Currently submitted to: JMIR Research Protocols
Date Submitted: Apr 6, 2026
Open Peer Review Period: Apr 8, 2026 - Jun 3, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
“Assessment of Jawbone Invasion and Its Correlation with Worst Pattern of Invasion and Depth of Invasion in Oral Squamous Cell Carcinoma: A Research Protocol”
ABSTRACT
Background:
Bone invasion in Oral Squamous Cell Carcinoma (OSCC) is a significant prognostic variable whose association with other important histopathological variables like Depth of Invasion (DOI) and Worst Pattern of Invasion (WPOI) has not been carefully examined. DOI is implemented in exsisting staging systems, and WPOI is acknowledged to predict tumor aggressiveness. Limited literature has been conducted to determine their collaborative relationship with bone involvement. Understanding these correlations will enhance histopathological assessment, which leads to better clinical decisions.
Objective:
This study will help to assess the presence of bone invasion in OSCC patients. It will also help in determining DOI and WPOI. Further, a comparative study will be carried out between the occurrence and degree of bone invasion with DOI and WPOI in OSCC patients.
Methods:
Histopathologically confirmed 80 cases of OSCC, which have been through surgical resection, will be included in this observational study. DOI will be evaluated based on hematoxylin and eosin-stained sections using standardized guidelines. WPOI will be measured in types 1-5 according to the set criteria and will be graded accordingly. Bone invasion will be evaluated histopathologically following decalcification, which will be categorized as either present or absent. Statistical tests will include chi-square analysis and logistic regression to establish the relationship between DOI, WPOI and bone invasion.
Results:
It is expected that the increased values of DOI and improved grades of WPOI (Types 4 and 5) will have a strong correlation with bone invasion. The cases exhibiting infiltrative patterns of invasion and a deeper depth of the tumor are likely to show more aggressive biological behavior and more chance of bone infiltration. These findings are expected to support the use of DOI, WPOI and bone invasion as predictive markers in OSCC. By March 6, 2026 data of 50 patients are collected, and the remaining 30 patient’s data will be collected during the study.
Conclusions:
It is anticipated that the study will emphasize the importance of DOI and WPOI evaluation and assessment of bone invasion to increase accuracy and prognosis in OSCC cases. Establishing significant correlations between these parameters can lead to better histopathological assessment and improved treatment planning, leading to better patient outcomes. Clinical Trial: not required
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