Association of Syndecan-1 immunoexpression with epithelial dysplasia in oral verrucous carcinoma

Background: Oral verrucous carcinoma (OVC) is an uncommon variant of well-differentiated squamous cell carcinoma with an excellent prognosis. Epithelial dysplasia in OVC is a sign of a poorer prognosis. Syndecan-1 immunoexpression is absent in squamous epithelial dysplasia and squamous cell carcinoma. This study aimed to investigate the association between Syndecan-1 immunoexpression and epithelial dysplasia in oral verrucous carcinoma. Methods: A cross-sectional study was done at the Department of Pathology, Bangabandhu Sheikh Mujib Medical University, from 2021 to 2023 and included 45 cases of histologically diagnosed OVC. Histopathological variables were assessed and Syndecan-1 immunoexpression was determined. Fisher’s exact test was done to examine the relationship between the loss of Syndecan-1 and OVC dysplasia. Results: Out of 45, histologically diagnosed OVC subjects, 66.7% showed no features of epithelial dysplasia, and 33.3% of cases revealed the presence of epithelial dysplasia in routine hematoxylin and eosin stains. The cases which revealed no epithelial dysplasia showed positive expression of Syndecan-1. Among the cases that revealed epithelial dysplasia, 26.7% showed loss of Syndecan-1 expression in the dysplastic area, and 6.7% showed positive expression of Syndecan-1. The loss of Syndecan-1 expression was significantly (P<0.01) associated with epithelial dysplasia in OVC. Conclusion: Syndecan-1 immunostain and routine hematoxylin and eosin stain can help detect epithelial dysplasia in oral verrucous carcinoma. Therefore, early detection of epithelial dysplasia in OVC will help the clinician properly manage the patient.