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Podoplanin & its role in diagnosis of cancer invasion

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    Podoplanin & its role in diagnosis of cancer invasion Podoplanin & its role in diagnosis of cancer invasion Presentation Transcript

    • PODOPLANIN IN TUMOR INVASION – A PROMISING NEW APPROACH DR RATNADEEP GANGULY MD, DNB, MIAC, MNAMS Consultant Surgical Pathologist DR TIBAR BANNERJEE MS, MCh Consultant Plastic Surgeon THE MISSION HOSPITAL Durgapur, INDIA
    • PATIENT #1 42y/male, papillomatous growth, right side of cheek Leukoplakia, left side
    •  
    • DIAGNOSIS Papillomatous growth Microinvasive squamous cell carcinoma, max depth of invasion 2mm from BM Leukoplakia Squamous hyperplasia, keratosis without dysplasia, no invasive ca
    • PATIENT #2 38y/male, ulceroproliferative growth in oral cavity
    •  
    • DIAGNOSIS Ulceroproliferative growth – Squamous cell carcinoma, appearing moderately differentiated in this biopsy
    • DIAGNOSTIC PITFALLS WITH ONLY HISTOMORPHOLOGICAL EXAMINATION
      • Well oriented sections as opposed tangential sections
      • Inflammation, edema & fibrosis around invasive nests
      • Certain parameters subjective
      • Detached nests of benign mucosa
      • Dysplastic mucosa in head/neck may be a little thickened appearing like a mass
      • Squamous mucosa forming in salivary acini
    • PATTERNS OF TISSUE INVASION
      • SINGLE CELL INVASION
      • Mimics early developmental process (epithelial-mesenchymal transition)
      • Loss of E-cadherin expression
      • COLLECTIVE CELL MIGRATION
      • Less well understood
      • Podoplanin expression
      • Upregulated at the edges of large tumor masses eg. SCC of lip, oral cavity, ovarian granulosa cell tumor, mesothelioma
    • SINGLE CELL INVASION LOSS OF E-cadherin(BROWN) NO PODOPLANIN COLLECTIVE CELL MIGR N NO LOSS OF E-cadherin PODOPLANIN(RED) AT ADVANCING EDGE
    • WHAT IS PODOPLANIN ?
      • Protein expressed in most human tissues
      • Upregulated in tumor edges
      • Bypasses epithelial-mesenchymal transformation in carcinogenesis
      • Promotes tumor cell spreading, migration & invasion
    • WHAT IS PODOPLANIN ? – contd.
      • SCC, CNS tumors & germinal neoplasms are +ve
      • Collective cell migration - +ve
      • Invasion of single cells / small cell groups (Adenocarcinomas) - –ve
      • Good adjunct in detection of equivocal invasion / microinvasion in SCC of skin, lip, oral cavity
    • OTHER MEANS TO DETECT TUMOR INVASION
      • DEMONSTRATION OF BASEMENT MEMBRANE / BASAL CELL LAYER BY:
      • Cytochemistry:
      • Methenamine silver stain (black reticulin fibers)
      • PAS reaction (magenta)
      • Immunohistochemistry:
      • Collagen type IV & VII
      • Laminin
      • High mol wt cytokeratin (HMWCK - 34E  12) – Basal layer
      Basement membrane Basement membrane
    • COLLAGEN TYPE IV IN BLOOD VESSEL - IMMUNOHISTOCHEMISTRY
    • THANK YOU