Multiple drug resistant, tumorigenic stem-like cells in oral cancer

•Four distinct subpopulations with varying stemness potential exist in oral cancer.•Transition of one fraction to other highlighted phenotypic switch and plasticity.•This study proposes a central dogma for epithelial carcinogenesis in oral cancer.

An in vitro cell line model was established to exemplify tumor stem cell concept in oral cancer. We were able to identify CD147 expressing fractions in SCC172 OSCC cell line with differing Hoechst dye efflux activity and DNA content. In vivo tumorigenic assay revealed three fractions enriched with stem-like cells capable of undergoing mesenchymal transition and a non-tumorigenic fraction. The regeneration potential and transition of one fraction to other imitated the phenotypic switch and functional disparities evidenced during oral tumor progression. Knowledge of these additional stem-like subsets will improve understanding of stem cell based oral epithelial tumor progression from normal to malignant lesions.