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<p>Oral squamous cell carcinoma (OSCC) exhibits significant clinical heterogeneity and unpredictable prognosis despite established grading and staging systems. Osteoclastic-like giant cells (OLGCs), rarely observed within tumor epithelial islands, remain poorly characterized in OSCC. This study explores their clinicopathological significance using a novel metric—Giant Cell Index (GCI). To assess the occurrence, intraepithelial localization, and prognostic relevance of OLGCs in OSCC using quantitative grading, and to determine associations with established prognostic parameters. This retrospective study included 16 histopathologically confirmed OSCC cases, categorized into OLGC-positive (<i>n</i> = 8) and OLGC-negative (<i>n</i> = 8) groups. OLGCs were identified on H&amp;E sections within tumor epithelial islands. GCI was calculated as: <i>Total OLGCs × Maximum nuclei per OLGC</i>, and graded (0–3). Associations with tumor stage, grade, lymph node status, depth of invasion(DOI), worst pattern of invasion (WPOI), extracapsular spread (ECS) and survival outcomes were statistically analyzed. OLGCs were observed in 50% of cases. GCI ranged from 0 to 414, with Grade 3 GCI (&gt; 400) seen in 2 cases. Significant associations were found between higher GCI and nodal metastasis (<i>p</i> = 0.042) and ECS trend (<i>p</i> = 0.044). No significant correlations were observed with T-stage, DOI, WPOI, or survival outcomes, as all patients were disease-free at follow-up. Intraepithelial OLGCs in OSCC may reflect tumor aggressiveness, particularly regarding nodal spread. The GCI offers a reproducible, low-cost histological adjunct that warrants further validation in larger cohorts with extended follow-up.</p>

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Unveiling Osteoclastic-like Giant Cells in OSCC: Histomorphological Insights into an Overlooked Entity

  • 期刊论文

  • 发表日期：

    2026年2月14日

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  • R. Keerthika,
  • Akhilesh Chandra,
  • Rahul Agarwal

摘要

Oral squamous cell carcinoma (OSCC) exhibits significant clinical heterogeneity and unpredictable prognosis despite established grading and staging systems. Osteoclastic-like giant cells (OLGCs), rarely observed within tumor epithelial islands, remain poorly characterized in OSCC. This study explores their clinicopathological significance using a novel metric—Giant Cell Index (GCI). To assess the occurrence, intraepithelial localization, and prognostic relevance of OLGCs in OSCC using quantitative grading, and to determine associations with established prognostic parameters. This retrospective study included 16 histopathologically confirmed OSCC cases, categorized into OLGC-positive (n = 8) and OLGC-negative (n = 8) groups. OLGCs were identified on H&E sections within tumor epithelial islands. GCI was calculated as: Total OLGCs × Maximum nuclei per OLGC, and graded (0–3). Associations with tumor stage, grade, lymph node status, depth of invasion(DOI), worst pattern of invasion (WPOI), extracapsular spread (ECS) and survival outcomes were statistically analyzed. OLGCs were observed in 50% of cases. GCI ranged from 0 to 414, with Grade 3 GCI (> 400) seen in 2 cases. Significant associations were found between higher GCI and nodal metastasis (p = 0.042) and ECS trend (p = 0.044). No significant correlations were observed with T-stage, DOI, WPOI, or survival outcomes, as all patients were disease-free at follow-up. Intraepithelial OLGCs in OSCC may reflect tumor aggressiveness, particularly regarding nodal spread. The GCI offers a reproducible, low-cost histological adjunct that warrants further validation in larger cohorts with extended follow-up.