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Pimolbutr K, Lim WT, Leeson R, Hopper C, Kalavrezos N, Liew C, Schilling C, Sinha D, Jay A, Agrawal R, Porter S, Fedele S. Prognosis of oral epithelial dysplasia in individuals with and without oral lichen planus. Oral Dis 2024; 30:504-517. [PMID: 36648368 DOI: 10.1111/odi.14503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To investigate the role of oral lichen planus (OLP) on the long-term prognosis of oral epithelial dysplasia (OED). METHODS Retrospective single-centre cohort study using the 2007-2019 database of the Head and Neck Cancer and Oral Medicine units of University College London Hospital. The exposure of interest was the presence of OLP, and the prognostic outcomes included the development of new primary episodes of OED, progression to malignancy and mortality. Cox proportional hazard and Poisson regression models were performed. RESULTS A total of 299 patients, of whom 144 had OED arising on the background of OLP (OLP/OED) and 155 had OED without underlying OLP (non-OLP/OED), were included. A pre-existing diagnosis of OLP was significantly associated with a twofold increased risk of subsequent primary OED events (HR = 2.02, p = 0.04), which also developed faster (1.46 vs. 2.96 years, p = 0.04) and with more involvement of non-cancer-prone sites (p = 0.001) than in the non-OLP/OED group. There was no difference between groups in the progression to malignancy or mortality. CONCLUSIONS Oral lichen planus/OED patients are at higher risk of multiple episodes of primary OED, which can develop faster and at non-cancer-prone sites as compared to non-OLP/OED individuals. Further research is needed to clarify the effects of OLP upon progression to OSCC and mortality.
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Affiliation(s)
- Kununya Pimolbutr
- UCL Eastman Dental Institute, University College London, London, UK
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Woei Tatt Lim
- Oral and Maxillofacial Surgery Department, Sarawak General Hospital, Kuching, Malaysia
| | - Rachel Leeson
- UCL Eastman Dental Institute, University College London, London, UK
| | - Colin Hopper
- UCL Eastman Dental Institute, University College London, London, UK
| | - Nicholas Kalavrezos
- Head and Neck Surgery Department, University College London Hospitals (UCLH), London, UK
| | - Colin Liew
- Head and Neck Surgery Department, University College London Hospitals (UCLH), London, UK
| | - Clare Schilling
- Head and Neck Surgery Department, University College London Hospitals (UCLH), London, UK
| | - Deepti Sinha
- Head and Neck Surgery Department, University College London Hospitals (UCLH), London, UK
| | - Amrita Jay
- Department of Cellular Pathology, University College London Hospitals (UCLH), London, UK
| | - Reshma Agrawal
- Department of Cellular Pathology, University College London Hospitals (UCLH), London, UK
| | - Stephen Porter
- UCL Eastman Dental Institute, University College London, London, UK
- NIHR UCLH Biomedical Research Centre, London, UK
| | - Stefano Fedele
- UCL Eastman Dental Institute, University College London, London, UK
- NIHR UCLH Biomedical Research Centre, London, UK
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Mattila V, Wilkman T, Avellán NL, Mesimäki K, Furuholm J, Ruokonen H, Nylund K. Survival of dental implants and occurrence of mucosal overgrowth in patients with head and neck cancer treated with/without radiotherapy and mucosal graft-two-year follow-up. Clin Oral Investig 2024; 28:117. [PMID: 38273180 PMCID: PMC10811186 DOI: 10.1007/s00784-023-05479-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVES The primary aim of the present study was to compare head and neck cancer treatment modality surgery and surgery with radiotherapy or chemoradiotherapy alone for dental implant (DI) survival. The second aim was to evaluate the prevalence of mucosal overgrowth around DI after treatment with or without mucosal grafts. MATERIALS AND METHODS An observational retrospective study consisted of 59 patients with malignant head and neck tumors that received DI between 2015 and 2019. Treatment modalities together with information on oral rehabilitation with DI, prevalence of mucosal overgrowth, and precursor lesions were gathered from the hospital records. Radiation doses were determined using a sum of three-dimensional dose distributions. RESULTS Overall DI survival rate was 88%, in irritated jaw 89%, and in nonirradiated jaw 88% in this observational period (p = 0.415, mean follow-up was 2 years 10 months, range 9-82 months). Mucosal overgrowth was found in 42 of 196 implants (21%), of which 36 cases (86%) were associated in grafted areas (p < 0.001). Oral lichen planus/lichenoid reaction was diagnosed in 14 of all 59 (24%) oral cancer patients. CONCLUSION Implant survival was not significantly influenced by radiation therapy in this observational period. In grafted bone, implant survival was significantly inferior than in native bone. Mucosal overgrowth around implants was more common in mucosal grafted areas versus nongrafted. CLINICAL RELEVANCE This study demonstrates the impact of grafted bone to dental implant survival rate and mucosal overgrowth.
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Affiliation(s)
- Viivi Mattila
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Tommy Wilkman
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Nina-Li Avellán
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karri Mesimäki
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jussi Furuholm
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hellevi Ruokonen
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karita Nylund
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Yosefof E, Kurman N, Edri N, Rosenfeld E, Bachar G, Shpitzer T, Yehuda M, Mizrachi A, Najjar E. The Clinical Behavior and Recurrence Patterns of Oral Cavity Cancer in Oral Lichen Planus Patients. Laryngoscope 2024. [PMID: 38265161 DOI: 10.1002/lary.31307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Oral lichen planus (OLP) is a chronic inflammatory disorder involving epithelia with squamous differentiation. Although described as a potential malignant precursor, the characteristics of malignancies arising among these patients are not widely described. Our goal was to describe the patterns of disease recurrence of patients with oral cavity squamous cell carcinoma (OSCC) arising on the background of OLP. METHODS A retrospective analysis of all surgically treated patients with OSCC at a university-affiliated tertiary care center between 2000 and 2020. RESULTS Two hundred seventy-nine patients with OSCC treated surgically were included. Forty (14.3%) had OLP. The mean age of patients with OLP was 70.9 years compared with 64.3 years for non-OLP patients (p = 0.03). OLP patients had a significantly higher rate of disease recurrence, persistence, or multiple primary disease (70% vs. 33.9%, p < 0.001). The mean number of sequential oncologic events for each patient with recurrence was also significantly higher among OLP patients (1.86 vs. 1.36, p = 0.03), a difference explained by a higher rate of multiple primary presentations (0.71 vs. 0.28, p = 0.008). A significant difference in disease-free survival (DFS) was demonstrated between the groups as patients with OLP had a lower 5-year DFS (34.7% vs. 61.3%, log-rank p value <0.001). On multivariate analysis, OLP was significantly associated with multiple primary events (p < 0.001, Odds ratio = 7.42, 95% confidence interval 2.9-19). CONCLUSIONS OSCC patients with OLP background demand close clinical follow-up, as multiple primary disease is significantly more common and the DFS is significantly lower among these patients. A thorough clinical evaluation for all oral cavity subsites is mandatory. LEVEL OF EVIDENCE 3 Laryngoscope, 2024.
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Affiliation(s)
- Eyal Yosefof
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel
| | - Noga Kurman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel
| | - Nofar Edri
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eli Rosenfeld
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Maxillofacial Surgery, Rabin Medical Center, Petach Tikva, Israel
| | - Gideon Bachar
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Thomas Shpitzer
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Yehuda
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviram Mizrachi
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Esmat Najjar
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Zhang S, Deng Y, Ji T, Wang Y, Liu W. Overestimated risk of transformation in oral lichen planus: In reply with emphasis on natural history of proliferative verrucous leukoplakia. Oral Oncol 2023; 136:106263. [PMID: 36444802 DOI: 10.1016/j.oraloncology.2022.106263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Shijian Zhang
- Department of Oral and Maxillofacial Surgery, Zhang Zhiyuan Academician Workstation, Hainan Western Central Hospital, Shanghai Ninth People's Hospital, Danzhou, Hainan, China; Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yiwen Deng
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China; Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Ji
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yufeng Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China.
