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Kitabatake K, Ishikawa S, Sugimoto M, Enomoto A, Kaneko M, Ota S, Edamatsu K, Yusa K, Hemmi T, Okuyama N, Iino M. Salivary metabolomics for oral leukoplakia with and without dysplasia. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101618. [PMID: 37659754 DOI: 10.1016/j.jormas.2023.101618] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/09/2023] [Accepted: 08/30/2023] [Indexed: 09/04/2023]
Abstract
PURPOSE Oral leukoplakia (OL) is a common potentially malignant oral disorder. Therefore, there is a need for simple screening methods for OL before its transformation into oral cancer. Furthermore, because invasive open biopsy is the sole method to determine if an OL lesion is dysplastic, there is also a clinical need for non-invasive methods to differentiate dysplastic OL from non-dysplastic OL. This study aimed to identify salivary metabolites that can help differentiate patients with OL from healthy controls (HC) and also dysplastic OL from non-dysplastic OL. MATERIAL & METHODS Whole unstimulated saliva samples were collected from patients with OL (n = 30) and HCs (n = 29). The OL group included nine patients with dysplastic OL and 20 with non-dysplastic OL. Hydrophilic metabolites in the saliva samples were comprehensively analyzed through capillary electrophoresis mass spectrometry. To evaluate the discrimination ability of a combination of multiple markers, a multiple logistic regression (MLR) model was developed to differentiate patients with OL from HCs and dysplastic OL from non-dysplastic OL. RESULTS Twenty-eight metabolites were evidently different between patients with OL and HCs. Finally, three metabolites (guanine, carnitine, and N-acetylputrescine) were selected to develop the MLR model, which resulted in a high area under curve (AUC) of the receiver operating characteristic (ROC) to differentiate patients with OL from HCs (AUC = 0.946, p < 0.001, 95% confidential interval [CI] = 0.889- 1.000). Similarly, two metabolites were evidently different between patients with dysplastic and non-dysplastic OL. Finally, only one metabolite (7-methylguanine) was selected in the MLR model, which revealed a moderate discrimination ability for dysplastic and non-dysplastic OL (AUC = 0761, p = 0.027, 95% CI = 0.551-0.972). CONCLUSION Our candidate salivary metabolites showed potential not only to discriminate OL from HC, but also to discriminate dysplastic OL from non-dysplastic OL.
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Affiliation(s)
- Kenichiro Kitabatake
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
| | - Shigeo Ishikawa
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan.
| | - Masahiro Sugimoto
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan
| | - Ayame Enomoto
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan
| | - Miku Kaneko
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan
| | - Sana Ota
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan
| | - Kaoru Edamatsu
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
| | - Kazuyuki Yusa
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
| | - Tomoharu Hemmi
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
| | - Naoki Okuyama
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial - Plastic and Reconstructive Surgery Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
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Peng Q, Duan N, Wang X, Wang W. The potential roles of cigarette smoke-induced extracellular vesicles in oral leukoplakia. Eur J Med Res 2023; 28:250. [PMID: 37481562 PMCID: PMC10362576 DOI: 10.1186/s40001-023-01217-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/08/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND The onset of oral leukoplakia (OLK), the most common oral lesion with a high risk of malignant transformation, is closely associated with the exposure of cigarette smoke. Cigarette smoke is a complicated mixture of more than 4500 different chemicals including various oxidants and free radical, which contributes to the onset of immune and inflammatory response or even carcinogenesis. Recent studies have proved that the exposure of cigarette smoke leads to the onset and aggravation of many diseases via significantly changed the production and components of extracellular vesicles. The extracellular vesicles are membrane-enclosed nanosized particles secreted by diverse cells and involved in cell-cell communication because of their ability to deliver a number of bioactive molecules including proteins, lipids, DNAs and RNAs. Getting insight into the mechanisms of extracellular vesicles in regulating OLK upon cigarette smoke stimulation contributes to unravel the pathophysiology of OLK in-depth. However, evidence done on the role of extracellular vesicles in cigarette smoke-induced OLK is still in its infancy. MATERIALS AND METHODS Relevant literatures on cigarette smoke, oral leukoplakia and extracellular vesicles were searched in PubMed database. CONCLUSIONS In this review, we summarize the recent findings about the function of extracellular vesicles in the pathogenesis of cigarette smoke-induced diseases, and to infer their potential utilizations as diagnostic biomarkers, prognostic evaluation, and therapeutic targets of OLK in the future.
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Affiliation(s)
- Qiao Peng
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Ning Duan
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China
| | - Xiang Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China.
| | - Wenmei Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Nanjing, 210008, China.
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Evren I, Brouns ER, Poell JB, Wils LJ, Brakenhoff RH, Bloemena E, de Visscher JGAM. Associations between clinical and histopathological characteristics in oral leukoplakia. Oral Dis 2023; 29:696-706. [PMID: 34601770 PMCID: PMC10078678 DOI: 10.1111/odi.14038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/22/2021] [Accepted: 09/14/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To identify possible associations between patients' demographics and habits and the clinical aspects and histopathological characteristics of oral leukoplakia (OL) at patients' first visit. METHOD A total of 140 consecutive patients with OL at a single institute between 1997 and 2019. All biopsies were microscopically examined for classic dysplasia (CD) (WHO definition oral epithelial dysplasia) and differentiated dysplasia (DD) known from differentiated vulvar intraepithelial neoplasia. Clinical characteristics were correlated to histopathological diagnosis and odds ratios (OR) were calculated. RESULTS A total of 96 females and 44 males, mean age 58 years, were presented. OLs were found mainly on the tongue (41%) and floor of mouth (FOM) (18%). Homogeneous OLs (58%) were associated with smoking, FOM and size <2cm and non-homogeneous OLs (42%) with non-smokers. No dysplasia was present in 40% and any dysplasia (AD) in 60%. Tongue OLs were correlated with AD (OR:6.0) and CD (OR:5.7). FOM OLs were correlated with CD (OR:4.5). DD was correlated with non-homogeneous OLs (OR:2.6). CONCLUSIONS CD was most frequently observed in tongue and FOM OLs, while DD was associated with non-homogeneous OLs. In this series of patients, there was no consistent reliable association between the clinical and histopathological features and clinical characteristics can therefore not substitute microscopic examination of biopsies.
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Affiliation(s)
- Ilkay Evren
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Elisabeth R Brouns
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jos B Poell
- Department of Otolaryngology/Head & Neck Surgery, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Leon J Wils
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Ruud H Brakenhoff
- Department of Otolaryngology/Head & Neck Surgery, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Elisabeth Bloemena
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.,Department of Pathology, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Jan G A M de Visscher
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Shah JS, Dubey J. Prevalence and factors associated with oral potentially malignant disorders and oral squamous cell carcinoma: An institutional study. J Cancer Res Ther 2023; 19:S536-S544. [PMID: 38384016 DOI: 10.4103/jcrt.jcrt_759_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/04/2022] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Incidence & prevalence of OPMDs & OSCC is increasing day by day, thereby escalating the burden of oral cancer in India. Oral cancer ranks in the top three of all cancers in India and is quickly becoming a health priority. This study aims to assess prevalence and associated factors of OPMDs and OSCC in patients attending dental OPD and its association with age, gender, habit (type & duration), clinical presentation and site of involvement. MATERIAL AND METHODS A prospectively 12 months study was conducted in the outpatient department. Patient's data whether suspected or proven cases of OPMDs & OSCC and fits in clinical criteria were reviewed and analysed for demographic data, oral adverse habit, clinical presentation and site of involvement. RESULTS Overall 38,588 patient's data were analysed for 12 month time duration. Out of this 552 (1.43%) cases of OPMDs and 58 (0.15%) cases of OSCC were reported. Out of 552 maximum patients were reported with OSMF (34.4%), followed by other lesions and minimum with LP (7.9%). Age group most commonly affected was above 45 years (44.9%) of age. Males (81.1%) were affected more than females. OPMDs (92%) and OSCC (96.5%) were mostly associated with smokeless or smoking form of tobacco. CONCLUSION Present study evaluated the prevalence rates and associated factors of OPMDs & OSCC, which is beneficial for general practitioner in early diagnosis, formulating better treatment plan and to educate general population about risk factors, early signs and symptoms of these lesions.
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Affiliation(s)
- Jigna S Shah
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Ahmedabad, Gujarat, India
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Sahoo PK, Sarkar S, Ghosh D, Mahata S, Pal R, Mistry T, Ghosh S, Roy A, Bucha H, Mandal S, Nasare VD. Premalignant and malignant lesions of oral cavity in eastern India: a hospital-based study. Eur J Cancer Prev 2021; 30:393-399. [PMID: 33252366 DOI: 10.1097/cej.0000000000000640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Oral carcinoma and precancers are major public health challenges in India and other developing countries. OBJECTIVES Aim of the study was to assess the associations of demographic characteristics, addictions, chief complaints of mouth/oral and clinical diagnosis by cytology smear and punch biopsy in early detection of oral premalignant and malignant lesions. Methods Study was designed on retrospective data of case files of CDC, CNCI, Kolkata, from patients attended from January 1996 to September 2016. History was taken, histopathology and Pap smear were performed. Descriptive statistical analysis, cross-tabulation and Pearson's Chi-square test were done. RESULTS Total participants (n = 692); 110 (15.9%) having history of swallowing betel leaf, nut lime, dokta, jarda, catecheu with an average of 11 years. Three hundred twenty-five (46.9%) had multiple addiction (cigarette/bidi/tobacco/all). Ninety-eight (12.1%), 99 (12.2%) and 68 (8.4%) were addicted to cigarette, bidi and chewing tobacco, respectively. Twenty-nine participants were addicted to alcohol; 18 (2.6%) and 11 (1.5%) took country and foreign alcohol correspondingly. Clinicians thoroughly examined lips (4.1%), buccal mucosa (27.3%), gingival (2.8%), tongue (23.1%), hard and soft palate (4.9%), mouth loor (5.2%) and other parts (32.3%); diagnosed participants as normal (22.8%)/benign (23.1%)/premalignant (39.1%)/malignant (14.8%). Smears confirmed 60, 131, 42, 9 and 8 cases as carcinoma, mild, moderate, severe dysplasia and inflammation, respectively. The punch biopsy identified 11 carcinomas, two severe, two moderate and seveeen mild dysplasia's. Chi-square test showed significant association between smear and examination (P = 0.022), diagnosis and examinations of the oral cancer patients (P = 0.0001). CONCLUSION The study provided strong evidence that betel leaf, chewing tobacco, smoking and alcohol are independent risk factors for oral cancer. Cytological smear and biopsy are cost-effective approaches for early detection.
