Immunohistochemical Expression of CD44 and ALDH1 in Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma

Background: In potentially malignant disorders and oral squamous cell carcinomas (OSCC), hyaluronan receptor cluster of differentiation 44 (CD44) and aldehyde dehydrogenase 1 (ALDH1) were often used as cancer stem cell (CSC) markers. The aim of the present study was to identify and compare CD44 and ALDH1 protein markers in relation with pathological variance of OSMF and OSCC. Materials and method: Thirty specimens of OSMF and 34 specimens of OSCC patients with primary OSCC, from the Department of Oral Medicine, University of Dental Medicine, Yangon, were analyzed cross-sectional study for the expression of CD44 and ALDH1. Result: CD44 was expressed in 80% of OSMF and 58.82% of OSCC samples while ALDH1 was expressed in 56.67% of OSMF and 55.88% of OSCC samples. CD44 and ALDH1 expression patterns were not completely overlapping within OSMF and OSCC cases. Co-expression of CD44 and ALDH1 in OSMF was 56.67% while 41.18% in OSCC. Kruskal-Wallis test for CD44 and ALDH1 in OSMF was 8.980 (p = .030) and 12.565 (p = .028) while Kruskal-Wallis test for CD44 and ALDH1 in OSCC was 8.304 (p = .081) and 5.900 (p = .207). CD44 and ALDH1 showed lesser expression in association with lymphoplasmacytic infiltration at the epithelialconnective tissue junction of OSMF. Correlation of CD44+/ALDH1+ cells and lymphoplasmacytic infiltration in OSCC was statistically significant (p = .026). Conclusion: In conclusion, CD44 and ALDH1 expression showed a more distinct distribution pattern in potentially malignant lesion, OSMF. However, these markers were not sufficient to precisely isolate the CSC subpopulation from