title: The relationship of proliferating cell density at the invasive tumour front with prognostic and risk factors in human oral squamous cell carcinoma.
abstract: BACKGROUND
  We hypothesise that the density of proliferating cells at the invasive tumour front (ITF) has a positive relationship with prognostic and risk factors in human oral squamous cell carcinoma (SCC).
  
  
  METHODS
  Tissues from 47 human oral SCC specimens were collected and stained with a monoclonal antibody directed against the Ki-67 antigen using a horseradish peroxidase based two-step immunostaining method. Counting was performed on two parallel sections at the ITF using an image analyser. The Ki-67 labelling index (LI) was determined by measuring the number of nuclei/mm(2) of epithelium.
  
  
  RESULTS
  Our results show that the density of proliferating cells is related to clinical staging, with advanced stage of disease having a significantly higher Ki-67 LI compared with early stage of disease (2111 +/- 905 vs. 1908 +/- 913; P = 0.03). Importantly, this study shows that tumours that have metastasised have a significantly higher Ki-67 LI than tumours where distant metastasis was not detected (3257 +/- 650 vs. 1966 +/- 881; P < 0.0001).
  
  
  CONCLUSIONS
  Cell proliferation, as measured by the Ki-67 LI at the ITF, has a positive relationship with clinical staging, tumour thickness, smoking status of the patient and alcohol consumption. Further, we suggest that a multicenter study with a large cohort of patients is indicated to fully elucidate whether cell proliferation at the ITF is directly related to patient survival.
authors.affiliation: Department of Obstetrics and Gynaecology, The Queen Elizabeth II Research Institute for Mothers and Infants, College of Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia. vijay@gumdoctors.com.au
authors.forename: Vijay
authors.initials: V
authors.lastname: Tumuluri
authors.forename: Graham A
authors.initials: GA
authors.lastname: Thomas
authors.forename: Ian S
authors.initials: IS
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary; D002452:Cell Count; D002455:Cell Division; D002467:Cell Nucleus / Q000648:ultrastructure; D015331:Cohort Studies; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D009062:Mouth Neoplasms / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D015996:Survival Rate
chemical_list: D019394:Ki-67 Antigen