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Affiliation(s)
| | | | | | | | - Ranita Pal
- Departments of Pathology and Cancer Screening
| | | | | | - Asoke Roy
- Departments of Pathology and Cancer Screening
| | | | - Syamsundar Mandal
- Epidemiology and Biostatistics, Chittaranjan National Cancer Institute, Kolkata, India
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Worakhajit P, Fuangtharnthip P, Khovidhunkit SOP, Chiewwit P, Klongnoi B. The Relationship of Tobacco, Alcohol, and Betel Quid with the Formation of Oral Potentially Malignant Disorders: A Community-Based Study from Northeastern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8738. [PMID: 34444487 PMCID: PMC8392647 DOI: 10.3390/ijerph18168738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 01/05/2023]
Abstract
This study's objective was to describe the relationship between the main risk factors for oral cancer, including tobacco (in the form of cigarettes, smokeless tobacco (SLT), secondhand smoking (SS)), alcohol, and betel quid (BQ), and the occurrence of oral potentially malignant disorders (OPMDs). A community-based case-control study was conducted with a population of 1448 adults aged 40 years or above in northeastern Thailand. Patients aged 60 years or above (OR 1.79, p < 0.001) and female patients (OR 2.17, p < 0.001) had a significant chance of having OPMDs. Our multivariate analysis showed that the most potent risk factor for OPMDs occurrence was betel quid (BQ) (adjusted OR 4.65, p < 0.001), followed by alcohol (OR 3.40, p < 0.001). Even former users were at risk of developing OPMDs. The synergistic effect between these main risk factors was significantly shown in the group exposed to SLT, SS, BQ, and alcohol. The most potent synergistic effect was found in the group exposed to SLT, BQ and alcohol with the OR = 20.96.
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Affiliation(s)
- Prangtip Worakhajit
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; (P.W.); (P.C.)
| | - Pornpoj Fuangtharnthip
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; (P.F.); (S.-o.P.K.)
| | | | - Pim Chiewwit
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; (P.W.); (P.C.)
| | - Boworn Klongnoi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; (P.W.); (P.C.)
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Kerr AR, Lodi G. Management of Oral Potentially Malignant Disorders. Oral Dis 2021; 27:2008-2025. [PMID: 34324758 DOI: 10.1111/odi.13980] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/07/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
Patients with oral potentially malignant disorders (OPMDs), including oral leukoplakia and erythroplakia, proliferative verrucous leukoplakia, oral submucous fibrosis, and oral lichen planus/lichenoid lesions can be challenging to manage. A small proportion will undergo cancer development and determining a patient's cancer risk is key to making management decisions. Yet, our understanding of the natural history of OPMDs has not been fully elucidated, and a precision approach based on the integration of numerous predictive markers has not been validated by prospective studies. Evidence-based health promotion by clinicians and healthcare systems is not embraced universally. Medical and surgical interventions evaluated by rigorous research measuring important endpoints, such as cancer development, mortality, or survival are difficult and expensive to run. Most of these studies employ non-ideal surrogate endpoints and have deep methodologic flaws. Diagnostic criteria for enrolling research subjects are not uniform, and patients with the highest risk for cancer development comprise small proportions of those enrolled. Few studies explore quality of life and patient preferences. It is time to rethink how we approach the management of these patients, across each OPMD, and considering the healthcare infrastructure and cost effectiveness. Global networks with well-characterized patient populations with OPMDs and well-designed interventional trials using validated outcome measures are needed.
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Affiliation(s)
- A Ross Kerr
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine.,New York University College of Dentistry, New York, NY, USA
| | - Giovanni Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milano, Italia
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Deneuve S, Guerlain J, Dupret-Bories A, Majoufre C, Philouze P, Ceruse P, Perreard M, Sigaud N, Barry B, Ransy P, Schultz P, Malard O, Morinière S, Chatellier A, De Monès E, Folia M, Virard F, Fervers B. Oral tongue squamous cell carcinomas in young patients according to their smoking status: a GETTEC study. Eur Arch Otorhinolaryngol 2021; 279:415-424. [PMID: 33877432 DOI: 10.1007/s00405-021-06793-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/31/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Incidence of oral tongue squamous cell carcinoma (OTSCC) is increasing, especially in young adults, despite decreasing tobacco and alcohol consumption. METHODS This multicentric retrospective study of 185 young adults with OTSCC (median follow-up 43 months), investigated risk factors, tumour characteristics and oncological outcomes according to the smoking status. RESULTS Overall, 38% of patients were smokers (S). Non-smokers (NS) were significantly younger than S. Sex ratios were 1.1 for N and 1.8 for S. NS patients were less frequently cannabis or alcohol users than S, but were more likely to have a history of leukoplakia. Second primaries were observed in NS (4.4%) and in S (12.7%). Despite more frequent local relapse in NS (p = 0.018), there was no difference in diagnostic stage and overall survival between groups. CONCLUSION OTSCC affects differently young S and NS patients suggesting the existence of a specific clinical entity of OTSCC in non-smoking young adults.
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Affiliation(s)
- Sophie Deneuve
- Surgical Oncology Department, Léon Bérard Comprehensive Cancer Center, 28 rue Laennec, 69008, Lyon, France. .,INSERM UA8, Radiation: Défense, Santé , Environnement, Lyon, France.
| | - Joanne Guerlain
- Head and Neck Department, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - Agnès Dupret-Bories
- Head and Neck Department, Toulouse University Cancer Institute, Toulouse, France
| | - Claire Majoufre
- Maxillofacial Surgery, CHU Bordeaux Pellegrin, Bordeaux, France
| | | | | | | | - Nicolas Sigaud
- Maxillofacial Surgery, CHU Lyon Sud, Pierre-Bénite, France
| | | | | | | | | | | | | | | | | | - François Virard
- INSERM U1052-CNRS UMR5286, Cancer Research Center, centre Léon Berard, Lyon 1 University, Lyon, France.,Université de Lyon, Faculté d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Béatrice Fervers
- INSERM UA8, Radiation: Défense, Santé , Environnement, Lyon, France.,Cancer and Environnement Department, Léon Bérard Comprehensive Cancer Center, Lyon, France
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Effect of smoking status and programmed death-ligand 1 expression on the microenvironment and malignant transformation of oral leukoplakia: A retrospective cohort study. PLoS One 2021; 16:e0250359. [PMID: 33861793 PMCID: PMC8051817 DOI: 10.1371/journal.pone.0250359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/06/2021] [Indexed: 01/21/2023] Open
Abstract
Tobacco smoking is associated with an increased risk of oral leukoplakia and head and neck cancer. Although it has recently been reported that the establishment of an immunosuppressive microenvironment in oral potentially malignant disorders may lead to malignant transformation, it is unclear whether the microenvironments of oral potentially malignant disorders differ according to smoking status. We examined differences in programmed death-ligand 1 (PD-L1) expression and subepithelial CD163+ TAM and CD8+ cell/lymphocyte counts in the microenvironment of oral leukoplakia of smoking and non-smoking patients and investigated their associations with malignant transformation. Pathology reports and original biopsy request forms from 1995–2015 were retrospectively reviewed. Lesions clinically characterized as white plaques/lesions of the oral mucosa and pathologically diagnosed as oral epithelial dysplasia were included. Immunohistochemistry was performed to evaluate PD-L1 expression and subepithelial CD163+/CD8+ cell counts. The significance of prognostic factors in predicting malignant transformation was determined using Cox regression analysis. Statistical significance was defined as P<0.05. In total, 200 patients with oral leukoplakia were selected. The mean age at diagnosis was higher in non-smoking patients (n = 141; 66.9 years) than in smoking patients (n = 59; 60.5 years). The 5-year cumulative malignant transformation rate was higher in non-smoking patients than in smoking patients (9.3% vs. 3.0%, respectively). Oral leukoplakia was associated with significantly higher PD-L1 expression and increased numbers of subepithelial CD163+ cells in the non-smoking group compared with the smoking group. Non-smoking-related oral leukoplakia with positive PD-L1 expression was associated with a 6.97-fold (95% confidence interval: 2.14–22.7) increased risk of malignant transformation. The microenvironment of oral leukoplakia differed according to smoking status. A combination of smoking status and PD-L1 expression may predict malignant transformation in oral leukoplakia patients. This study highlights the importance of understanding the interaction between smoking and the microenvironment in oral leukoplakia.
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Prevalence and risk factors of potentially malignant disorders of the mucosa in the general population: Mucosa lesions a general health problem? Ann Anat 2021; 237:151724. [PMID: 33798694 DOI: 10.1016/j.aanat.2021.151724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/10/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
AIM Oral cancer mostly develops from oral mucosa regions with morphological alterations transforming malignant. These visible precancerous mucosa lesions are named potentially malignant disorders (PMD). We aimed to analyze the prevalence of PMD and its risk factors for PMD in a population-based sample in Northern Germany. MATERIAL AND METHODS Data of 6078 individuals from the population-based Study of Health in Pomerania (SHIP) was used. PMD were photographically documented and periodontal health was assessed in a standardized procedure. RESULTS PMD were observed in 54 individuals (0.9%). The most prevalent PMD was homogenous leukoplakia (n = 37) followed by Lichen ruber (n = 9). Smoking (Odds Ratio (OR) 2.70; 95% confidence interval (CI): 1.24-5.87), male sex (OR 3.32; 95%-CI: 1.77-6.21), type 2 diabetes mellitus (OR 2.07; 95%-CI: 1.08-3.98) and body mass index (OR 1.09; CI 1.04-1.14) were significantly associated with PMD, with the corresponding area under the curve (AUC) being 0.696 (CI: 0.655; 0.737). CONCLUSION Our results suggest a clinically relevant prevalence of PMD in the population. We identified male sex, type 2 diabetes mellitus, current smoking, and obesity as risk factors. We recommend photographic documentation and intensified training of medical and dental staff to detect and monitor PMD.
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Evren I, Brouns ER, Wils LJ, Poell JB, Peeters CFW, Brakenhoff RH, Bloemena E, de Visscher JGAM. Annual malignant transformation rate of oral leukoplakia remains consistent: A long-term follow-up study. Oral Oncol 2020; 110:105014. [PMID: 33038723 DOI: 10.1016/j.oraloncology.2020.105014] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/02/2020] [Accepted: 09/11/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Numerous clinical and histopathological characteristics have been associated with malignant transformation (MT) of oral leukoplakia (OL), including classic and differentiated epithelial dysplasia, but MT predictions remain suboptimal. The objective of this study was to determine the annual MT rate of OL and to identify clinicopathological risk factors associated with MT. PATIENTS AND METHODS 170 patients with OL were included in this retrospective cohort study, 117 females and 53 males. Follow-up ranged from 12 to 219 months (median 54). The analyzed variables included age, gender, smoking habits, clinical presentation, subsite, size and treatment. In a subgroup of 140 patients, histopathological diagnoses were reviewed with regard to the presence of dysplasia, discerning both classic dysplasia and differentiated dysplasia. RESULTS MT occurred in 23% of the patients, resulting in an annual MT rate of 4.9% (95% CI: 3.5 - 6.6) which remained consistent. High-risk subsite (tongue and floor of mouth) was the only clinical predictor for MT (Hazard Ratio = 2.7, 95% CI: 1.3 - 5.5, p = 0.007). In 140 patients, classic dysplasia (Hazard Ratio = 7.2, 95% CI: 1.6 - 33.1, p = 0.012) and differentiated dysplasia (Hazard Ratio = 6.6, 95% CI: 1.2 - 25.4, p = 0.026) were predictors for MT. Binary grading between dysplasia and no dysplasia was significant for predicting MT (Hazard Ratio = 6.4, 95% CI: 1.5 - 27.5, p = 0.013). CONCLUSION Since annual MT rate of OL remains stable during follow-up, regular long-term or even life-long follow-up is advocated. Specific oral subsites and epithelial dysplasia are predictors for MT of OL.