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Cai X, Zhang J, Zhang H, Li T. Overestimated risk of transformation in oral lichen planus. Oral Oncol 2022; 133:106025. [PMID: 35858493 DOI: 10.1016/j.oraloncology.2022.106025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Oral lichen planus (OLP) was classified as an oral potentially malignant disorder due to the association with oral squamous cell carcinoma (OSCC). However, the malignant potential of OLP has been controversial. Whether epithelial dysplasia should be differentiated from OLP and lichenoid dysplasia could be identified as a pathological entity has been the subject of debate. MATERIALS AND METHODS We recruited a large retrospective cohort with 3568 patients, and 10 of them developed OSCC. These cases were reviewed retrospectively to investigate association between OLP and OSCC. RESULTS In 10 cases of OSCC, three of them were primary cancers distinct from the site with OLP, two were malignant transformation of proliferative verrucous leukoplakia, and five were malignant transformation of oral leukoplakia. All OSCC is not transformed from OLP. Therefore, previous insights into OLP might have overestimated its transformation risk. There may be the reasons: I. did not distinguish OLP from epithelial dysplasia, II. neglect of oral leukoplakia with dysplasia developed in the course after OLP, III. misdiagnosis in the early stage of proliferative verrucous leukoplakia. CONCLUSION The pathological and molecular biological features of OLP differed from those of oral leukoplakia and OSCC. Strict control of the diagnostic criteria for OLP and close surveillance during the course could contribute to correctly identify the origin of OSCC and avoid overestimating the risk of OLP transformation.
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Bindakhil M, Akintoye S, Corby P, Stoopler ET, Greenberg MS, Shanti R, Tanaka TI, Sollecito TP. Influence of topical corticosteroids on malignant transformation of oral lichen planus. J Oral Pathol Med 2021; 51:188-193. [PMID: 34748663 DOI: 10.1111/jop.13257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/20/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is considered an oral potentially malignant disorder. While OLP has been associated with the development of oral squamous cell carcinoma (OSCC), little is known about the role of topical corticosteroids therapy (TCT) in the promotion of carcinogenesis. The study aimed to determine if TCT influences the time of malignant transformation of OLP to OSCC. The study also investigates this correlation in the presence or absence of Candida overgrowth, and in the context of conventional OSCC risk factors such as smoking, alcohol use, and male gender. METHODS A retrospective analysis of electronic health records at a tertiary care academic medical center was performed. Patients with OLP and OSCC were considered for inclusion. The diagnosis of OLP required both clinical and histological documentation. RESULTS Eighty-two patients met inclusion criteria, consisting of 48 women (58.25%) and 34 men (41.5%) and the mean patient age was 65.9 years (SD = 13.25). Forty-five patients (54.9%) received TCT for OLP before they developed OSCC. The time between the OLP and OSCC diagnoses increased by four years in patients who received topical steroid therapy for OLP (p < 0.001) and decreased by three years (p = 0.010) in those with Candida overgrowth. Gender, smoking, and alcohol use did not have a statistically significant influence on the time between OLP and OSCC. CONCLUSION The management of OLP using TCT potentially delayed cancer development in our study. Conversely, it appears that Candida may play a role in the field cancerization of OLP patients.
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Affiliation(s)
- Mohammed Bindakhil
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Sunday Akintoye
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Patricia Corby
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Eric T Stoopler
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Martin S Greenberg
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Rabie Shanti
- Department of Oral and Maxillofacial Surgery and Pharmacology, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA.,Department of Otorhinolaryngology/Head and Neck Surgery, Perelman School of Medicine University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Takako I Tanaka
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Thomas P Sollecito
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
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Eita AAB, Zaki AM, Mahmoud SA. Serum 8-isoprostane levels in patients with resistant oral lichen planus before and after treatment with lycopene: a randomized clinical trial. BMC Oral Health 2021; 21:343. [PMID: 34266435 PMCID: PMC8281687 DOI: 10.1186/s12903-021-01711-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022] Open
Abstract
Background Oral lichen planus is an autoimmune disease in which topical steroids are the first line of treatment. The adverse effects of systemic corticosteroids prescribed for resistant oral lichen planus cases advocate alternative modalities. Lycopene is an antioxidant with a wide range of beneficial properties. This trial aimed to evaluate the effect of pure lycopene as compared to systemic corticosteroids (Prednisolone) on the symptoms, signs and oxidative stress in patients with erosive oral lichen planus recalcitrant to topical steroids. Methods Twenty patients were randomly divided into the test (lycopene) and control (corticosteroids) groups. Numeric rating scale and Escudier et al. (Br J Dermatol 4:765–770, 2007. 10.1111/j.1365-2133.2007.08106.x) lesion scores were assessed at baseline and weeks 4 and 8 from baseline. Serum levels of 8-isoprostane were measured in all patients at baseline and at the end of treatment (week 8). Results There was a significant reduction in signs and symptoms after the end of treatment in each group. However, no significant difference was found between the lycopene and the corticosteroids group. Moreover, a significant reduction in 8-isoprostane levels was observed in the lycopene group from baseline and as compared to the control group. Conclusions Based on the study results, lycopene is a safe and effective therapeutic modality for resistant oral lichen planus. 8-isoprostane is a biomarker of lipid peroxidation that can be reduced by lycopene. Trial registration ID: PACTR202003484099670. 'Retrospectively registered on 11/3/2020'. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01711-z.
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Affiliation(s)
- Aliaa Abdelmoniem Bedeir Eita
- Oral Medicine, Periodontology, Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Azza Mohamed Zaki
- Oral Medicine, Periodontology, Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Sabah Abdelhady Mahmoud
- Medical Biochemistry Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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8
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Gissi DB, Gabusi A, Tarsitano A, Asioli S, Rossi R, Marchetti C, Montebugnoli L, Foschini MP, Morandi L. Application of a non-invasive oral brushing procedure based on bisulfite sequencing of a 13-gene panel to study high-risk OSCC patients. Cancer Biomark 2021; 28:499-510. [PMID: 32568174 DOI: 10.3233/cbm-190422] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND A non-invasive sampling procedure for the early detection of Oral Squamous Cell Carcinoma (OSCC) based on DNA methylation analysis of a panel of 13 genes was applied in 4 different OSCC risk-group of patients. Aim of the study is to evaluate the between-group differences and the variables related to the methylation profile of each group. METHODS Oral brushing samples were collected from 54 healthy subjects, 31 Oral Leukoplakia (OL) patients, 18 Oral Lichen Planus (OLP) patients and 26 patients previously treated for OSCC. Each sample was considered positive or negative in relation to a predefined cut-off value. RESULTS None of the samples from 54 healthy subjects were positive, whereas 22/31 OL, 3/18 OLP and 8/26 surgically treated OSCC samples showed positive values with respect to the cut-off. In OL patients, dysplasia was the only variable significantly related to positive values: 10/10 OLs with high-grade dysplasia were positive with respect to 12/21 OLs without dysplasia (Chi 6.039, p< 0.05). CONCLUSION DNA methylation analysis in epithelial cells collected by oral brushing seems to be a promising genetic method to distinguish lesions at high risk of developing OSCC. Larger population studies and an adequate follow-up period are necessary to confirm these preliminary data.
