A Stereological Study On Oral Verrucous Carcinoma

Objective:To prove the truth of the three clinic typs of OVC and the difference between OVC and OSCC further according to the ultrastructural features.Methods:Each 5 cases of normal oral mucosa(NM),the exogenic type of oral verrucous carcinoma,the infiltrative type of oral verrucous carcinoma,the cystoid type of oral verrucous carcinoma,the wdOSCC and the m/pdOSCC was investigated by stereologic method to analysis the nucleus,nuclear-cytoplasmic ratio,desmosome,desmosome in cytoplasm and mitochondria.Results:1 Morphological results:(1) Verrucous carcinoma exogenous type groups:epithelial cell differentiates well,the gap between cells widened slightly more than the normal mucosa group,cell borders clearly,no obvious membrane pseudopodia,cell shape is regular,Keratocyst beads can be seen between epithelial cells;nucleus is large and the shape is normal,nucleolar can be seen,chromatin becomes less,the proportion of cytoplasm is less than the normal group,more desmosomes,but in cytoplasm there is almost no demosomes,less mitochondria.(2) Verrucous carcinoma cyst-type groups:poorly differentiated epithelial cells,the heteromorphism is clear,cells were elongated like the spindle,the cell gap is wider than the external type,the cell boundaries are clear,less desmosomes between cells,pseudopodium can be seen on the membrane;nucleus is large and irregularly shaped with notches showing lobulated,small proportion of cytoplasm,vacuolation exists and more desmosomes in cytoplasm,less mitochondria and endoplasmic reticulum.(3) Verrucous Carcinoma Infiltrating groups:poorly differentiated epithelial cells,special-type is clear,the gap between cells is wider than exogenous type,cell boundaries clearly,less desmosome,more pseudopodium on the membrane,tension fibers probe into the silk-like pseudopodium along the membrane and connect with desmosomes; nucleus is large and irregularly shaped with notches,the nucleus has depression,was lobulated,obvious nucleolus and rich chromatin, especially near the nuclear membrane.Smaller proportion of cytoplasm, cytoplasmic vacuolation,and some cells only have the bare nucleus;more desmosomes and less mitochondria and endoplasmic reticulum in cytoplasm.2 The results of statistics(1):Among the three types of OVC,the bulk density of nucleus in the eOVC is lower than that in the iOVC(P＜0.05).The nuclear-cytoplasmic ratio and the numerical density of desmosome in cytoplasm in the iOVC and cOVC is higher than those in the eOVC(P＜0.05);The numerical density of desmosome in the iOVC and cOVC is lower than those in the eOVC(P＜0.05);There is no significant difference between iOVC and cOVC on the bulk density of nucleus,the nuclear-cytoplasmic ratio,the numerical density of desmosome in cytoplasm and desmosome.There are also no significant differences on the the numerical density of mitochondria among the three groups.(2) The bulk density of nucleus,the nuclear-cytoplasmic ratio and the numerical density of desmosome in cytoplasm in the NM group are lower than those in the eOVC,iOVC,cOVC,wdOSCC and m-pdOSCC group(P＜0.05).The numerical density of desmosome and mitochondria in the NM group are higher than those in the other five groups(P＜0.05). The bulk density of nucleus,the nuclear-cytoplasmic ratio and the numerical density of desmosome in cytoplasm in the iOVC and cOVC are higher than those in the wdOSCC.The numerical density of desmosome in the iOVC and cOVC is lower than that in the wdOSCC(P＜0.05).There is no significant difference between eOVC and wdOSCC on the five morphological parameters.There is no significant difference on the numerical density of mitochondria among the iOVC, cOVC,wdOSCC and m/pdOSCC.Conclusions:1,The three clinical types of oral verrucous carcinoma have their own morphological ultrastructural features2,We find that the bulk density of nucleus,the nuclear-cytoplasmic ratio and the numerical density of desmosome in cytoplasm in the eOVC are smaller than those of the iOVC and cOVC obviously and the numerical density of desmosome in the eOVC is more than that of the iOVC and cOVC.3,The differentiation the cOVC and iOVC is between the wdOSCC and the m/pdOSCC.4,The cOVC and iOVC may have a worse differentiation than that of the m/pdOSCC according to the numerical density of desmosome in cytoplasm.