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Affiliation(s)
- Ilkay Evren
- Amsterdam UMC, location VUmc, Department of Oral and Maxillofacial Surgery / Oral Pathology, Cancer Center Amsterdam, Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - Elisabeth R Brouns
- Amsterdam UMC, location VUmc, Department of Oral and Maxillofacial Surgery / Oral Pathology, Cancer Center Amsterdam, Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - Leon J Wils
- Amsterdam UMC, location VUmc, Department of Oral and Maxillofacial Surgery / Oral Pathology, Cancer Center Amsterdam, Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - Jos B Poell
- Amsterdam UMC, location VUmc, Department of Otolaryngology / Head & Neck Surgery, Cancer Center Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - Carel F W Peeters
- Amsterdam UMC, location VUmc, Department of Epidemiology & Data Science, Amsterdam Public Health research institute, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - Ruud H Brakenhoff
- Amsterdam UMC, location VUmc, Department of Otolaryngology / Head & Neck Surgery, Cancer Center Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - Elisabeth Bloemena
- Amsterdam UMC, location VUmc, Department of Oral and Maxillofacial Surgery / Oral Pathology, Cancer Center Amsterdam, Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; Amsterdam UMC, location VUmc, Department of Pathology, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - Jan G A M de Visscher
- Amsterdam UMC, location VUmc, Department of Oral and Maxillofacial Surgery / Oral Pathology, Cancer Center Amsterdam, Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
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12
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Abstract
The Surveillance, Epidemiology, and End Results program from the National Cancer Institute reports that the aggregate number of oral cavity and pharyngeal cancer cases has been increasing over the past decade and, despite an overall decline in oral cavity cancers, this increase is largely related to a dramatic increase in cancers involving oropharyngeal subsites. Early detection of oral cavity cancers is commensurate with improved survival, and opportunistic screening by trained clinicians to detect oral cavity cancer and oral potentially malignant disorders is recommended by the American Dental Association and the American Academy of Oral Medicine.
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Affiliation(s)
- David Ojeda
- Department of Comprehensive Dentistry, University of Texas Health Science Center San Antonio, School of Dentistry, 7703 Floyd Curl Drive, office 2.565U, San Antonio, TX 78229-3900, USA
| | - Michaell A Huber
- Department of Comprehensive Dentistry, University of Texas Health Science Center San Antonio, School of Dentistry, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Alexander R Kerr
- Department of Oral & Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, 345 East 24th Street, Room 813C, New York, NY 10010, USA.
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13
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Amin NR, Yussif N, Ahmed E. The effect of smoking on clinical presentation and expression of TLR-2 and CD34 in Oral lichen Planus patients: clinical and immunohistochemical study. BMC Oral Health 2020; 20:129. [PMID: 32349717 PMCID: PMC7191681 DOI: 10.1186/s12903-020-01118-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral lichen planus is a chronic inflammatory disease which is considered as a potential precancerous condition. Numerous studies have confirmed that inflammation is a strong risk factor for cancer development. Smoking is associated with potentially malignant disorders of the oral and oropharyngeal mucosa. The adverse consequences of smoking in various pathologies are mediated by its effects on the immune-inflammatory system. Little is known about the influence of cigarette smoke content on the course of OLP and inflammatory response. METHODS Twenty oral lichen planus smoker patients, 20 oral lichen planus non-smoker patients and 20 control patients were included in this work. Pain and clinical scores were calculated for each patient. Image analysis to calculate area percent for TLR-2 and CD34 immuno-expression was performed. Data was tabulated and statistically analyzed. RESULTS The present study showed no statistically significant difference in clinical and pain scores between the smoker and non-smoker groups. However, there was a significant difference in area percent values for TLR-2 and CD34 immuno-expression between the smoker and the non-smoker groups. CONCLUSION Smoking enhanced TLR-2 and CD34 expression in OLP which are considered as inflammatory mediators and are contributing factors in the pathogenesis of oral lichen planus.
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Affiliation(s)
- Nermine Raouf Amin
- Oral and Maxillofacial Pathology department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nermin Yussif
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - Enji Ahmed
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.,Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
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14
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Giudice LW, Graff EA, Haripersad Y, Frydrych AM, Parsons R, Kujan O, Farah CS. Chronic disease comorbidity in patients with oral leukoplakia: A matched case-control study. Oral Dis 2020; 26:894-902. [PMID: 32106348 DOI: 10.1111/odi.13315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/11/2020] [Accepted: 02/21/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the presence of chronic diseases in patients with oral leukoplakia (OL) compared to controls matched for age group, gender, smoking and alcohol use. SUBJECTS AND METHODS This case-control study examined the general demographics, medical and social histories of 105 OL cases and 391 controls matched for age group, gender, tobacco and alcohol use. All OL cases were diagnosed based on both clinical and histopathological findings. RESULTS Chronic diseases were significantly associated with OL, namely dyslipidaemia (p < .0001), musculoskeletal diseases (p = .0101) and asthma (p = .0052). The use of ACE inhibitors (p = .0177), opioid analgesics (p = .0300), anticoagulants (p = .0055) and statins (p = .0010) was significantly associated with OL. Dyslipidaemia (p < .0001; odds ratio [95% CI]: 6.4 [3.5-11.6]) and asthma (p = .0110; odds ratio [95% CI]: 2.2 [1.2-4.0]) were identified as independent predictors of OL in multivariate analysis, both of which were significantly more common amongst cases than controls. CONCLUSIONS Results from this first Australian study suggest that dyslipidaemia and asthma may constitute independent predictors for the presence of OL. However, longitudinal studies are needed to ascertain the temporal relationship between OL and chronic disease comorbidity and the mechanisms underlying these associations.
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Affiliation(s)
- Lance W Giudice
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Emrik A Graff
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Yasmita Haripersad
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | | | - Richard Parsons
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Bentley, WA, Australia
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Camile S Farah
- Australian Centre for Oral Oncology Research & Education, Nedlands, WA, Australia.,Oral, Maxillofacial and Dental Surgery, Fiona Stanley Hospital, Murdoch, WA, Australia
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15
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Abstract
Oral potentially malignant disorders (OPMDs) are precursor lesions that may undergo malignant transformation to oral cancer. These lesions most commonly present clinically as white patches (leukoplakia). However, they may also be red (erythroplakia), or red and white (erythroleukoplakia). There are many risk factors associated with the development of an OPMD, and with the risk of malignant transformation of the lesion. A biopsy with subsequent microscopic examination from the lesional tissue is necessary in identification of OPMD. This article reviews the clinical appearance of OPMDs, associated risk factors, diagnosis and histologic appearance, and treatment.
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Affiliation(s)
- Stephanie L Wetzel
- Atlanta Oral Pathology, 2701 North Decatur Road, Decatur, GA 30022, USA.
| | - Jessica Wollenberg
- Randolph Oral Pathology Associates, 447 Route 10, Suite 5, Randolph, NJ 07869, USA
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16
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Emran S, Hurskainen M, Tomppo L, Lappalainen R, Kullaa AM, Myllymaa S. Bioimpedance spectroscopy and spectral camera techniques in detection of oral mucosal diseases: a narrative review of the state-of-the-art. J Med Eng Technol 2019; 43:474-491. [DOI: 10.1080/03091902.2019.1692940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Shekh Emran
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Miia Hurskainen
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Laura Tomppo
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Reijo Lappalainen
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Arja M. Kullaa
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Educational Dental Clinic, Kuopio University Hospital, Kuopio, Finland
| | - Sami Myllymaa
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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17
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Tilakaratne WM, Jayasooriya PR, Jayasuriya NS, De Silva RK. Oral epithelial dysplasia: Causes, quantification, prognosis, and management challenges. Periodontol 2000 2019; 80:126-147. [PMID: 31090138 DOI: 10.1111/prd.12259] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Oral epithelial dysplasia is a spectrum of architectural and cytological epithelial changes caused by accumulation of genetic changes, and is associated with an increased risk of progression to squamous cell carcinoma. It is a microscopic diagnosis of immense clinical importance. The initial reports of oral potentially malignant disorders with oral epithelial dysplasia transforming to oral cancer helped in understanding the nature of oral malignancies. Since then, clinical studies on oral potentially malignant disorders have combined microscopic findings of oral epithelial dysplasia to assess the malignant transformation potential of different grades of epithelial dysplasia. A significant amount of scientific literature has amassed on oral epithelial dysplasia relating to aspects of its diagnosis and management. However, the evidence base is weak as a result of the significant variability of published research. Poorly described study methods, variability in different oral epithelial dysplasia grading systems, inter- and intra-examiner variability causing issues of reliability, inadequate sample size, and inconsistent durations of follow-up are some of the methodological issues contributing to the failure to provide dependable information. Randomized clinical trials on the malignant transformation potential of oral epithelial dysplasia and its treatment outcomes are limited. This comprehensive literature review on oral epithelial dysplasia summarizes the scientific knowledge published in the scientific literature in English since its first description. The historical development, etiological factors, grading systems, diagnostic criteria, assessment of risk factors and prevention of malignant transformation, management principles of different grades of oral epithelial dysplasia (surgical and nonsurgical), recommendations on follow-up, and prognostic indicators are discussed in detail.
