The value of CD163 tumor associated macrophages and tumor budding in oral squamous cell carcinoma

Background Oral squamous cell carcinoma (OSCC) has a disabling poor prognostic outcome representing a common locally aggressive head and neck cancer with high metastatic potential. Investigating prognostic new perspectives in depth taking into consideration the critical role of the tumor microenvironment will have a major impact on the improvement of patient care and outcome. Aim To assess the value of CD163 tumor associated macrophages (TAMs) immunohistochemical expression and tumor budding (TB) in OSCC. Patients and methods A total of 60 cases diagnosed as OSCC (39 biopsies and 21 radical specimens) were assessed for histopathological parameters according to the fifth WHO-Head and Neck tumors and tumor infiltrating lymphocytes (TILs) recorded as(0–10%) as low and TILs (11–100%) as high. TB score (TBS) values as low (0–4 buds), intermediate (5–9 buds) and high (>10 buds). Immunohistochemical staining for CD163 was preformed on all cases and evaluated expression in TAMs as (0) for no positive cells, (1+) score when 1–25% positive TAMs were seen, (2+) score recorded when 26–50% positive TAMs seen and (3+) score when greater than 50% positive TAMs present. Results CD163 expression showed a statistically significant correlation with poor prognostic parameters in all cases as histologic grade ( P =0.009), the worst pattern of invasion (WPOI) ( P =0.001), and Perineural invasion ( P =0.024). Tumor stage and size in radical specimens exhibited a positive significance with CD163-TAMs expression having a P value of less than 0.001 and 0.008, respectively. TBS recorded a significant correlation with tumor grade ( P =0.001), WPOI ( P =0.001), and the mean expression for CD163-expression ( P =0.043). Conclusion CD163 TAMs higher expression is significantly correlated to poor pathological parameters including (tumor size, grade, WPOI, perineural invasion, TB, stage). A higher TBS is significantly correlated to higher tumor grade and WPOI. CD163 + TAMs and TBS are poor prognostic parameters in OSCC. CD163 TAMs expression can represent a potential therapeutic target.