Role Of Glut - 1 In Oral Squamous Cell Carcinoma With Histopathological Correlation

Abstract

Background: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity and is associated with significant morbidity and mortality. Despite advances in treatment, prognosis remains poor due to late diagnosis and aggressive tumor behavior. Altered glucose metabolism is a hallmark of cancer, and Glucose Transporter-1 (GLUT-1) plays a crucial role in facilitating increased glucose uptake in malignant cells.

OBJECTIVES: To assess the histopathological features of oral squamous cell carcinoma and to evaluate the immunohistochemical expression of GLUT-1 in OSCC compared with non-neoplastic oral epithelium. Additionally, the study aimed to correlate GLUT-1 expression with clinicopathological prognostic parameters including tumor size, histological grade, TNM stage, lymphovascular invasion, and perineural invasion.

Materials and methods: This prospective comparative study was conducted on 32 surgically resected OSCC specimens and 32 non-neoplastic oral squamous epithelium specimens received for routine histopathological examination. All tissues were processed and stained with hematoxylin and eosin for histopathological evaluation. Tumors were graded and staged according to the AJCC (8th edition, 2017) staging system. Immunohistochemical staining for GLUT-1 was performed on paraffin-embedded sections. GLUT-1 expression was assessed based on membranous staining, percentage of positive cells, and staining intensity. Statistical analysis was performed using SPSS version 22, with a p value <0.05 considered statistically significant.

RESULTS: All OSCC cases (100%) showed membranous GLUT-1 positivity. Strong GLUT-1 expression (3+) was observed in 62.5% of OSCC cases, while moderate expression was seen in 31.3% and low expression in 6.3%. None of the non-neoplastic cases showed strong GLUT-1 expression. Increased GLUT-1 expression was predominantly observed in tumors with advanced TNM stage (Stage III and IV), larger tumor size, and in cases with lymphovascular and perineural invasion. A highly significant difference in GLUT-1 expression was noted between OSCC and non-neoplastic tissues (p < 0.001).

Conclusion: GLUT-1 expression was significantly increased in OSCC compared to non-neoplastic oral epithelium and showed a strong association with adverse histopathological prognostic factors. GLUT-1 may serve as a useful prognostic biomarker for identifying aggressive OSCC and high-risk patients.