Head and Neck Squamous Cell Carcinoma

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Head and Neck Squamous Cell Carcinoma (HNSCC) is the 8th and 13th most common malignancy in the world for males and females, respectively, with the majority of malignancies of the upper aero-digestive tract being oral squamous cell carcinomas (OSCC) (Warnakulasuriya, 2009; Scully and Bagan, 2009; Nicole et al., 2010). The highest incidence of OSCC is found in India due to the increased preponderance of habits like chewing tobacco, betel quid and areca-nut which are the most important risk factors (Facompre et al., 2012). According to The Gujarat Cancer & Research Registry, the scenario is worst in Gujarat because 53.65% in males and 15.64% in females of all cancers are found to be Tobacco Related Cancers (TRCs) (National Cancer Registry Report, 2008). Despite the recent advances in first line treatments, the 5 year survival rate after treatment remains disappointingly low at about 15-50% for the past 3 decades (Carvalho et al., 2005; Prince and Ailles, 2008; Warnakulasuriya, 2009; McCullough et al., 2010). The resultant poor prognosis is owed to a low response rate to current therapeutic strategies, late stage diagnosis, high risk of primary site recurrence and aggressive metastases to loco-regional lymph nodes, strongly suggestive of an urge to improve the diagnostic capabilities and treatment efficacy. Increasing experimental evidence supports the cancer stem cell model in HNSCC, which is in favor of a small proportion of cells with the capability of sustaining tumour formation and growth, self-renewal and differentiation in a tumour type and context dependent manner. These CSCs have a probable role in resistance to therapy, establishment of metastasis and recurrence which is allusive of the fact that targeted elimination of th... ... middle of paper ... ...more tumourigenic potential than by CD44+ marker. Also, c-Met+ /CD44+combination yielded tumours in 80% of cases while c-Met+/ALDH1+ displayed tumour formation in 66% cases (Sun and Wang, 2011). Thus c-Met has been proposed as a potent CSC marker in HNSCC but further investigation with a greater number of samples and a comparison of c-Met+ with other CSC and stemness markers could give a clear depiction (Sun and Wang, 2011). Side Populations (SPs): Identification of CSCs is widely done by the side population approach which involves elimination of Hoechst 33342. Hoechst 33342, a fluorescent DNA-binding dye, preferentially binds to A-T rich regions of tumourigenic cells. These SPs express high levels of the ATP-binding cassette (ABC) transporter superfamily (e.g. MDR1, MRP1, ABCB5, ABCG2) that facilitates the efflux of this dye and other drugs (Zhang et al., 2009).

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