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Affiliation(s)
- Davide B Gissi
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Andrea Gabusi
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Achille Tarsitano
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Section of Maxillo-facial Surgery at Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Sofia Asioli
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology at Bellaria Hospital, University of Bologna, Bologna, Italy
| | - Roberto Rossi
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Claudio Marchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Section of Maxillo-facial Surgery at Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Lucio Montebugnoli
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Maria P Foschini
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology at Bellaria Hospital, University of Bologna, Bologna, Italy
| | - Luca Morandi
- Department of Biomedical and Neuromotor Sciences, Functional MR Unit, IRCCS Istituto Delle Scienze Neurologiche di Bologna, University of Bologna, Bologna, Italy
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Gilligan G, Garola F, Piemonte E, Leonardi N, Panico R, Warnakulasuriya S. Lichenoid proliferative leukoplakia, lichenoid lesions with evolution to proliferative leukoplakia or a continuum of the same precancerous condition? A revised hypothesis. J Oral Pathol Med 2020; 50:129-135. [PMID: 33225541 DOI: 10.1111/jop.13133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multiple white plaques of the oral mucosa are usually associated with potentially malignant disorders such as oral lichen planus, oral lichenoid lesions and proliferative verrucous leukoplakia. Previous studies in the current literature describe a potential clinical overlap in these entities. The aim of this study is to review clinicopathological and evolutive features of these Oral Potentially Malignant Disorders highlighting the dynamic changes of diagnoses. DISCUSSION It was previously hypothesized that a subset of patients with oral lichen planus or oral lichenoid diagnosis, could develop multiple white plaques during the natural history of the disease, fulfilling diagnostic criteria for proliferative verrucous leukoplakia. Consequently, these entities could, under certain conditions, obey a continuum of the same precancerous condition in the context of the field cancerization theory, increasing the risk of malignant transformation. Nevertheless, there is limited scientific evidence concerning this issue. CONCLUSION Further studies are needed to understand the biological and evolutive features of the link between these oral potentially malignant disorders. Regardless of its diagnosis, these patients with multifocal white lesions must be carefully monitored to detect early malignant transformation.
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Affiliation(s)
- Gerardo Gilligan
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Federico Garola
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Eduardo Piemonte
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Nicolás Leonardi
- Oral Medicine Department, Dentistry School, Health Sciences Faculty, Universidad Católica de Córdoba, Córdoba, Argentina
| | - René Panico
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, London, UK
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Aguirre-Urizar JM, Alberdi-Navarro J, Lafuente-Ibáñez de Mendoza I, Marichalar-Mendia X, Martínez-Revilla B, Parra-Pérez C, Juan-Galíndez AD, Echebarria-Goicouria MÁ. Clinicopathological and prognostic characterization of oral lichenoid disease and its main subtypes: A series of 384 cases. Med Oral Patol Oral Cir Bucal 2020; 25:e554-e562. [PMID: 32388519 PMCID: PMC7338060 DOI: 10.4317/medoral.23576] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/08/2020] [Indexed: 02/06/2023] Open
Abstract
Background To clinicopathologically characterize the diagnosis of oral lichenoid disease (OLD) and its main subtypes: oral lichen planus (OLP) and oral lichenoid lesion (OLL), in order to correctly asses their prognosis.
Material and Methods Ambispective cohort study of 384 patients with diagnosis of OLD, based on pre-established clinical and histopathological criteria. We have analysed 272 (70.8%) women and 112 (29.2%), whose mean age was 57.1+/-11.8 years (range 21-90); minimum follow-up time was 36 months. A specific protocol was designed for this study, where we gathered the data of each patient, including malignant transformation.
Results OLP was diagnosed in 229 cases (77.9%) and OLL in 85 (22.1%). Tobacco consumption was found in 20.3% of the patients and alcohol intake in 41.1%. Liver pathology was present in 10.7% of the cases, thyroid pathology in 11.5%, arterial hypertension in 15.6%, diabetes mellitus in 7.6%, psycho-emotional disorders in 33.3%, skin involvement in 12% and genital involvement in 4.9%. Ten patients (2.6%) developed an oral squamous cell carcinoma, 5 (1.7%) with OLP and 5 (5.9%) with OLL.
Conclusions OLD is a potentially malignant disorder of the oral mucosa which has to be correctly diagnosed as either OLP or OLL, since the risk of malignancy of these subtypes is significantly different. Key words:Oral lichenoid disease, oral lichen planus, oral lichenoid lesion, diagnosis, malignant transformation, prognosis.
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Affiliation(s)
- J-M Aguirre-Urizar
- Department of Stomatology II University of the Basque Country (UPV/EHU) Barrio Sarriena sn. 48940. Leioa, Spain
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Best DL, Herzog C, Powell C, Braun T, Ward BB, Moe J. Oral Lichen Planus-Associated Oral Cavity Squamous Cell Carcinoma Is Associated With Improved Survival and Increased Risk of Recurrence. J Oral Maxillofac Surg 2020; 78:1193-1202. [PMID: 32114008 DOI: 10.1016/j.joms.2020.01.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE We investigated the overall survival (OS), disease-specific survival (DSS), and disease-free survival among patients with oral lichen planus-associated oral cavity squamous cell carcinoma (OLP-OCSCC). The secondary objective was to assess the annual risk of tumor recurrence or second primary tumor (SPT). MATERIALS AND METHODS A comparative retrospective study was performed of patients with OLP-OCSCC presenting between June 2007 and December 2018 to the Department of Oral and Maxillofacial Surgery, Michigan Medicine (Ann Arbor, MI) and patients with OCSCC in the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database (1973 to 2015). RESULTS A total of 87 patients with OLP-OCSCC met the inclusion criteria, and 55,165 patients with OCSCC from the SEER database were included. The proportion of women was greater in the OLP group than in the SEER group (56.3 vs 38.0%; P < .001). In the OLP group, 47.1% had no smoking history and 43.7% had no alcohol history. Most patients in the OLP group had presented with stage I disease (46.0%) compared with 31.7% in the SEER group (P = .004). Overall, the OS and DSS were significantly greater in the OLP group than in the SEER group at all points from 1 to 5 years (P ≤ .01). In the OLP group, 46 patients (52.9%) had at least 1 recurrence or SPT. At 10 years, the predicted mean number of recurrences was 1.93 per patient (95% confidence interval, 1.56 to 2.39). CONCLUSIONS OLP-OCSCC frequently affects women, nonsmokers, and nondrinkers and presents with localized disease at a high frequency. Patients with OLP-OCSCC have increased OS and DSS and a greater risk of tumor recurrence or SPT compared with OCSCC in the general population. Lifelong, frequent surveillance is recommended for patients with OLP-OCSCC owing to the risk of late recurrence. Future studies are needed to understand the pathophysiology of OLP-OCSCC.
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Affiliation(s)
- David L Best
- Resident, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
| | - Curtis Herzog
- Dental Student, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Corey Powell
- Consultant, Department of Statistics, Computing, and Analytics Research, University of Michigan, Ann Arbor, MI
| | - Thomas Braun
- Professor, Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - Brent B Ward
- Section Head, Chair, and Associate Professor, Department of Oral and Maxillofacial Surgery; and Director, Oncology/Microvascular Surgery Fellowship, University of Michigan, Ann Arbor, MI
| | - Justine Moe
- Assistant Professor and Residency Program Director, Department of Oral and Maxillofacial Surgery; and Associate Director, Oncology/Microvascular Surgery Fellowship, University of Michigan, Ann Arbor, MI.
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Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Periodontol 2019; 89 Suppl 1:S28-S45. [PMID: 29926945 DOI: 10.1002/jper.17-0163] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/04/2017] [Accepted: 09/13/2017] [Indexed: 12/20/2022]
Abstract
While plaque-induced gingivitis is one of the most common human inflammatory diseases, several non-plaque-induced gingival diseases are less common but often of major significance for patients. The non-plaque-induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. A classification is proposed, based on the etiology of the lesions and includes: Genetic/Developmental disorders; Specific infections; Inflammatory and immune conditions and lesions; Reactive processes; Neoplasms; Endocrine, Nutritional and metabolic diseases; Traumatic lesions; and Gingival pigmentation.