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Affiliation(s)
- Wanninayake M Tilakaratne
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Primali R Jayasooriya
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Nadeena S Jayasuriya
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Rohana Kumara De Silva
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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18
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Dineshkumar T, Srikanth P, Nagarathinam AE, Rajkumar K, Priyadharini S, Shruthi TA. Diagnostic Utility of Cytology in Assessment of Ploidy Status in Potentially Malignant Oral Disorders. Asian Pac J Cancer Prev 2019; 20:3145-3151. [PMID: 31653166 PMCID: PMC6982665 DOI: 10.31557/apjcp.2019.20.10.3145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Oral leukoplakia, the most common potentially malignant oral disorder (PMOD) may progress to oral squamous cell carcinoma (OSCC). Although, the current standard of care for assessing its malignant potential remains histological examination and assessing the severity of dysplasia, DNA ploidy analysis has been suggested as a surrogate marker to predict the behaviour of PMODs. OBJECTIVES To detect aneuploidy and to correlate ploidy status with different grades of dysplasia in both tissue and cytology samples to predict the behaviour of these potentially malignant disorders and to assess the diagnostic utility of cytology samples for ploidy analysis. METHODOLOGY After obtaining ethical clearance and consent, tissue and cytology samples of leukoplakia were collected and grouped based on the dysplastic findings into low-risk (n=20) and high-risk (n=20). DNA ploidy analysis was done using high resolution flow cytometry and its diagnostic utility was assessed. RESULTS Diagnostic utility was expressed in terms of sensitivity, specificity, PPV and NPV. On comparing the ploidy status of individual cases between tissue and cytology samples, cytology was able to accurately determine the ploidy status in majority of the cases. In the low-risk group, cytology had a sensitivity and specificity of 100% and a PPV and NPV of 100% with an overall diagnostic accuracy of 100%. Among the high-risk group, cytology had a sensitivity of 80% and specificity of 100% with a PPV of 100% and NPV of 83.33% and had an overall diagnostic accuracy of 90%. Combining both groups together, it had a sensitivity of 85.71% and specificity of 100% with a PPV of 100% and NPV of 92.31% and had an overall diagnostic accuracy of 94.74%. CONCLUSION Overall, this study showed a positive correlation between cytology and tissue samples and ploidy and grade of dysplasia and cytology proved to be a simple and efficient with a reasonable diagnostic value.
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Affiliation(s)
- Thayalan Dineshkumar
- Department of Oral and Maxillofacial Pathology, SRM Dental College and Hospitals, SRM Institute of Science and Technology, Ramapuram, Chennai, India
| | - Prabakar Srikanth
- Department of Oral and Maxillofacial Pathology, SRM Dental College and Hospitals, SRM Institute of Science and Technology, Ramapuram, Chennai, India
| | - A E Nagarathinam
- Department of Oral and Maxillofacial Pathology, SRM Dental College and Hospitals, SRM Institute of Science and Technology, Ramapuram, Chennai, India
| | - Krishnan Rajkumar
- Department of Oral and Maxillofacial Pathology, SRM Dental College and Hospitals, SRM Institute of Science and Technology, Ramapuram, Chennai, India
| | - Shankaran Priyadharini
- Department of Oral and Maxillofacial Pathology, SRM Dental College and Hospitals, SRM Institute of Science and Technology, Ramapuram, Chennai, India
| | - T A Shruthi
- Department of Oral and Maxillofacial Pathology, SRM Dental College and Hospitals, SRM Institute of Science and Technology, Ramapuram, Chennai, India
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19
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Wu W, Wang Z, Zhou Z. Role of the human papillomavirus in malignant transformation of oral leukoplakia distinct from oropharyngeal squamous cell carcinoma: A study of 76 patients with internal-control specimens. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:273-279. [DOI: 10.1016/j.oooo.2019.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 12/22/2018] [Accepted: 01/03/2019] [Indexed: 10/27/2022]
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20
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Targeting Cellular Metabolism Modulates Head and Neck Oncogenesis. Int J Mol Sci 2019; 20:ijms20163960. [PMID: 31416244 PMCID: PMC6721038 DOI: 10.3390/ijms20163960] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 12/24/2022] Open
Abstract
Considering the great energy and biomass demand for cell survival, cancer cells exhibit unique metabolic signatures compared to normal cells. Head and neck squamous cell carcinoma (HNSCC) is one of the most prevalent neoplasms worldwide. Recent findings have shown that environmental challenges, as well as intrinsic metabolic manipulations, could modulate HNSCC experimentally and serve as clinic prognostic indicators, suggesting that a better understanding of dynamic metabolic changes during HNSCC development could be of great benefit for developing adjuvant anti-cancer schemes other than conventional therapies. However, the following questions are still poorly understood: (i) how does metabolic reprogramming occur during HNSCC development? (ii) how does the tumorous milieu contribute to HNSCC tumourigenesis? and (iii) at the molecular level, how do various metabolic cues interact with each other to control the oncogenicity and therapeutic sensitivity of HNSCC? In this review article, the regulatory roles of different metabolic pathways in HNSCC and its microenvironment in controlling the malignancy are therefore discussed in the hope of providing a systemic overview regarding what we knew and how cancer metabolism could be translated for the development of anti-cancer therapeutic reagents.
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21
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Frydrych AM, Kujan O, Farah CS. Chronic disease comorbidity in patients with oral leukoplakia. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41548-018-0015-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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22
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Verhulst MJL, Loos BG, Gerdes VEA, Teeuw WJ. Evaluating All Potential Oral Complications of Diabetes Mellitus. Front Endocrinol (Lausanne) 2019; 10:56. [PMID: 30962800 PMCID: PMC6439528 DOI: 10.3389/fendo.2019.00056] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/22/2019] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus (DM) is associated with several microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular diseases. The pathogenesis of these complications is complex, and involves metabolic and hemodynamic disturbances, including hyperglycemia, insulin resistance, dyslipidemia, hypertension, and immune dysfunction. These disturbances initiate several damaging processes, such as increased reactive oxygen species (ROS) production, inflammation, and ischemia. These processes mainly exert their damaging effect on endothelial and nerve cells, hence the susceptibility of densely vascularized and innervated sites, such as the eyes, kidneys, and nerves. Since the oral cavity is also highly vascularized and innervated, oral complications can be expected as well. The relationship between DM and oral diseases has received considerable attention in the past few decades. However, most studies only focus on periodontitis, and still approach DM from the limited perspective of elevated blood glucose levels only. In this review, we will assess other potential oral complications as well, including: dental caries, dry mouth, oral mucosal lesions, oral cancer, taste disturbances, temporomandibular disorders, burning mouth syndrome, apical periodontitis, and peri-implant diseases. Each oral complication will be briefly introduced, followed by an assessment of the literature studying epidemiological associations with DM. We will also elaborate on pathogenic mechanisms that might explain associations between DM and oral complications. To do so, we aim to expand our perspective of DM by not only considering elevated blood glucose levels, but also including literature about the other important pathogenic mechanisms, such as insulin resistance, dyslipidemia, hypertension, and immune dysfunction.
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Affiliation(s)
- Martijn J. L. Verhulst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
- *Correspondence: Martijn J. L. Verhulst
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
| | - Victor E. A. Gerdes
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, Netherlands
| | - Wijnand J. Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
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23
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Yen AMF, Wang ST, Peng BY, Cheng YC, Siewchaisakul P, Hsu CY, Chen SLS. Impact of oral potentially malignant disorder subtypes on all-cause and cause-specific mortality in males. Oral Dis 2018; 25:750-757. [PMID: 30592115 DOI: 10.1111/odi.13028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To quantify the effect of oral potentially malignant disorder (OPMD) subtypes on mortality from oral cancer and type 2 diabetes among areca nut chewers and/or cigarette smokers. MATERIALS AND METHODS A retrospective cohort design was devised to follow 14,749 men attending community-based screening program for oral cancer between 1998 and 2000 and followed until 2010. The Cox proportional hazards regression model was applied to assess the effect of OPMD on death. RESULTS A total of 1,291(8.75%) patients were detected as OPMD. Among those free of T2DM at baseline, the elevated risk for death from T2DM was noted for OSF (aHR = 3.62, 95% CI: 1.25-10.51) and erythroplakia (aHR = 5.01, 95% CI: 1.17-21.45). The elevated risk for all-cause death for OPMD was mainly explained by deaths from oral cancer and T2DM but not other causes of death. CONCLUSIONS Oral potentially malignant disorder, particularly OSF and erythroplakia, in male cigarette smokers and/or areca nut chewers led to an incremental elevated risk of T2DM mortality in the way of being distal to the occurrence of T2DM, implying that early detection and prevention of OPMD may not only reduce oral cancer mortality but also result in the reduction of T2DM mortality.
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Affiliation(s)
- Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Oral Health Care Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sen-Te Wang
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Bou-Yue Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ya-Chung Cheng
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Pallop Siewchaisakul
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Oral Health Care Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chen-Yang Hsu
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Oral Health Care Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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24
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Reduced CD8 + T cells infiltration can be associated to a malignant transformation in potentially malignant oral epithelial lesions. Clin Oral Investig 2018; 23:1913-1919. [PMID: 30229300 DOI: 10.1007/s00784-018-2622-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 09/06/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the immunohistochemical expressions of PD1, CD4+, and CD8+ in premalignant lesions (OPML) that were transformed into oral squamous cell carcinoma OSCC (OPML-OSCC), in OSCC and also in premalignant lesions that were not transformed into OSCC (OPML-NOSSC). MATERIALS AND METHODS Retrospective analyses were performed in order to verify the demographic characteristics of the patients. CD4, CD8, and PD1 IMH studies were carried out on OPML and OSCC samples from 11 patients with OPML-OSCC and OPML, together with samples from 14 patients with OPML-NOSCC. The differences between OPML-OSCC and OPML-NOSCC were analyzed. RESULTS Non-homogenous leukoplakia, together with the related oral subsite, and the lack of an exposure to tobacco, were all associated with malignant transformations. There were no statistical differences in the PD1 expression and the CD4+ cells in OPML-OSCC and OPML-NOSCC. A significant increment in the CD8+ cells was noted in the OPML that evolved into carcinomas when compared with OPML-NOSCC (p = 0.05), whereas there were higher CD8+ cells levels in the carcinomas when compared with the OPML that evolved into carcinomas (p = 0.027). CONCLUSIONS CD8+ cells infiltrate more in OPML-NOSCC than in OPML-OSCC. Carcinoma is more infiltrated by CD8+ cells than its associated OPML. CLINICAL RELEVANCE Understanding immunological factors associated with malignant transformation of oral premalignant lesions can open a new way to treat this disease.
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26
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Porter S, Gueiros LA, Leão JC, Fedele S. Risk factors and etiopathogenesis of potentially premalignant oral epithelial lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:603-611. [PMID: 29891084 DOI: 10.1016/j.oooo.2018.03.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/03/2018] [Accepted: 03/06/2018] [Indexed: 12/27/2022]
Abstract
Potentially malignant oral mucosal disease has some ability to give rise to malignancy of the oral epithelium, that is, oral squamous cell carcinoma (OSCC). The present article provides a succinct review of the possible or probable causes of potentially premalignant oral epithelial lesions. There is a focus upon studies that examined the causes or etiologic associations with clinically likely or histopathologically detectable oral epithelial dysplasia.
