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Article Abstract
Background: Head and Neck Squamous Cell Carcinoma (HNSCC) is an aggressive cancer and a leading cause of malignancy in India and the Asian subcontinent. Conventionally, histopathologic grading of tumor has focused primarily on tumor characteristics. However, the tumor microenvironment (TME) also plays a crucial role in the invasion and metastasis of many cancers, including Head and Neck Squamous Cell Carcinoma.
Materials And Methods: A total of 40 resected specimens of HNSCC were included in an observational cross-sectional study at a tertiary care center. Fibrotic cancer stroma was categorized into mature, intermediate, and immature and compared with various histopathological parameters. Statistical analysis was performed by the Kruskal-Walli's test, ANOVA, and Fisher's exact test using SPSS version 25.
Results: There were 40 cases of HNSCC, with buccal mucosa being the most common site. Fibrotic cancer stroma was categorized into mature (22.5%), intermediate (37.5%), and immature (40%) stroma. Maximum tumor size was most commonly associated with immature stroma (P < 0.05). Higher primary tumor stage (T3 and T4) and advanced N stage were also significantly associated with immature stroma (P value < 0.05). Mature stroma was more commonly seen in cases with well-differentiated tumor (88.89%). Intermediate stroma was equally distributed in well-differentiated and moderately differentiated squamous cell carcinoma (46.47% in each grade), and poorly differentiated histological grade was seen with immature stroma (18.75%). However, no significant association was found between histological grade and stroma type. Median tumor thickness and mean depth of invasion were highest in immature stroma, both showing a significant association with stroma type (P < 0.05).
Conclusion: Fibrotic cancer stroma proves to be a valuable predictor of tumor behavior and lymph node metastasis in individuals diagnosed with HNSCC.
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