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Affiliation(s)
- Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
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Ratib S, Burden-Teh E, Leonardi-Bee J, Harwood C, Bath-Hextall F. Long-term topical corticosteroid use and risk of skin cancer: a systematic review. ACTA ACUST UNITED AC 2019; 16:1387-1397. [PMID: 29894408 DOI: 10.11124/jbisrir-2017-003393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The objective of this systematic review was to synthesize available research evidence to determine the risk of skin cancer in patients with long-term use of topical corticosteroids (TCS). INTRODUCTION Topical corticosteroids are one of the most commonly prescribed medicines in dermatology and the mainstay of the treatment of atopic dermatitis and other skin conditions such as psoriasis. They are often required for months or years to control the disease and ultimately restore patients' quality of life. In some patients, TCS may have a local immunosuppressive effect and theoretically increase the risk of skin cancer, whilst on the other hand TCS may decrease the risk of skin cancer in patients where TCS are used to treat inflammatory skin disease. To date, no systematic review has been performed to collate evidence on the effect of long-term TCS use on the risk of skin cancer. INCLUSION CRITERIA This review considered studies that included people of all ages, genders and ethnicities, including HIV and transplant participants or participants with genetic diseases (for example, Gorlin-Goltz syndrome) This review considered studies that evaluated long-term use of topical corticosteroids. "Long-term" was defined as using TCS more than once a week for a month or longer. The review included cohort, cross-sectional and case-control observational studies exploring the association between the stated intervention and outcomes. The primary outcome measures of interest were: non-melanoma skin cancer (keratinocyte carcinoma), cutaneous squamous cell carcinoma (cSSC), basal cell carcinoma (BCC) or melanoma skin cancer. Genital and oral skin cancers are considered to be slightly different so we did not include them in this review. METHODS We performed a comprehensive search of MEDLINE, Embase and LILACS on November 9, 2017 to identify observational epidemiological studies assessing the association between long-term TCS use and skin cancer. We also searched EThOS at the British Library and three drug safety databases to identify unpublished work. The titles, abstracts and full text identified from the search were assessed independently by two authors against pre-specified inclusion/exclusion criteria. Methodological quality was not assessed as no articles were found which met the inclusion criteria. Data extraction was not possible as no articles were found which met the inclusion criteria. It was not possible to complete data synthesis as no articles were found which met the inclusion criteria. RESULTS A total of 1703 potentially relevant studies were identified following a comprehensive electronic search. After abstract and title screening, 51 full texts were assessed for eligibility criteria. Of these, no study met the inclusion criteria. No additional records were identified from searching unpublished literature. CONCLUSIONS We did not find any studies that could help us establish if long-term TCS use is associated with skin cancer. Future research using primary care databases might give a better understanding regarding long-term use of TCS and skin cancer.
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Affiliation(s)
- Sonia Ratib
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Esther Burden-Teh
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.,The Nottingham Centre for Evidence-Based Healthcare: a Joanna Briggs Institute Centre of Excellence
| | | | - Fiona Bath-Hextall
- The Nottingham Centre for Evidence-Based Healthcare: a Joanna Briggs Institute Centre of Excellence
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Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Clin Periodontol 2019; 45 Suppl 20:S28-S43. [PMID: 29926497 DOI: 10.1111/jcpe.12938] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/04/2017] [Accepted: 09/13/2017] [Indexed: 12/16/2022]
Abstract
While plaque-induced gingivitis is one of the most common human inflammatory diseases, several non-plaque-induced gingival diseases are less common but often of major significance for patients. The non-plaque-induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. A classification is proposed, based on the etiology of the lesions and includes: Genetic/Developmental disorders; Specific infections; Inflammatory and immune conditions and lesions; Reactive processes; Neoplasms; Endocrine, Nutritional and metabolic diseases; Traumatic lesions; and Gingival pigmentation.
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Affiliation(s)
- Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
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Yang X, Shi L, Zhou Z, Liu W. Podoplanin and ABCG2 expression in oral erythroplakia revisited: Potential evidence for cancer stem cells driving the process of field cancerization. Oral Oncol 2019; 101:104368. [PMID: 31300272 DOI: 10.1016/j.oraloncology.2019.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/03/2019] [Accepted: 07/06/2019] [Indexed: 11/30/2022]
Abstract
A model of field cancerization orchestrated by the cancer stem cells (CSC) was proposed. Podoplanin and ABCG2 are promising marker of CSCs for head and neck cancer. We revisited the correlation of the two markers with the follow-up data of the patients with oral erythroplakia (OE). Strikingly, we observed that the expression of podoplanin and ABCG2 within a single pre-neoplastic OE lesion significantly correlate with subsequently developing multiple and multifocal carcinomas, thus to some extent demonstrating the concept of field cancerization. Collectively, a point to highlight was that a preliminary evidence that provided by this revisited study supported the perspective on cancer stem cells driving the process of field cancerization.
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Affiliation(s)
- Xi Yang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Linjun Shi
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zengtong Zhou
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
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Shi L, Jiang W, Liu W. Retrospective analysis of oral erythroplakia focused on multiple and multifocal malignant behavior. Oral Dis 2019; 25:1829-1830. [PMID: 31188512 DOI: 10.1111/odi.13144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Linjun Shi
- Department of Oral Mucosal Diseases, College of Stomatology Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai China
- National Clinical Research Center for Oral Diseases Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology Shanghai China
| | - Wen Jiang
- Department of Oral and Maxillofacial‐Head and Neck Oncology Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Wei Liu
- Department of Oral and Maxillofacial‐Head and Neck Oncology Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai China
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Thomson PJ. Perspectives on oral squamous cell carcinoma prevention-proliferation, position, progression and prediction. J Oral Pathol Med 2018; 47:803-807. [PMID: 29752860 DOI: 10.1111/jop.12733] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2018] [Indexed: 11/27/2022]
Abstract
Squamous cell carcinoma arising from oral mucosal epithelium remains a lethal and deforming disease due to tumour invasion, oro-facial destruction, cervical lymph node metastasis and ultimate blood-borne dissemination. Worldwide, 300 000 new cases are seen each year, with a recent and significant rise in incidence affecting particularly the young. To rationalize perspectives on preventive strategies in oral cancer management, this study addresses a number of fundamental questions regarding carcinogenesis: proliferation-what epithelial cell changes precede tumour development? Position-why are certain oral sites so predisposed to cancer? Progression-why do some precursor lesions progress to invasive carcinoma and others do not? Prediction-how can we predict individual patient and/or lesion behaviour to prevent disease progression? By improving our understanding of oral carcinogenesis, can we thereby facilitate more effective primary, secondary and tertiary preventive strategies and ultimately reduce the global burden of oral squamous cell carcinoma (OSCC)?
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Affiliation(s)
- P J Thomson
- Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Gissi DB, Asioli S, Gabusi A. Two Unusual Cases of Oral Lichen Planus Arising After Oral Squamous Cell Carcinoma: Can Oral Cancer Trigger Autoimmunity? Int J Surg Pathol 2017; 25:443-448. [PMID: 28381149 DOI: 10.1177/1066896917699070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Autoimmune diseases occur when the immune system fails to recognize self-antigens expressed on the body's own cells and attacks them. Oral lichen planus (OLP) is a chronic autoimmune mucocutaneous disease of the oral cavity characterized by white/red lesions. Considered a potentially malignant disorder, OLP evolution into oral squamous cell carcinoma (OSCC) is still a matter of debate. While chronic autoimmune inflammation is considered a potential risk factor for malignant transformation in many solid tumors, the opposite idea that cancer may trigger autoimmune responses remains controversial. We describe 2 patients who developed lesions clinically suggestive of OLP with histological evidence of lichenoid infiltration some time after OSCC removal, even in areas far from the neoplastic site. Neither patient had OLP before the diagnosis of OSCC, or reported exposure to OLP-associated etiologic factors, and neither. experienced tumor recurrence during follow-up. Our findings suggest that oral cancer remission may be linked to OLP development, but further studies are necessary to unveil the underlying mechanisms and possible prognostic implications.
