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Evaluation of myofibroblasts in prognosis of oral squamous cell carcinoma: A systematic review

 Department of Oral Pathology and Microbiology, Vasantdada Patil Dental College and Hospital, Budhgaon, Maharashtra, India

Correspondence Address:
Priya Shirish Joshi,
Department of Oral Pathology and Microbiology, Vasantdada Patil Dental College and Hospital, Kavalapur-Sangli, Budhgaon, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_1074_20

Background: Oral squamous cell carcinoma (OSCC), one of the 10 most prevalent cancers worldwide, has a global annual incidence of approximately 300,000 new cases and 145,000 deaths, with considerable geographical and environmental risk factor differences. Myofibroblasts contribute to the tumor stroma through activation and recruitment of resting fibroblasts to the tumor tissue. Studies have shown that myofibroblasts play a significant role in the progression of oral cancers and they also seem to have some prognostic values in OSCC. Aim: This systematic review aims to recognize the role of myofibroblasts in prognosis/survival of patients with OSCC. Design: This study design was a systematic review. Materials and Methods: Studies assessing the prognostic relevance of myofibroblasts (alpha-smooth muscle actin-positive fibroblasts) in patients with OSCC were systematically reviewed using PubMed, PubMed Central, Google Scholar, and Clinical Key databases. The outcomes assessed were prognosis of OSCC patients in terms of overall survival, disease-free survival, and progression-free survival. Results: Most of the studies assessed myofibroblasts using immunohistochemistry to evaluate its distribution pattern and staining intensity. The presence of high levels of myofibroblasts in the stroma of OSCC patients predicted shortened time to progression of the disease and an overall decrease in survival. Moreover, high presence of myofibroblasts in association with various histopathological prognostic parameters including advanced disease stage (TNM staging), recurrence, tumor grade, depth of invasion, vascular, lymphatic and neural invasion, and extranodal metastatic spread was noted. Conclusion: The distribution pattern and staining intensity of the myofibroblasts predict its role as a prognostic biomarker.

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