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Affiliation(s)
| | - Luiz Alcino Gueiros
- Oral Medicine Unit. Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Brazil
| | - Jair Carneiro Leão
- Oral Medicine Unit. Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Brazil
| | - Stefano Fedele
- UCL Eastman Dental Institute, London, UK; Oral Theme of the UCL/UCLH NIHR Biomedical Research Centre, UK
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27
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Speight PM, Khurram SA, Kujan O. Oral potentially malignant disorders: risk of progression to malignancy. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:612-627. [PMID: 29396319 DOI: 10.1016/j.oooo.2017.12.011] [Citation(s) in RCA: 261] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/04/2017] [Accepted: 12/05/2017] [Indexed: 01/08/2023]
Abstract
Oral potentially malignant disorders (OPMDs) have a statistically increased risk of progressing to cancer, but the risk varies according to a range of patient- or lesion-related factors. It is difficult to predict the risk of progression in any individual patient, and the clinician must make a judgment based on assessment of each case. The most commonly encountered OPMD is leukoplakia, but others, including lichen planus, oral submucous fibrosis, and erythroplakia, may also be seen. Factors associated with an increased risk of malignant transformation include sex; site and type of lesion; habits, such as smoking and alcohol consumption; and the presence of epithelial dysplasia on histologic examination. In this review, we attempt to identify important risk factors and present a simple algorithm that can be used as a guide for risk assessment at each stage of the clinical evaluation of a patient.
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Affiliation(s)
- Paul M Speight
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, Australia
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28
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Richter P, Faroon O, Pappas RS. Cadmium and Cadmium/Zinc Ratios and Tobacco-Related Morbidities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1154. [PMID: 28961214 PMCID: PMC5664655 DOI: 10.3390/ijerph14101154] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 09/20/2017] [Accepted: 09/22/2017] [Indexed: 01/04/2023]
Abstract
Metals are one of five major categories of carcinogenic or toxic constituents in tobacco and tobacco smoke. Cadmium is highly volatile and a higher percentage of the total tobacco cadmium content is efficiently transferred to mainstream tobacco smoke than many other toxic metals in tobacco. Inhaled cadmium bioaccumulates in the lungs and is distributed beyond the lungs to other tissues, with a total body biological half-life of one to two decades. Chronic cadmium exposure through tobacco use elevates blood and urine cadmium concentrations. Cadmium is a carcinogen, and an inducer of proinflammatory immune responses. Elevated exposure to cadmium is associated with reduced pulmonary function, obstructive lung disease, bronchogenic carcinoma, cardiovascular diseases including myocardial infarction, peripheral arterial disease, prostate cancer, cervical cancer, pancreatic cancer, and various oral pathologies. Cadmium and zinc have a toxicologically inverse relationship. Zinc is an essential element and is reportedly antagonistic to some manifestations of cadmium toxicity. This review summarizes associations between blood, urine, and tissue cadmium concentrations with emphasis on cadmium exposure due to tobacco use and several disease states. Available data about zinc and cadmium/zinc ratios and tobacco-related diseases is summarized from studies reporting smoking status. Collectively, data suggest that blood, urine, and tissue cadmium and cadmium/zinc ratios are often significantly different between smokers and nonsmokers and they are also different in smokers for several diseases and cancers. Additional biomonitoring data such as blood or serum and urine zinc and cadmium levels and cadmium/zinc ratios in smokers may provide further insight into the development and progression of diseases of the lung, cardiovascular system, and possibly other organs.
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Affiliation(s)
- Patricia Richter
- Tobacco and Volatiles Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F44, Atlanta, GA 30341, USA.
| | - Obaid Faroon
- Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - R Steven Pappas
- Tobacco and Volatiles Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F44, Atlanta, GA 30341, USA.
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Liang H, Yang Z, Wang JB, Yu P, Fan JH, Qiao YL, Taylor PR. Association between oral leukoplakia and risk of upper gastrointestinal cancer death: A follow-up study of the Linxian General Population Trial. Thorac Cancer 2017; 8:642-648. [PMID: 28929584 PMCID: PMC5707438 DOI: 10.1111/1759-7714.12501] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 07/26/2017] [Accepted: 07/27/2017] [Indexed: 01/31/2023] Open
Abstract
Background This study was conducted to explore the association between oral leukoplakia (OL) and the risk of upper gastrointestinal cancer death in the Linxian General Population Trial Cohort. Methods A prospective cohort study of the Linxian General Population Trial Cohort was performed. Participants with OL were treated as an exposed group, and the remainder was selected as a control group. All subjects were followed monthly by village health workers and reviewed quarterly by the Linxian Cancer Registry. Hazard ratios (HRs) and 95% confidence interval (CIs) were evaluated using proportional hazard and proportional subdistribution hazard models, respectively. Results Over a median of 27 years of observation, 29 476 subjects were followed‐up. A total of 17 473 deaths occurred, including 2345 esophageal squamous cell carcinoma (ESCC), 1139 gastric cardia carcinoma, and 506 gastric non‐cardia carcinoma deaths. Significant increased ESCC mortality was observed in subjects with OL (exposed 9.66% vs. unexposed 7.39%; P < 0.0001). Furthermore, subjects with OL had a 22% higher risk of death from ESCC (HR 1.22, 95% CI 1.10–1.34; P = 0.0001) after adjusted covariates. In subjects aged ≤52 at the baseline, OL was significantly associated with an elevated risk of ESCC mortality (HR 1.32, 95% CI 1.13–1.54; P = 0.0005). No significant associations were observed for gastric cardia carcinoma and non‐cardia carcinoma mortality. Conclusions OL may increase the risk of ESCC mortality, especially in the younger population. These associations should be investigated in further studies.
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Affiliation(s)
- He Liang
- Department of Cancer Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital, Beijing, China
| | - Zhao Yang
- Department of Cancer Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital, Beijing, China
| | - Jian-Bing Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Pei Yu
- Department of Cancer Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital, Beijing, China
| | - Jin-Hu Fan
- Department of Cancer Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital, Beijing, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College Cancer Hospital, Beijing, China
| | - Philip R Taylor
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Sakata J, Yoshida R, Matsuoka Y, Nagata M, Hirosue A, Kawahara K, Nakamura T, Nakamoto M, Hirayama M, Takahashi N, Nakashima H, Arita H, Ogi H, Hiraki A, Shinohara M, Nakayama H. Predictive value of the combination of SMAD4 expression and lymphocyte infiltration in malignant transformation of oral leukoplakia. Cancer Med 2017; 6:730-738. [PMID: 28256094 PMCID: PMC5387127 DOI: 10.1002/cam4.1005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/02/2016] [Accepted: 12/12/2016] [Indexed: 12/21/2022] Open
Abstract
Oral leukoplakia (OL) is a common, potentially malignant disorder of the oral cavity. SMAD4 was initially identified as a tumor suppressor and central mediator of transforming growth factor (TGF)‐β signaling. In this study, we aimed to determine the expression patterns of SMAD4 in OL, its relationship with the degree of inflammation, and its clinical implications as a biomarker for OL malignant transformation. A total of 150 patients with OL were enrolled in this study. Paraffin‐embedded sections obtained from biopsy or resection specimens were subjected to immunohistochemical analysis. Associations among the status of epithelial SMAD4 expression, stromal lymphocyte infiltration, and malignant transformation of OL were examined. Malignant transformation was significantly associated with the status of SMAD4 expression (P = 0.0017) and lymphocyte infiltration status (P = 0.0054). Cox regression analysis, based on the event‐free survival (EFS), revealed that a low SMAD4 expression was a significant prognostic factor in OL patients (hazard ratio, 2.632; P = 0.043). In addition, a low SMAD4 expression was closely correlated with high lymphocyte infiltration (P = 0.00035), resulting in a significant correlation between the combination of low SMAD4 expression and high lymphocyte infiltration with malignant transformation of OL (P = 0.00027). The combination of the status of epithelial SMAD4 expression and stromal lymphocyte infiltration may be a useful biomarker for predicting malignant transformation in OL patients. These results suggest that not only epithelial SMAD4 loss, but also stromal features, may regulate the risk of malignant transformation of OL.
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Affiliation(s)
- Junki Sakata
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Ryoji Yoshida
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuichiro Matsuoka
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masashi Nagata
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Akiyuki Hirosue
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenta Kawahara
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takuya Nakamura
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masafumi Nakamoto
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masatoshi Hirayama
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Nozomu Takahashi
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hikaru Nakashima
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hidetaka Arita
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hidenao Ogi
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Akimitsu Hiraki
- Section of Oral Oncology, Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka, Japan
| | | | - Hideki Nakayama
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Granero Fernandez M, Lopez-Jornet P. Association between smoking, glycaemia, blood lipoproteins and risk of oral leukoplakia. Aust Dent J 2016; 62:47-51. [DOI: 10.1111/adj.12431] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2016] [Indexed: 12/15/2022]
Affiliation(s)
- M Granero Fernandez
- Oral Medicine; Faculty of Medicine; University of Murcia; Spain Murcia Institute of Bio-Health Research (IMIB-Arrixaca); Murcia Spain
| | - P Lopez-Jornet
- Clínica Odontológica Universitaria Medicina Oral; Hospital Morales Meseguer Adv. Marques de los velez s/n; Murcia Spain
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Abbasi F, Raoof M, Khatami R, Shadman N, Borjian-Boroojeni F, Nazari F. Effectiveness of Amlexanox and Adcortyl for the treatment of recurrent aphthous ulcers. J Clin Exp Dent 2016; 8:e368-e372. [PMID: 27703603 PMCID: PMC5045682 DOI: 10.4317/jced.52540] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 09/05/2015] [Indexed: 11/28/2022] Open
Abstract
Background Recurrent aphthous stomatitis (RAS) is a common condition that affects approximately 20% of the general population. The ulcers can interfere with speech and eating and cause significant pain and discomfort. This study aimed to evaluate the efficacy of Amlexanox and Adcortyl in the treatment of aphthous ulcers. Material and Methods In this randomized double blind clinical trial with sequential patient entry, a total of 40 patients who presented with aphthous ulcers were included. Patients were received Amlexanox or Adcortyl four times daily for 7 days. Patients were evaluated for pain, lesion size, and tingling at one day, three days, five days and seven days follow-ups. The treatment effects were then evaluated using the Wilcoxon–Mann–Whitney (WMW) test. Values of p<0.05 were considered significant. Results No significant differences in pain score, tingling and lesion size were observed on similar days between Amlexanox and Adcortyl groups. In both groups, reduction in the assessed variables was significant between days 1-3, 3-5, and 5-7 (p < 0.001). Conclusions This study indicated that Amlexanox as well as Adcortyl was effective in relieving pain and reducing the lesion size during the treatment of aphthous ulcers. Key words:Recurrent aphthous stomatitis, Amlexanox, Adcortyl, pain relief.