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Sanketh DS, Srinivasan SR, Patil S, Ranganathan K. Issues related to diagnosing oral lichen planus among oral pathologists in South India: A pilot survey. ACTA ACUST UNITED AC 2016; 8. [PMID: 27782368 DOI: 10.1111/jicd.12246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/26/2016] [Indexed: 01/02/2023]
Abstract
AIM In the present study, we simulated clinical scenarios by explicitly describing the history and clinical and histological features of hypothetical patients presenting with oral lichen planus (OLP), oral lichenoid lesion, and epithelial dysplasia in a self-designed questionnaire. By doing so, we aimed to elicit a diagnosis from oral pathologists and trainees, analyze their responses, appraise issues, and propose solutions regarding the diagnosis of OLP. METHODS The questionnaire was distributed to 100 oral pathologists and trainees in South India. Six questions were designed to assess awareness of the diagnostic aspects of OLP. Ten questions were hypothetical clinical scenarios (HCS) devised to evaluate respondents' knowledge of diagnostic guidelines and the criteria used by the respondents to render a diagnosis. RESULTS There were 60 of 100 responses to the questionnaire. More than half the respondents were aware of the World Health Organization and modified guidelines of OLP. We observed considerable variations in diagnoses for the HCS. CONCLUSIONS Our study illustrates the ambiguity in rendering an accurate diagnosis, despite adequate guidelines. Based on the responses for the HCS, we hypothesized that changes in the distribution (unilateral or bilateral) and clinical characteristic of OLP, and habits of patients, have a significant bearing on the clinical and final diagnoses of the lesion.
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Affiliation(s)
- D Sharathkumar Sanketh
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, India
| | - Samuel Raj Srinivasan
- Department of Public Health Dentistry, Thai Mookambikai Dental College, Chennai, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Kannan Ranganathan
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, India
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Vidyalakshmi S, Nirmal RM, Veeravarmal V, Santhadevy A, Aravindhan R, Sumathy. Buccal Micronuclei Assay as a Tool For Biomonitoring DNA Damage in Oral Lichen Planus. J Clin Diagn Res 2016; 10:ZC05-7. [PMID: 27630941 DOI: 10.7860/jcdr/2016/17074.8072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/01/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The malignant transformation rate of Oral Lichen Planus (OLP) is between 0% and 5.8%. Oral lesions of lichen planus clinically presents itself multifocally, simulating the process of field cancerization in high risk malignancies. The Buccal MicroNucleus Cytome Assay (BMN Assay) provides a platform to identify the high risk individuals by evaluating the markers of nuclear damage at an earliest micro invasive phase. AIM To evaluate DNA damage in exfoliated buccal mucosal cells in individuals with oral lichen planus lesions and thereby to delineate the high risk group. MATERIALS AND METHODS Buccal smears from 22 OLP and 10 control samples were stained in modified Feulgen-Rossenback reaction for micronuclei assay. Cytological evaluation of number of MicroNucleated cells (CMN), Total Number of Micronuclei (TMN) in micronucleated cells was done in both groups. RESULTS Frequency of micronucleated cells (CMN) when compared among the study and control group, a mean value of 4.27 ± 1.80 and 0.90 ± 0.88 were obtained respectively. On comparing the total number of micronuclei in the micronucleated cells (TMN) between the study and control groups, a mean value of 5.38 ± 2.42 and 1.5 ± 0.88 were obtained respectively. CONCLUSION There was a significant increase in the frequency of micronuclei and the micronucleated cells in the oral lichen planus as compared to normal individuals.
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Affiliation(s)
- S Vidyalakshmi
- Senior Lecturer, Department of Oral and Maxillofacial Pathology, Indira Gandhi Institute of Dental Sciences , Pillaiyarkuppam, Pondicherry, India
| | - R Madhavan Nirmal
- Professor, Department of Oral and Maxillofacial Pathology, Rajah Muthiah Dental College and Hospital, Annamalai University , Chidambaram, India
| | - V Veeravarmal
- Professor, Department of Oral and Maxillofacial Pathology, Rajah Muthiah Dental College and Hospital, Annamalai University , Chidambaram, India
| | - A Santhadevy
- Professor, Department of Oral and Maxillofacial Pathology, Indira Gandhi Institute of Dental Sciences , Pillaiyarkuppam, Pondicherry, India
| | - R Aravindhan
- Senior Lecturer, Department of Oral and Maxillofacial Pathology, SRM Kattankulathur Dental College & Hospital, SRM University , Potheri, Kanchipuram dt, India
| | - Sumathy
- Professor, Private Practioner, Pondicherry, India
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Sanketh DS, Patil S, Swetha B. Oral lichen planus and epithelial dysplasia with lichenoid features: a review and discussion with special reference to diagnosis. ACTA ACUST UNITED AC 2016; 8. [DOI: 10.1111/jicd.12233] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/25/2016] [Indexed: 01/08/2023]
Affiliation(s)
- D. SharathKumar Sanketh
- Department of Oral and Maxillofacial Pathology; Ragas Dental College and Hospital; Chennai India
| | - Shankargouda Patil
- Department of Oral Pathology; College of Dentistry; Jazan University; Riyadh Saudi Arabia
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Gonzalez-Moles MA, Gil-Montoya JA, Ruiz-Avila I, Bravo M. Is oral cancer incidence among patients with oral lichen planus/oral lichenoid lesions underestimated? J Oral Pathol Med 2016; 46:148-153. [DOI: 10.1111/jop.12480] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 12/22/2022]
Affiliation(s)
- M. A. Gonzalez-Moles
- School of Dentistry; Instituto de Biomedicina de Granada; University of Granada; Granada Spain
| | - J. A. Gil-Montoya
- School of Dentistry; Instituto de Biomedicina de Granada; University of Granada; Granada Spain
| | - I. Ruiz-Avila
- Unidad de Gestión Clínica de Anatomía Patológica; Instituto de Biomedicina de Granada Complejo Hospitalario San Cecilio; Granada Spain
| | - M. Bravo
- School of Dentistry; Instituto de Biomedicina de Granada; University of Granada; Granada Spain
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Chomik P, Michcik A, Michajłowski I, Starzyńska A. Application of direct oral microscopy in evaluating mucosal margins around invasive oral squamous cell carcinoma. Postepy Dermatol Alergol 2015; 32:349-57. [PMID: 26759543 DOI: 10.5114/pdia.2014.40792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 09/10/2014] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Direct oral microscopy constitutes a novel, non-invasive diagnostic technique, which aids clinical examination of the oral cavity. The oral mucosa is examined at multiple magnifications and features such as sub-epithelial mucosal vessels, surface patterns, colour tone, transparency and the exact demarcation of mucosal lesions are estimated. The incidence of oral squamous cell carcinoma (OSCC) oscillates between 1.9% and 3.5%, which makes it the eighth most common carcinoma occurring around the world and in Poland. The 5-year survival rates oscillate between 20% and 30%. AIM The aim of the study was to evaluate clinically unchanged mucosal margins around OSCC by direct oral microscopy. The authors approached the question whether the borders of mucosal margins around OSCC established via direct oral microscopy differ from those established based on clinical examination. MATERIAL AND METHODS Fifteen patients diagnosed with OSCC were enrolled. Patients were first clinically examined to evaluate the extent of the tumour and to plan resection margins. Eventually, direct oral microscopy was performed to establish the width of the subclinically unchanged mucosal margins based on a standard picture of healthy oral mucosae, followed by comparison with those established by clinical evaluation. RESULTS Histopathologic results of biopsies from areas indicated by direct oral microscopy revealed dysplasia in 86.7% of patients, whereas biopsies from areas indicated by clinical examination revealed dysplasia only in 40% of individuals, resulting in the need for widening of mucosal margins. CONCLUSIONS Direct oral microscopy enables detection of dysplasia within clinically unaltered mucosal margins around OSCC, which results in more precise establishing of resection boundaries, contributing to improvement of resection totality.
