to screen out those patients who are at particular risk of a relapse. During the past 10 years, study of the DNA content distribution, the proliferation markers and certain oncogenes has come into the focus of attention; great interest is also shown in the extracellular matrix components and the metalloproteinases, which play key roles in the invasion and metastasis formation.