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Affiliation(s)
- Farid Abbasi
- Associate Professor. Department of Oral Medicine, School of Dentistry, Shahed University of Medical Sciences, Tehran, Iran
| | - Maryam Raoof
- Assistant Professor. Laboratory of Molecular Neuroscience, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Roya Khatami
- Postgraduate Student of Oral Medicine. School of Dentistry, Shahed University, Tehran, Iran
| | - Niloofar Shadman
- Assistant Professor. Department of Operative Dentistry, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Farahnaz Nazari
- Postgraduate Student of Endodontics. School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
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Feng Z, Xu QS, Qin LZ, Li H, Huang X, Su M, Han Z. Second primary cancer after index head and neck squamous cell carcinoma in Northern China. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:95-102. [PMID: 27720651 DOI: 10.1016/j.oooo.2016.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/04/2016] [Accepted: 08/11/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate the clinicopathologic features, prognostic factors, and management of patients in the North Chinese population with head and neck squamous cell carcinoma (HNSCC) who developed a second primary malignancy (SPM). METHODS This was a retrospective study including 1818 eligible patients between June 1999 and April 2011. RESULTS A total of 188 HNSCC patients developed SPM. Multiple oral dysplastic lesions (MODLs) (P < .001) were among the risk factors for occurrence of SPM. However, MODLs were closely associated with many mild pathologic features, such as early T stage (P < .001), early N stage (P = .036), good pathologic differentiation (P < .001), and mild growth pattern (P < .001). Interestingly, multivariate survival analysis showed that SPM patients had a better prognosis if they had the characteristics of MODLs (P = .020). CONCLUSIONS MODLs were a crucial risk factor leading to the occurrence of oral SPM after an index HNSCC in patients in Northern China. However, SPM patients with the characteristics of MODLs had a better prognosis.
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Affiliation(s)
- Zhien Feng
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Qiao Shi Xu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Li Zheng Qin
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Hua Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Xin Huang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Ming Su
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Zhengxue Han
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
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Lodi G, Franchini R, Warnakulasuriya S, Varoni EM, Sardella A, Kerr AR, Carrassi A, MacDonald LCI, Worthington HV. Interventions for treating oral leukoplakia to prevent oral cancer. Cochrane Database Syst Rev 2016; 7:CD001829. [PMID: 27471845 PMCID: PMC6457856 DOI: 10.1002/14651858.cd001829.pub4] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Oral leukoplakia is a relatively common oral lesion that, in a small proportion of people, precedes the development of oral cancer. Most leukoplakias are asymptomatic; therefore, the primary objective of treatment should be to prevent onset of cancer. This review updates our previous review, published in 2006. OBJECTIVES To assess the effectiveness, safety and acceptability of treatments for leukoplakia in preventing oral cancer. SEARCH METHODS We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 16 May 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 4), MEDLINE Ovid (1946 to 16 May 2016), Embase Ovid (1980 to 16 May 2016) and CancerLit via PubMed (1950 to 16 May 2016). We searched the metaRegister of Controlled Trials (to 10 February 2015), ClinicalTrials.gov (to 16 May 2016) and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials (to 16 May 2016). We placed no restrictions on the language or date of publication when searching electronic databases. SELECTION CRITERIA We included randomised controlled trials (RCTs) that enrolled people with a diagnosis of oral leukoplakia and compared any treatment versus placebo or no treatment. DATA COLLECTION AND ANALYSIS We collected data using a data extraction form. Oral cancer development, demonstrated by histopathological examination, was our primary outcome. Secondary outcomes were clinical resolution of the lesion, improvement of histological features and adverse events. We contacted trial authors for further details when information was unclear. When valid and relevant data were available, we conducted a meta-analysis of the data using a fixed-effect model when we identified fewer than four studies with no heterogeneity. For dichotomous outcomes, we calculated risk ratios (RRs) and 95% confidence intervals (CIs). We assessed risk of bias in studies by using the Cochrane tool. We assessed the overall quality of the evidence by using standardised criteria (Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE)). MAIN RESULTS We included 14 studies (909 participants) in this review. Surgical interventions, including laser therapy and cryotherapy, have never been studied by means of an RCT that included a no treatment or placebo arm. The included trials tested a range of medical and complementary treatments, in particular, vitamin A and retinoids (four studies); beta carotene or carotenoids (three studies); non-steroidal anti-inflammatory drugs (NSAIDs), specifically ketorolac and celecoxib (two studies); herbal extracts (four studies), including tea components, a Chinese herbal mixture and freeze-dried black raspberry gel; bleomycin (one study); and Bowman-Birk inhibitor (one study).We judged one study to be at low risk of bias, seven at unclear risk and six at high risk. In general, we judged the overall quality of the evidence to be low or very low, so findings are uncertain and further research is needed.Five studies recorded cancer incidence, only three of which provided useable data. None of the studies provided evidence that active treatment reduced the risk of oral cancer more than placebo: systemic vitamin A (RR 0.11, 95% CI 0.01 to 2.05; 85 participants, one study); systemic beta carotene (RR 0.71, 95% CI 0.24 to 2.09; 132 participants, two studies); and topical bleomycin (RR 3.00, 95% CI 0.32 to 27.83; 20 participants, one study). Follow-up ranged between two and seven years.Some individual studies suggested effectiveness of some proposed treatments, namely, systemic vitamin A, beta carotene and lycopene, for achieving clinical resolution of lesions more often than placebo. Similarly, single studies found that systemic retinoic acid and lycopene may provide some benefit in terms of improvement in histological features. Some studies also reported a high rate of relapse.Side effects of varying severity were often described; however, it seems likely that interventions were well accepted by participants because drop-out rates were similar between treatment and control groups. AUTHORS' CONCLUSIONS Surgical treatment for oral leukoplakia has not been assessed in an RCT that included a no treatment or placebo comparison. Nor has cessation of risk factors such as smoking been assessed. The available evidence on medical and complementary interventions for treating people with leukoplakia is very limited. We do not currently have evidence of a treatment that is effective for preventing the development of oral cancer. Treatments such as vitamin A and beta carotene may be effective in healing oral lesions, but relapses and adverse effects are common. Larger trials of longer duration are required to properly evaluate the effects of leukoplakia treatments on the risk of developing oral cancer. High-quality research is particularly needed to assess surgical treatment and to assess the effects of risk factor cessation in people with leukoplakia.
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Affiliation(s)
- Giovanni Lodi
- Università degli Studi di MilanoDipartimento di Scienze Biomediche, Chirurgiche e OdontoiatricheVia Beldiletto 1/3MilanItaly20142
| | - Roberto Franchini
- Università degli Studi di MilanoDipartimento di Scienze Biomediche, Chirurgiche e OdontoiatricheVia Beldiletto 1/3MilanItaly20142
| | - Saman Warnakulasuriya
- King's College LondonClinical and Diagnostic SciencesBessemer RoadDenmark Hill CampusLondonUKSE5 9RW
| | - Elena Maria Varoni
- Università degli Studi di MilanoDipartimento di Scienze Biomediche, Chirurgiche e OdontoiatricheVia Beldiletto 1/3MilanItaly20142
| | - Andrea Sardella
- Università degli Studi di MilanoDipartimento di Scienze Biomediche, Chirurgiche e OdontoiatricheVia Beldiletto 1/3MilanItaly20142
| | - Alexander R Kerr
- New York University College of DentistryDepartment of Oral and Maxillofacial Pathology, Radiology and Medicine345 East 24th StreetSchwartz BuildingNew YorkUSA10010
| | - Antonio Carrassi
- Università degli Studi di MilanoDipartimento di Scienze Biomediche, Chirurgiche e OdontoiatricheVia Beldiletto 1/3MilanItaly20142
| | - L CI MacDonald
- School of Dentistry, The University of ManchesterCochrane Oral HealthJ R Moore Building, Oxford RoadManchesterUK
| | - Helen V Worthington
- School of Dentistry, The University of ManchesterCochrane Oral HealthJ R Moore Building, Oxford RoadManchesterUK
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Mondal K, Mandal R, Sarkar BC. A study of Ki-67 expression and its clinicopathological determinants in nondysplastic oral leukoplakia. Contemp Clin Dent 2016; 7:493-499. [PMID: 27994417 PMCID: PMC5141664 DOI: 10.4103/0976-237x.194106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Context: Oral cancer is the third most prevalent malignancy in India. Leukoplakia is its most common precursor lesion. Aims: This study aimed at evaluation of the Ki-67 expression and thereby detection of the dysplastic potential in histopathologically nondysplastic oral leukoplakia (OL). Secondarily, another purpose was to correlate various clinicopathological factors with the labeling indices (LIs) of Ki-67 in those cases as well. Settings and Design: In total, 97 OL cases were examined. Relevant clinical and demographic information was retrieved from the pro forma, prefilled by the patients themselves during their first visit. Subjects and Methods: Ki-67 immunohistochemical staining was performed on paraffin-embedded tissue samples. Its LIs were calculated and correlated with different clinicopathological parameters using statistical software SPSS version 16.0. Results: 58.8% (57 cases) lesions exhibited a Ki-67 positivity of ≤5%, and 25.8% (25 cases) lesions exhibited it in the range of 6%–25%. Only 15 (15.4%) patches were stained positively between 26% and 60%. Patients’ age beyond 50 years, nonhomogeneous leukoplakia, and tobacco addiction were the significant risk factors for high Ki-67 scores (P < 0.05). Conclusions: Ki-67 is an essential immunohistochemical marker for epithelial dysplasia in OL, especially when the conventional histopathology fails to appreciate the same. In this purpose, Ki-67 labeling on a routine basis delivers the most convenient results for patients aged above 50 years, and/or addicted to tobacco products, and/or suffering from nonhomogeneous patches.
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Affiliation(s)
- Krishnendu Mondal
- Department of Pathology, North Bengal Medical College and Hospital, Darjeeling, West Bengal, India
| | - Rupali Mandal
- Department of Pathology, North Bengal Medical College and Hospital, Darjeeling, West Bengal, India
| | - Badal Chandra Sarkar
- Department of Oral Pathology, North Bengal Dental College and Hospital, Darjeeling, West Bengal, India
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Vellappally S, Binmgren MA, Huraib SB, Hashem MI, Patil S, Anil S. Assessment of DNA Damage in Leukoplakia Patients with Different Degrees of Dysplasia. J Contemp Dent Pract 2015; 16:971-6. [PMID: 27018032 DOI: 10.5005/jp-journals-10024-1790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Single cell gel electrophoresis (SCGE) assay also known as comet assay is a rapid and highly sensitive fluorescent molecular technique for detecting various forms of deoxyribonucleic acid (DNA) damage at individual cellular level. MATERIALS AND METHODS The present study was done to detect the extent of DNA damage in oral leukoplakia (OL) and compare with normal individuals. The sample population was obtained from an outpatient clinic of a tertiary teaching dental institute. A total of 36 consecutive patients with leukoplakia and 10 healthy normal volunteers were recruited for the study and assessed for the extent of DNA damage using SCGE following clinical diagnosis and histological grading. Peripheral blood was obtained by venipuncture and SCGE assay was performed. Mean comet tail length was recorded and analyzed statistically to compare the extent of damage in each group. RESULTS The mean comet tail length seen in leukoplakia patients with moderate to severe dysplasia was 1.25 ± 0.14 mm while for the control subjects, it was 0.31 ± 0.10 mm. The difference was statistically significant (p = 0.000). On comparing within the grades of leukoplakia, a progressive trend of increasing tail length was observed with increasing grades of dysplasia. CONCLUSION Deoxyribonucleic acid damage as measured by SCGE is seen in leukoplakia. A stepwise increase in DNA damage levels from healthy controls, through patients with non-dysplastic epithelium to varying grades of dysplasia has been observed indicating the extent of DNA damage in this high risk group.
