The role of NFATc4 in the diagnosis of perineural invasion in tongue squamous cell carcinoma

Objective: To explore the role of activated T-cell nuclear factor cytoplasmic 4 (NFATc4) in the diagnosis of perineural invasion (PNI) in tongue squamous cell carcinoma (TSCC) by comparing the immunohistochemical staining characteristics of NFATc4 with those of S100 calcium binding protein (S100) and p75 neurotrophin receptor (p75) for PNI in TSCC. Methods: A total of 59 pathological specimens of TSCC and 10 precancerous lesions were collected as control group. Each specimen underwent serial sectioning and immunohistochemical staining to observe the staining of TSCC as well as nerves by NFATc4. These staining patterns were then compared with those of S100 and p75. Results: In the 59 TSCC pathological specimens, the positivity rate of NFATc4 was 47.5% (28/59), and the PNI incidence was 35.6% (21/59). The PNI incidence was higher in the NFATc4 positive expression group than that in the NFATc4 negative expression group (P＜0.05). NFATc4 staining was observed as light staining of the nerve endothelium and staining of the TSCC cell cytoplasm. The identification results of NFATc4 of nerves were not statistically different from those of S100 and p75 (P＞0.05). Conclusion: There is an association between NFATc4 expression and the occurrence of PNI. NFATc4 can stain the TSCC tissues while staining the nerve bundles, which makes it possible to visualize the relationship between the tumor and the nerves in the same field of view. This visualization enhances the diagnostic accuracy of PNI, indicating that NFATc4 can potentially serve as a diagnostic indicator for PNI.