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Yahalom R, Yarom N, Shani T, Amariglio N, Kaplan I, Trakhtenbrot L, Hirshberg A. Oral lichen planus patients exhibit consistent chromosomal numerical aberrations: A follow-up analysis: Aneuploidy in oral lichen planus. Head Neck 2016; 38:E741-6. [DOI: 10.1002/hed.24086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 11/12/2014] [Accepted: 04/14/2015] [Indexed: 11/07/2022] Open
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Abstract
The concept of field cancerization has been ever changing since its first description by Slaughter et al in 1953. Field cancerization explains the mechanisms by which second primary tumors (SPTs) develop. SPTs are the tumors, which develop in the oral cavity in succession to the primary malignant tumors, which might vary in duration ranging from few months to years. Conceivably, a population of daughter cells with early genetic changes (without histopathology) remains in the organ, demonstrating the concept of field cancerization. This review explains the concept of field cancerization and various field theories along with molecular basis of field formation.
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Affiliation(s)
- Robin Sabharwal
- Department of Oral and Maxillofacial Pathology, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Ashish Mahendra
- Department of Oral Pathology, Chandra Dental College Barabanki, India
| | - Ninad J Moon
- Department of Periodontology, RKDF Dental College, Bhopal, India
| | - Parul Gupta
- Department of Orthodontics, Kalka Dental College, UP, India
| | - Ashish Jain
- Department of Conservative Dentistry, Krishna Dental College, UP, India
| | - Shivangi Gupta
- Department of Periodontology, Divya Jyoti College of Dental Sciences and Research, Ajit Mahal, Modinagar, Ghaziabad, Uttar Pradesh, India
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Landini G, Mylonas P, Shah IZ, Hamburger J. The reported rates of transformation of oral lichen planus. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 2014. [DOI: 10.1016/j.ajoms.2013.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Lucio M, Andrea G, Bartolomeo GD, Fabio C, Dora S. Between-lesion discrepancies in terms of dysplasia, cell turnover and diagnosis in patients with multiple potentially malignant oral lesions. Open Dent J 2013; 7:169-74. [PMID: 24363787 PMCID: PMC3866629 DOI: 10.2174/1874210601307010169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 10/26/2013] [Indexed: 02/03/2023] Open
Abstract
Objective: The present study assessed patients with multiple oral lesions to evaluate the mis-estimation rate in terms of diagnosis and risk of malignant transformation when only one biopsy is performed.
Study Design: Thirty-five patients presenting at least two white and/or red lesions in different oral mucosa sites with a final diagnosis of leuko/erythroplakias or lichenoid lesions were included, for a total of 70 biopsies.
Results: Nineteen patients (54%) had at least one between-lesion discrepancy considering the presence/absence of dysplasia (10 patients), normal/high cell turnover (13 patients) or diagnosis (5 patients). Discrepancies were not related to clinical aspect or within-patient similarity of lesions.
Conclusions: Multiple oral lesions in the same patient can significantly differ in terms of dysplasia, high cell turnover and, even diagnosis. Multiple biopsies are imperative and diagnosis as well as risk of malignant transformation should be formulated for each single lesion rather than for each individual patient.
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Affiliation(s)
- Montebugnoli Lucio
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Gabusi Andrea
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | | | - Cervellati Fabio
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Servidio Dora
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
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Segura S, Rozas-Muñoz E, Toll A, Martín-Ezquerra G, Masferrer E, Espinet B, Rodriguez M, Baró T, Barranco C, Pujol R. Evaluation of MYC status in oral lichen planus in patients with progression to oral squamous cell carcinoma. Br J Dermatol 2013; 169:106-14. [DOI: 10.1111/bjd.12303] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2013] [Indexed: 12/15/2022]
Affiliation(s)
- S. Segura
- Department of Dermatology; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
| | - E. Rozas-Muñoz
- Department of Dermatology; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
| | - A. Toll
- Department of Dermatology; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
- Department of Cytogenetics; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
| | - G. Martín-Ezquerra
- Department of Dermatology; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
| | - E. Masferrer
- Department of Dermatology; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
| | - B. Espinet
- Department of Cytogenetics; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
| | - M. Rodriguez
- Department of Cytogenetics; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
| | - T. Baró
- Department of Cytogenetics; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
| | - C. Barranco
- Department of Cytogenetics; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
- Universitat Autònoma de Barcelona; Barcelona Spain
| | - R.M. Pujol
- Department of Dermatology; Hospital del Mar; Parc de Salut Mar, Passeig Marítim 25-29 08003 Barcelona Spain
- Universitat Autònoma de Barcelona; Barcelona Spain
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Bardellini E, Amadori F, Flocchini P, Bonadeo S, Majorana A. Clinicopathological features and malignant transformation of oral lichen planus: a 12-years retrospective study. Acta Odontol Scand 2013; 71:834-40. [PMID: 23116326 DOI: 10.3109/00016357.2012.734407] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Oral lichen planus (OLP) is known to be associated with the risk of developing oral squamous cell carcinoma (OSCC). The objective of this study was to investigate the clinicopathological features of OLP and the prevalence of malignant transformation in this setting. MATERIALS AND METHODS This retrospective study was carried out on 204 medical records of patients with histologically proven OLP who received long-term follow-up (range 6 months-12 years). Data were entered in an informatic database. The statistical analysis, when needed, was performed with the chi-squared test for significance (p < 0.05). RESULTS At the moment of the diagnosis, out of 204 patients (163 female and 41 male; mean age 54.5 years), 107 patients (52.45%) suffered from systemic chronic diseases, in particular 46 (22.5%) from hepatitis C. Clinically, the reticular form of OLP was the predominant one and most patients had multiple oral sites of involvement. Fourteen patients showed extra-oral lesions. A percentage of malignant transformation less than 1% was found. In fact, two patients (0.98%) underwent a malignant transformation at a site previously diagnosed as OLP. CONCLUSIONS At present, OLP is accepted as being a potential malignant disorder, therefore lifelong follow-up is recommended.
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Affiliation(s)
- Elena Bardellini
- Dental Clinic, Department of Oral Medicine, University of Brescia, Brescia, Italy.