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Affiliation(s)
- Sajith Vellappally
- Assistant Professor, Department of Dental Health, Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia, e-mail:
| | - Mohammed A Binmgren
- Department of Dental Health, Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sahar Bin Huraib
- Department of Dental Health, Dental Public Health, College of Applied Medical Sciences, King Saud University, Riyadh Saudi Arabia
| | - Mohamed I Hashem
- Department of Dental Health, College of Applied Medical Science, King Saud University; Dental Biomaterial Department Al-Azhar University, Cairo, Egypt
| | | | - Sukumaran Anil
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Feng Z, Xu QS, Niu QF, Qin LZ, Li JZ, Su M, Li H, Han Z. Risk factors for patients with multiple synchronous primary cancers involving oral and oropharyngeal subsites. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 121:360-6. [PMID: 26899291 DOI: 10.1016/j.oooo.2015.10.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 10/05/2015] [Accepted: 10/29/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate risk factors and prognosis for multiple synchronous primary cancers (MSPCs) associated with head and neck squamous cell carcinoma. STUDY DESIGN The retrospective study included 1623 patients. RESULTS The most common MSPC site involved was the head and neck region. The presence of multiple oral dysplastic lesions (P < .001) was the sole risk factor for the occurrence of MSPCs. A multivariate survival analysis showed that the pathologic grade (P = .003) was an independent predictive factor for the 5-year disease-specific survival of patients with MSPCs. A Kaplan-Meier analysis showed that the 5-year disease-specific survival of patients who developed MSPCs was worse than that of patients who did not develop MSPCs (P = .020). CONCLUSIONS MSPCs are a significant negative prognostic factor for patients with head and neck squamous cell carcinoma. However, a worse prognosis is predicted for patients with MSPCs with several features: a higher pathologic grade, a more aggressive growth pattern, male gender plus a tobacco or alcohol habit, and no multiple oral dysplastic lesions.
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Affiliation(s)
- Zhien Feng
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Qiao Shi Xu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Qi Fang Niu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Li Zheng Qin
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Jin Zhong Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Ming Su
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Hua Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Zhengxue Han
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
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Type 2 diabetes mellitus and risk of oral cancer and precancerous lesions: a meta-analysis of observational studies. Oral Oncol 2015; 51:332-40. [PMID: 25650271 DOI: 10.1016/j.oraloncology.2015.01.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/22/2014] [Accepted: 01/02/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Associations between type 2 diabetes mellitus (type 2 DM) and risk of oral cancer and precancerous lesions have been reported with controversial findings. We performed a meta-analysis to explore these associations. METHODS We identified studies by a literature search of MEDLINE and EMBASE through May 31, 2014, and by searching the reference lists of pertinent articles. Summary relative risk (SRR) with 95% confidence interval (CI) was calculated with a random-effects model. Between- study heterogeneity was assessed using the Cochran's Q and I(2) statistics. RESULTS A total of 13 studies (4 case-control and 9 cohort studies) on the association between type 2 DM and oral cancer were included. Overall analysis found that compared with non-diabetic individuals, individuals with type 2 DM had a significantly elevated incidence of oral cancer (SRR=1.15, 95% CI: 1.02-1.29; Pheterogeneity=0.277, I(2)=15.4%; 10 studies). Subgroup analyses found that duration of follow-up (⩾11years) significantly altered this positive association. Type 2 DM was associated with increased oral cancer mortality (SRR=1.41, 95% CI: 1.16-1.72; 4 studies). Meta-analysis of the four case-control studies showed a positive association between type 2 DM and risk of oral precancerous lesions (SRR=1.85, 95%CI: 1.23-2.80; Pheterogeneity=0.038, I(2)=57.5%). No significant public bias was found across these studies. CONCLUSIONS These findings of this meta-analysis indicate that compared with non-diabetic individuals, individuals with type 2 DM have an elevated risk of oral cancer and precancerous lesions development.
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Oral premalignant lesions: epidemiological and clinical analysis in the northern Polish population. Postepy Dermatol Alergol 2014; 31:341-50. [PMID: 25610347 PMCID: PMC4293380 DOI: 10.5114/pdia.2014.40932] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 08/15/2013] [Accepted: 09/18/2013] [Indexed: 01/18/2023] Open
Abstract
Introduction Leukoplakia is the most common potentially malignant condition of the oral cavity. Aim Epidemiological and clinical analysis of patients with oral leukoplakia (OL) diagnosed and treated in the Department of Maxillofacial and Oral Surgery, Medical University of Gdansk. Material and methods The study was retrospective and prospective. Among 55 911 patients diagnosed and treated in the Department in 1999–2009, 204 people with OL were selected. The material includes 104 women and 100 men with an average age of 58.1. Most of the patients were in the age group of 50–70 years, average age was 58.1. Results The most common concomitant disease was diabetes. More than 88% of the patients declared occurrence of OL predisposing development factors (50.49% – cigarette smoking). Three hundred and twenty foci of OL were found among patients. Homogeneous OL dominated (72.05%). Multifocal OL was diagnosed in 58.3% of patients. The most common location of lesions was buccal mucosa (52.2%). Cancers developed on the basis of OL in 7 patients (3.43%). The percentage of malignant transformation was 12.19% for untreated patients and 1.41% for treated patients. The floor of the oral cavity was proven to be the location of the highest risk of oral squamous cell carcinoma. Patients with diabetes may be more likely to develop OL. The risk of malignant transformation is relatively high. In our material it was equal to 3.43%. Conclusions Cigarette smoking is the most important factor, which can influence the effectiveness of treatment.
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García-Chías B, Casado-De La Cruz L, Esparza-Gómez GC, Cerero-Lapiedra R. Diagnostic criteria in proliferative verrucous leukoplakia: evaluation. Med Oral Patol Oral Cir Bucal 2014; 19:e335-9. [PMID: 24608210 PMCID: PMC4119307 DOI: 10.4317/medoral.19424] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 10/03/2013] [Indexed: 11/12/2022] Open
Abstract
Objectives: to evaluate the ability of the diagnostic criteria proposed by Cerero et al in 2010 to perform an early diagnose in patients with proliferative verrucous leukoplakia.
Study Design: retrospective study with patients diagnosed with leukoplakia at Oral Medicine Service at Oral Medicine and Surgery Department at Dentistry Faculty at Universidad Complutense of Madrid.
Results: the criteria were applied in 116 patients, turning positive in 40 cases. Out of these, 24 (60%) had been previously diagnosed with PVL. Most frequent criteria were major criteria A and E, concerning lesion’s site and histopathology, and minor criteria b and c, concerning sex and smoking habit.
Conclusions: diagnostic criteria developed by Cerero et al can be a useful tool for an early diagnose of PVL, as in 60% of the cases, the criteria would have allowed to make an early diagnose of the disease.
Key words:Proliferative verrucous leukoplakia, criteria, diagnose, early.
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Affiliation(s)
- Begoña García-Chías
- Department of Medicine and Buccofacial Surgery, Faculty of Dentistry, Complutense University of Madrid, Spain,
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Samatha Y, Sankar AJS, Ganapathy KS, Srinivas K, Ankineedu D, Choudary ALS. Clinicopathologic evaluation of lesions associated with tobacco usage. J Contemp Dent Pract 2014; 15:466-472. [PMID: 25576115 DOI: 10.5005/jp-journals-10024-1564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Tobacco usage in different forms is the single most common etiological factor responsible for oral cancers. The aim of the present study was to record various mucosal lesions associated with tobacco usage and to ascertain the prevalence of dysplasia in them by histopathological evaluation and to compare the extent of dysplastic features seen among patients associated with a habit of smoked and smokeless form of tobacco. MATERIALS AND METHODS Seventy-six patients with the clinical diagnosis of tobacco related lesions (Leukoplakia, Erythroplakia, Nicotina stomatitis, Tobacco pouch keratosis) were selected. A detailed description of the clinical presentation of the lesion was noted and the patients were subjected to incisional biopsy followed by a histopathological evaluation. RESULTS Showed dysplastic changes in 50 cases (65.8%) ranging from mild dysplasia in 27 cases (35.5%), moderate dysplasia in 17 cases (22.4%) and 6 cases (7.9%) showed severe dysplasia. Moderate to severe dysplasia was 1.83 times more likely to occur with smokeless tobacco usage when compared to smoked form. Data obtained from this study reveals that patients with a duration of tobacco usage more than 10 years were 2.17 times more likely to have moderate to severe dysplasia (p = 0.154). CONCLUSION Thus, the study highlights the role of oral physicians in detecting oral mucosal lesions and screening high-risk patients on a regular basis and also reaffrms the importance of public education, stressing the risk factors for oral cancers.
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Affiliation(s)
- Yalamanchili Samatha
- Associate Professor, Department of Oral Medicine and Radiology, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India, e-mail:
| | - Avula Jogendra Sai Sankar
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - K S Ganapathy
- Former Principal and Head, Department of Oral Medicine and Radiology, The Oxford Dental College and Research Centre, Bengaluru, Karnataka India
| | - Kandula Srinivas
- Professor, Department of Oral Medicine and Radiology, ACES Maruthi Dental College, Bengaluru, Karnataka, India
| | - Dasari Ankineedu
- Resident, Department of Oral Medicine, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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Su YW, Lin YH, Pai MH, Lo AC, Lee YC, Fang IC, Lin J, Hsieh RK, Chang YF, Chen CL. Association between phosphorylated AMP-activated protein kinase and acetyl-CoA carboxylase expression and outcome in patients with squamous cell carcinoma of the head and neck. PLoS One 2014; 9:e96183. [PMID: 24769813 PMCID: PMC4000216 DOI: 10.1371/journal.pone.0096183] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 04/04/2014] [Indexed: 01/07/2023] Open
Abstract
Background Epidemiological studies have indicated that impaired glucose metabolism may increase the risk of squamous cell carcinoma of the head and neck (SCCHN). AMP-activated protein kinase (AMPK) regulates glucose and lipid metabolism via the phosphorylation and subsequent inactivation of its downstream target acetyl-CoA carboxylase (ACC).Thus, we analyzed the expression of pAMPK and its downstream target phosphorylated acetyl-CoA carboxylase (pACC), as well as their impact on the survival of patients with resected SCCHN. Methods One hundred eighteen patients with surgically resected SCCHN were enrolled. Immunohistochemical (IHC) staining for pAMPK and pACC was performed using tissue microarrays of operative specimens of SCCHN. The expression was divided into two or three groups according to the IHC score [pAMPK: negative (0), positive (1–3); pACC: negative (0), low expression (1, 2), and high expression (3)]. Statistical analysis was performed to determine the association of pAMPK expression with clinicopathological features and pACC and pErk expression. Results The positive rates of pAMPK and pACC expression were 64.4% (76/118) and 68.6% (81/118), respectively. pAMPK was significantly higher in patients aged younger than 60 years (P = 0.024; χ2test) and those with early-stage (T1/T2; P = 0.02; χ2 test) and oral cavity (P = 0.026; Fisher’s exact test) tumors. In multivariate analysis, pAMPK expression was not significantly correlated with overall survival (OS) (adjusted hazard ratio [HR]: 0.66; 95% confidence interval [CI]: 0.35–1.23), whereas high pACC expression was independently associated with worse OS in node-positive patients (adjusted HR: 17.58; 95% CI: 3.50–88.18). Conclusions Strong expression of pACC was found to be an independent prognostic marker for patients with node-positive SCCHN. Our results suggest that pACC may play a role in tumor progression of SCCHN and may help to identify patient subgroups at high risk for poor disease outcome.