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Montebugnoli L, Leonardi E, Morandi L, Farnedi A, Gissi DB, Marchetti C, Tarsitano A, Balbi T, Gentile L, Cocchi R, Foschini MP. Genetic relationship between multiple squamous cell carcinomas arising in the oral cavity. Head Neck 2013; 36:94-100. [DOI: 10.1002/hed.23259] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2013] [Indexed: 12/31/2022] Open
Affiliation(s)
- Lucio Montebugnoli
- Section of Oral Science; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | - Elisa Leonardi
- Section of Anatomic Pathology at Bellaria Hospital; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | - Luca Morandi
- Section of Anatomic Pathology at Bellaria Hospital; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | - Anna Farnedi
- Section of Anatomic Pathology at Bellaria Hospital; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | - Davide Bartolomeo Gissi
- Section of Oral Science; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | | | | | - Tiziana Balbi
- Department of Hematology and Oncology; Operative Unit of Anatomic Pathology at S. Orsola Hospital; Bologna
| | - Luciano Gentile
- Unit of Maxillofacial Surgery; Bellaria Hospital; Bologna Italy
| | - Roberto Cocchi
- “Casa sollievo della sofferenza” Hospital; San Giovanni Rotondo (FG); Italy
| | - Maria Pia Foschini
- Section of Anatomic Pathology at Bellaria Hospital; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
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de Carvalho Fraga CA, Alves LR, Marques-Silva L, de Sousa AA, Jorge AS, de Jesus SF, Vilela DN, Pinheiro UB, Jones KM, de Paula AM, Guimarães AL. High HIF-1α expression genotypes in oral lichen planus. Clin Oral Investig 2013; 17:2011-5. [PMID: 23334242 DOI: 10.1007/s00784-013-0920-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 01/07/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aim of this study is to assess whether C1772T and G1790A hypoxia-inducible factor-1 (HIF-1)α polymorphisms are associated with risk of oral lichen planus (OLP). MATERIAL AND METHODS Restriction fragment length polymorphism analysis was used to investigate HIF-1α C1779T and G1790A polymorphisms in 32 OLP and 88 individuals without OLP. RESULTS The frequency of the CC, TT, GA, and AA genotypes was higher in patients with OLP. Notably, individuals carrying the C and A, and T and A haplotypes showed a significant association OLP risk. CONCLUSIONS Our study demonstrated that the C1772T and G1790A polymorphisms of HIF-1α gene increased the risk of OLP. C1772T and G1790A polymorphisms of HIF-1α gene had differing patterns of allelic imbalance in the normal samples and subsequent chronic lesions. Further studies are necessary to elucidate the HIF-1α pathway in OLP, which would facilitate the development of novel therapeutic strategies for the prevention and treatment of OLP. CLINICAL RELEVANCE These results, in conjunction with previous studies, suggest that HIF-1α may play important roles in the chronicity of oral mucosa lesions of OLP patients. Taken together, we suggest that HIF-1α polymorphisms enhance its target genes, thereby altering the microenvironment and supporting sequential release of inflammatory mediators or cellular events in OLP. It appears unlikely that inhibition of a single proinflammatory mediator will prove useful in clinical practice, but several ways to reprogram mediators engaged in a wide array of roles simultaneously are encouraging.
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Mattavelli F, Pizzi N, Pennacchioli E, Radaelli S, Quattrone P, Mattavelli D, Fior A, Pilotti S. Neoplastic Lymphangiosis of the Upper Aerodigestive Tract Simulating Field Cancerization: Histopathological Analysis, Surgical Limits and Literature Review. Tumori 2012; 98:e115-7. [DOI: 10.1177/030089161209800425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neoplastic lymphangiosis is defined as extensive embolic spread of cancer cells in the lymphatic vessels often without any evidence of a mass. Instead, field cancerization is defined by the presence of multifocal neoplastic lesions in a mucosal field previously exposed to mutagenic factors. In this case report, this oncological entity was suggested by the wide extent and multifocality of the disease and by the patient's exposure to risk factors. Instead, the pathological slides revealed the integrity of the mucosa and the presence of widespread embolic metastasis to lymphatic vessels. Thus, the diagnosis was changed to neoplastic lymphangiosis. This clinical presentation is a negative prognostic factor, and surgical treatment is ineffective because of the impossibility to obtain adequate free margins. The present case underlines the poor prognosis of such locally advanced cancer and the importance of recognizing it early so that the treatment approach can be adapted.
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Affiliation(s)
| | - Natalia Pizzi
- Otolaryngology Unit, IRCCS Istituto
Nazionale dei Tumori, Milan
| | | | | | | | | | - Andrea Fior
- Maxillofacial Surgery Clinic,
Università degli Studi di Verona, Verona, Italy
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Seintou A, Gaydarov N, Lombardi T, Samson J. Histoire naturelle et transformation maligne du lichen plan buccal. 2èmepartie : présentation de 6 cas. ACTA ACUST UNITED AC 2012. [DOI: 10.1051/mbcb/2012019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Kaplan I, Ventura-Sharabi Y, Gal G, Calderon S, Anavi Y. The dynamics of oral lichen planus: a retrospective clinicopathological study. Head Neck Pathol 2012; 6:178-83. [PMID: 22160614 DOI: 10.1007/s12105-011-0318-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Accepted: 12/03/2011] [Indexed: 10/14/2022]
Abstract
To evaluate disease dynamics, treatment results, and frequency of malignant transformation. Ten-year single center retrospective study. The study included 171 patients, 28-99 years old. Follow-up was 1-16 years. 49.5% exhibited changes in clinical presentation, with 19% yearly increase of probability for type shift. Index of extent (number of oral locations) showed a mean 40% decrease and 94.1% reported improvement. There were significant differences between treated and untreated patients (P=0.012). Patients with or without systemic diseases had identical treatment requirements for oral lesions. The prevalence of SCC was 5.8%. Oral lichen planus constantly changes presentation and extent of involvement. The effect of systemic diseases was insignificant in the present study. There is a clear value for treatment to reduce the extent of lesions. The results indicate that all clinical forms of the disease need to be equally followed since the clinical presentation typically changes over time, while malignant transformation can occur in all forms.
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Affiliation(s)
- Giulio Fortuna
- Department of Dermatology, Program in Epithelial Biology, Stanford University School of Medicine, Stanford, Calif., USA
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Gonzalez-Moles MA, Scully C, Ruiz-Avila I. Molecular findings in oral premalignant fields: update on their diagnostic and clinical implications. Oral Dis 2011; 18:40-7. [DOI: 10.1111/j.1601-0825.2011.01845.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bombeccari GP, Guzzi G, Tettamanti M, Giannì AB, Baj A, Pallotti F, Spadari F. Oral lichen planus and malignant transformation: a longitudinal cohort study. ACTA ACUST UNITED AC 2011; 112:328-34. [PMID: 21782485 DOI: 10.1016/j.tripleo.2011.04.009] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 04/03/2011] [Accepted: 04/13/2011] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Oral lichen planus (OLP) is associated with risk for developing oral squamous cell carcinoma (OSCC). We performed a 7-year prospective study to assess the incidence of malignant transformation of OLP among adults. STUDY DESIGN Three hundred twenty-seven OLP patients, 229 women (70.0%) and 98 men (30.0%), were observed during the follow-up period. RESULTS During a mean follow-up of 81.7 months, 8 of 327 patients developed an OSCC in OLP areas (0.36%/y), yielding the high overall standardized incidence ratio of 17.7 (95% confidence interval [CI] 8.8-35.3). The standardized incidence ratio for OSCC was significantly higher in women [27.0 (95% CI 11.2-64.8)] than in men [11.2 (95% CI 3.6-34.9)]. Six OSCCs were well differentiated (75%) and 2 moderately differentiated (25%). Three subjects (37.5%) developed recurrences within 2 years (mean 16.1 ± 3.5 months). Disease-free survival rate after 69.8 months was 97.3%. CONCLUSIONS OLP was associated with a significant increase in the risk for OSCC. Close surveillance may help to reduce the morbidity of OSCC arising from OLP at 24 months.
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Affiliation(s)
- Gian Paolo Bombeccari
- Unit of Oral Pathology and Medicine, Department of Reconstructive and Diagnostic Surgical Sciences, University of Milan, Milan, Italy.
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Abstract
The concurrence of the intracranial multiple primary tumors (MPTs) consisting of acoustic neuroma (AN) and pituitary adenoma is very rare. Here, we report a 42-year-old female who presented with left AN associated with pituitary adenoma. A total of three such cases have been reported before and which also presented with left AN with pituitary adenoma. Recently, a new "field cancerization" model has been proposed, which could explain MPTs and is consistent with the pathogenesis of such cases. The model also indicates that when a pituitary tumor or AN is detected separately, we might consider the development of "expanding field" after oncological treatment especially after radiotherapy in order to prevent the second field tumor occurring.