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Affiliation(s)
- Ying-Wen Su
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yun-Ho Lin
- Division of Oral Pathology, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Man-Hui Pai
- Department of Anatomy, Taipei Medical University, Taipei, Taiwan
| | - An-Chi Lo
- Good Clinical Research Center, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yu-Chieh Lee
- Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan
| | - I-Chih Fang
- Good Clinical Research Center, Mackay Memorial Hospital, Taipei, Taiwan
| | - Johnson Lin
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ruey-Kuen Hsieh
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yi-Fang Chang
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Good Clinical Research Center, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chi-Long Chen
- Department of Pathology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- * E-mail:
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He Y, Gong Y, Gu J, Lee JJ, Lippman SM, Wu X. Increased leukocyte mitochondrial DNA copy number is associated with oral premalignant lesions: an epidemiology study. Carcinogenesis 2014; 35:1760-4. [PMID: 24743515 DOI: 10.1093/carcin/bgu093] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Although changes in the mitochondrial DNA (mtDNA) copy number in peripheral blood leukocytes (PBLs) have been linked to increased susceptibility to several cancers, the relationship between the mtDNA copy number in PBLs and the risk of cancer precursors has not been investigated. In this study, we measured the relative mtDNA copy number in PBLs of 143 patients with histologically confirmed oral premalignant lesions (OPLs) and of 357 healthy controls that were frequency-matched to patients according to age, sex and race. OPL patients had a significantly higher mtDNA copy number than the controls (1.36 ± 0.74 versus 1.11 ± 0.32; P < 0.001). In analyses stratified by sex, race, alcohol consumption and smoking status, the mtDNA copy number was higher in the OPL patients than in the controls in all the strata. Using the median mtDNA copy number in the control group as a cutoff, we found that individuals with a high mtDNA copy number had significantly higher risk of having OPLs than individuals with a low mtDNA copy number (adjusted odds ratio, 1.93; 95% confidence interval, 1.23-3.05, P = 0.004). Analysis of the joint effect of alcohol consumption and smoking revealed even greater risk for OPLs. Our results suggest that high mtDNA copy number in PBLs is significantly associated with having OPLs. To our knowledge, this is the first epidemiologic study to show that the mtDNA copy number may indicate the risk of cancer precursors.
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Affiliation(s)
- Yonggang He
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA, Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yilei Gong
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jian Gu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - J Jack Lee
- Department of Biostatistics, The University of Texas MD Anderson Center, Houston, TX 77030, USA and
| | - Scott M Lippman
- Moores Cancer Center, University of California San Diego, San Diego, CA 92093, USA
| | - Xifeng Wu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA,
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A retrospective analysis of clinical features of oral malignant and potentially malignant disorders with and without oral epithelial dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:725-33. [DOI: 10.1016/j.oooo.2013.08.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/05/2013] [Accepted: 08/07/2013] [Indexed: 12/20/2022]
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Lisa Cheng YS, Jordan L, Gorugantula LM, Schneiderman E, Chen HS, Rees T. Salivary interleukin-6 and -8 in patients with oral cancer and patients with chronic oral inflammatory diseases. J Periodontol 2013; 85:956-65. [PMID: 24147842 DOI: 10.1902/jop.2013.130320] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Previous research has indicated that salivary interleukin (IL)-6 and IL-8 are potential biomarkers for oral squamous cell carcinoma (OSCC). However, their levels have been found to be significantly elevated in patients with chronic periodontitis (CP) or oral lichen planus (OLP). The data also showed wide variations in levels among the different studies, and no standardization procedure was ever performed. Therefore, the objective of this study is to determine whether CP or OLP confounds the use of IL-6 or IL-8 for OSCC detection. METHODS Saliva samples were collected from five groups: OSCC before treatment (n = 18); CP (n = 21); disease-active OLP (n = 21); disease-inactive OLP (n = 20); and healthy controls (n = 21). IL-6 and IL-8 concentrations (determined by enzyme-linked immunosorbent assays) were compared, using total salivary protein-standardized levels to validate the data. The Kruskal-Wallis test (α = 0.05) followed by pairwise Mann-Whitney U (post hoc) tests with Bonferroni adjustments (α = 0.00625) were used for statistical analysis. RESULTS Salivary IL-6 levels were significantly higher in patients with OSCC than in patients with CP (P <0.001), disease-active OLP (P = 0.001), disease-inactive OLP (P <0.001), and healthy controls (P <0.001). Salivary IL-8 levels were significantly higher in patients with OSCC than in patients with CP (P <0.001), but only marginally significantly higher than in healthy controls (P = 0.014). Statistical results of standardized IL-6 and IL-8 levels were consistent with the non-standardized levels in all pairs except one. CONCLUSION Salivary IL-6 may be a useful biomarker in the detection of OSCC, unconfounded by CP or OLP.
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Affiliation(s)
- Yi-Shing Lisa Cheng
- Diagnostic Sciences, Baylor College of Dentistry, Texas A&M University, Dallas, TX
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Stott-Miller M, Chen C, Schwartz SM. Type II diabetes and metabolic syndrome in relation to head and neck squamous cell carcinoma risk: A SEER-Medicare database study. Cancer Epidemiol 2013; 37:428-33. [DOI: 10.1016/j.canep.2013.03.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 03/01/2013] [Accepted: 03/11/2013] [Indexed: 01/05/2023]
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Taggart MW, Rashid A, Ross WA, Abraham SC. Oesophageal hyperkeratosis: clinicopathological associations. Histopathology 2013; 63:463-73. [PMID: 23879628 DOI: 10.1111/his.12195] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 05/16/2013] [Indexed: 12/31/2022]
Abstract
AIMS Oesophageal hyperkeratosis is rarely described. In contrast to hyperkeratosis of orolaryngeal mucosa, where its risk factors and association with squamous neoplasia are well-studied, the prevalence and clinicopathological features of oesophageal hyperkeratosis are unknown. METHODS AND RESULTS We reviewed prospectively 1845 oesophageal biopsies and found hyperkeratosis in 37 (2.0%). Among 98 patients studied, hyperkeratosis occurred in two distinct settings: group 1 [within Barrett's oesophagus (BO)/adenocarcinoma, n = 61, 62%] and group 2 (outside BO/adenocarcinoma, n = 37, 38%). In contrast to group 1, hyperkeratosis in group 2 was more often multifocal (>3 foci in 51% versus 16%, P = 0.0001), involved mid-oesophagus (51% versus 2%, P < 0.0001), showed endoscopic leucoplakia (24% versus 3%, P = 0.003) and involved current/former alcohol users (51% versus 19%, P = 0.0012). Importantly, invasive squamous carcinoma and squamous dysplasia were seen only in group 2 (47% and 19% versus 0%, P < 0.0001). Further, 42% of group 2, but none of group 1, had benign or malignant squamous lesions of the oral cavity/larynx (P < 0.0001). CONCLUSION Hyperkeratosis involves ~2% of oesophageal biopsies and can be divided into cases occurring within BO/adenocarcinoma and those occurring outside BO/adenocarcinoma. The former lack clinical significance, whereas the latter are associated frequently with oesophageal squamous neoplasia and squamous pathology of the head and neck region.
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Affiliation(s)
- Melissa W Taggart
- Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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Brouns EREA, Baart JA, Karagozoglu KH, Aartman IHA, Bloemena E, van der Waal I. Malignant transformation of oral leukoplakia in a well-defined cohort of 144 patients. Oral Dis 2013; 20:e19-24. [DOI: 10.1111/odi.12095] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 02/26/2013] [Accepted: 02/26/2013] [Indexed: 11/30/2022]
Affiliation(s)
- EREA Brouns
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - JA Baart
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - KH Karagozoglu
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - IHA Aartman
- Department of Social Dentistry and Behavioural Sciences; Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - E Bloemena
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
- Department of Pathology; VU University Medical Center (VUmc); Amsterdam The Netherlands
| | - I van der Waal
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
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Abstract
PURPOSE This literature review investigates the occurrence of oral squamous cell carcinoma (OSCC) around osseointegrated dental implants (DI). METHODS Databases were searched from 1989 up to and including November 2011. The eligibility criteria were as follows: (1) original studies, (2) clinical studies and case reports, (3) reference lists of the relevant original and review articles, (4) intervention: occurrence of OSSC around osseointegrated DI, and (5) articles published only in English language. RESULTS Fourteen studies were included. In nine studies, the dental implant patients with diagnosed OSCC had previously been exposed to cancer. In five studies, the patients presented with a history of habitual tobacco smoking and alcohol consumption. CONCLUSION OSCC is more likely to arise around osseointegrated DI in patients with a previous history of cancer. However, the role of other factors including tobacco and alcohol usage cannot be disregarded.
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Arduino PG, Bagan J, El-Naggar AK, Carrozzo M. Urban legends series: oral leukoplakia. Oral Dis 2013; 19:642-59. [PMID: 23379968 DOI: 10.1111/odi.12065] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 11/29/2012] [Accepted: 12/18/2012] [Indexed: 02/06/2023]
Abstract
To date, the term oral leukoplakia (OL) should be used to recognize 'predominantly white plaques of questionable risk, having excluded (other) known diseases or disorders that carry no increased risk of cancer'. In this review, we addressed four controversial topics regarding oral leukoplakias (OLs): (i) Do tobacco and alcohol cause OLs?, (ii) What percentage of OLs transform into oral squamous cell carcinoma (OSCC)?, (iii) Can we distinguish between premalignant and innocent OLs?, and (iv) Is proliferative verrucous leukoplakia (PVL) a specific entity or just a form of multifocal leukoplakia? Results of extensive literature search suggest that (i) no definitive evidence for direct causal relationship between smoked tobacco and alcohol as causative factors of OLs, (ii and iii) the vast majority of OLs follow a benign course and do not progress into a cancer, and no widely accepted and/or validated clinical and/or biological factors can predict malignant transformation, and (iv) the distinction between multifocal/multiple leukoplakias and PVL in their early presentation is impossible; the temporal clinical progression and the high rate of recurrences and development of cancer of PVL are the most reliable features for diagnosis.
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Affiliation(s)
- P G Arduino
- Department of Surgical Sciences, Oral Medicine Section, Lingotto Dental School, University of Turin, Italy.
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