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Affiliation(s)
- Y Niu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Salazar-Sánchez N, López-Jornet P, Camacho-Alonso F, Sánchez-Siles M. Efficacy of topical Aloe vera in patients with oral lichen planus: a randomized double-blind study. J Oral Pathol Med 2010; 39:735-40. [PMID: 20923446 DOI: 10.1111/j.1600-0714.2010.00947.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Different treatments have been used in application to symptomatic oral lichen planus (OLP), with variable results, perhaps caused by the refractory nature of the disease. The objective of this study was to evaluate the efficacy of the topical application of aloe vera (AV) in OLP compared with placebo. METHODS A total of 64 patients with OLP were randomized in a double-blind study to either AV (32 patients) or placebo (32 patients), at a dose of 0.4 ml (70% concentration) three times a day. A Visual Analog Scale was used for rating pain, with the application of a clinical scale for scoring the lesions, the Oral Health Impact Profile 49 (OHIP-49), and the Hospital Anxiety-Depression (HAD) scale. The patients were evaluated after 6 and 12 weeks. RESULTS No statistically significant differences were recorded between both groups in relation to pain after 6 and 12 weeks. In the AV group, complete pain remission was achieved in 31.2% of the cases after 6 weeks, and in 61% after 12 weeks. In the placebo group, these percentages were 17.2% and 41.6%, respectively. There were no adverse effects in any of the groups. In relation to quality of life, significant differences were observed between the two groups in the psychological disability domain and total OHIP-49 score. CONCLUSION The topical application of AV improves the total quality of life score in patients with OLP.
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Affiliation(s)
- N Salazar-Sánchez
- Department of Oral Medicine, Faculty of Medicine and Odontology, University of Murcia, Avda. Marques de los Velez s ⁄ n, Murcia, Spain
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Crincoli V, Di Bisceglie MB, Scivetti M, Lucchese A, Tecco S, Festa F. Oral lichen planus: update on etiopathogenesis, diagnosis and treatment. Immunopharmacol Immunotoxicol 2010; 33:11-20. [DOI: 10.3109/08923973.2010.498014] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Safadi RA, Jaber SZA, Hammad HM, Hamasha AAH. Oral lichen planus shows higher expressions of tumor suppressor gene products of p53 and p21 compared to oral mucositis. An immunohistochemical study. Arch Oral Biol 2010; 55:454-61. [DOI: 10.1016/j.archoralbio.2010.03.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Revised: 03/23/2010] [Accepted: 03/24/2010] [Indexed: 01/02/2023]
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Bermejo-Fenoll A, Sánchez-Siles M, López-Jornet P, Camacho-Alonso F, Salazar-Sánchez N. A retrospective clinicopathological study of 550 patients with oral lichen planus in south-eastern Spain. J Oral Pathol Med 2010; 39:491-6. [PMID: 20456611 DOI: 10.1111/j.1600-0714.2010.00894.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study describes the clinicopathological characteristics of a group of patients with oral lichen planus (OLP) in south-eastern Spain. MATERIALS AND METHODS A retrospective descriptive study was made of 550 patients clinically and histopathologically diagnosed with OLP in the period 1991-2007. Patient gender, age, the prevalence of hepatitis C, symptoms and malignization were recorded. The clinical forms were classified as reticular-papular and atrophic-erosive. RESULTS Of the 550 patients, 128 (23.3%) were men and 422 (76.7%) women. The mean age was 56.35 +/- 13.67 years (range 14-91). The prevalence of hepatitis C was 3.5%. The red clinical forms were the most frequent, with 359 cases (64.2%). The lesions were asymptomatic in 159 patients (28.9%). Five patients developed oral squamous cell carcinoma (0.9%); none of these subjects was smokers. CONCLUSIONS Patients with OLP present different clinical manifestations. Women were more frequently affected by the disease, and the malignant transformation rate was under 1%.
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Affiliation(s)
- A Bermejo-Fenoll
- Mariano Sánchez-Siles, Clínica Odontológica Universitaria, Medicina Bucal, Hospital Morales Meseguer, Murcia, Spain
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Ghabanchi J, Fattahi MJ, Mardani M, Tadbir AA, Paydar AA. Polymorphism of tumor protein p53 codon 72 showed no association with oral lichen planus in Shiraz, Iran. J Craniofac Surg 2009; 20:2168-70. [PMID: 19884837 DOI: 10.1097/SCS.0b013e3181bf015e] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic relapsing inflammatory disease involving T-lymphocyte aggression targeted to the basal layer of the oral mucosa. The tumor suppressor tumor protein p53 (TP53), located on chromosome 17, has been involved in various malignancies. OBJECTIVE This study was undertaken to investigate the association of p53 codon 72 polymorphism with OLP in Southern Iranian patients. METHODS Twenty-five patients with lichen planus and 93 healthy blood donors as control group were recruited. DNA from peripheral blood mononuclear cells was extracted and amplified using allele-specific polymerase chain reaction. RESULTS The frequency of homozygotic arginine (Arg) at codon 72 was 44% in the patients and 37.6% in the controls; for homozygotic proline (Pro), it was 24% and 15.15%, respectively, and for heterozygotic arginine/proline, it was 32% and 47.3%, respectively. CONCLUSION The polymorphism in codon 72 of the TP53 gene was not associated with the OLP in Iranian patients.
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Uehara M, Sano K, Ikeda H, Nonaka M, Asahina I. Hypoxia-inducible factor 1 alpha in oral squamous cell carcinoma and its relation to prognosis. Oral Oncol 2010; 45:241-6. [PMID: 18675581 DOI: 10.1016/j.oraloncology.2008.05.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 05/12/2008] [Accepted: 05/06/2008] [Indexed: 10/21/2022]
Abstract
The aim of this study was to investigate the correlation between the expression of hypoxia-inducible factor 1 alpha (HIF-1 alpha) and proliferative activity in tumor cells, lymph node metastasis, as well as prognosis in patients with oral squamous cell carcinoma (OSCC). Fifty-seven biopsy specimens of OSCC were investigated for the expression of HIF-1 alpha and proliferating cell nuclear antigen (PCNA) by immunohistochemistry. None of the patients had received any prior treatments. The percentage of HIF-1 alpha immunopositive area (PHIA) was calculated using computer-assisted image analysis for quantitative assessment of HIF-1 alpha expression. The PCNA labeling index (LI) was evaluated as a proliferation marker. We found that the mean PHIA in all stages was 12.1% in the poor prognosis patients, and it was 6.4% in the good prognosis patients. There was a significant difference of PHIA between poor prognosis and good prognosis patients (P=0.0065). Furthermore, the mean PHIA in the patients who had no metastatic lymph nodes was 7.5%, while it was 11.7% in the patients who had metastatic lymph nodes. There was also a significant difference of PHIA between patients who had no metastatic lymph nodes and those who had metastatic lymph nodes (P=0.0487). On the other hand, significant correlation between PHIA and PCNA LI was not observed. These results provide the clinical data indicating that HIF-1 alpha may play an important role in lymph node metastasis and prognosis in patients with OSCC.
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Affiliation(s)
- Masataka Uehara
- Division of Regenerative Oral Surgery, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan.
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Abstract
The common oral diseases as well as oral cancer have the characteristic of field cancerization or field effect. Field cancerization, characterized by phenotypic and genetic changes in the neighboring cells of the frank cancer cells, is a clinical phenomenon first found in head and neck cancers. Field cancerization of the epithelia is currently a widely-accepted model in cancer biology as a manifestation of cancer progression. The concomitant changes in the tumor microenvironment have drawn more attention recently. Could the changes in the tumor microenvironment and the epithelial field cancerization concepts be linked? In view of the importance of stroma in the development of epithelium and evidence in carcinoma-associated stroma, we propose the question if stroma not only reciprocates the neoplastic changes of the epithelia, but also contributes to field cancerization. Actually one perspective paper pointed out that healing wound can influence the recurrence of field cancerization. In another words, the microenvironment of healing wound determines the prognosis of field cancerization. Based on the literatures published and our own work, we hypothesize a new model of field cancerization focusing on the co-evolution of the tumor microenvironment. We suggest that the microenvironment cannot be neglected when treating diseases with characteristics of field cancerization.
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Affiliation(s)
- Lin Ge
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan, China
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