Impairments in Food Oral Processing in Patients Treated for Tongue Cancer

Oral processing behavior and dental caries; an insight into a new relationship

INTRODUCTION

Previous evidence suggests an individual variation in the preferred oral processing behavior. Individuals can be classified as firm processing(FPL) or soft processing likers(SPL). FPL(crunchers and chewers) prefer using their teeth while SPL(smooshers and suckers) prefer using the tongue and the palate when processing different food items. Variation in the preferred oral processing behavior has been associated with differences in food texture preference and eating time. Time is one of the factors directly related to the development of dental caries(tooth decay). Oral retention and eating times are associated with greater caries experience. This study aims to explore if a relationship exists between the preferred oral processing behavior and the individual's caries experience.

MATERIALS AND METHODS

This was a cross-sectional, dental center-based study conducted at Jordan University of Science and Technology. Five hundred participants consented to fill out the preferred oral processing behavior(POPB) questionnaire. Anthropometric measurements (including weight, height, and waist circumference) were recorded. A single trained and calibrated dentist registered each participant's caries experience and plaque levels using the DMFS index and plaque index of Silness and Loe.

RESULTS

A total of 351(70.2%) and 149(29.8%) participants were typed as FPL and SPL, respectively. SPL demonstrated higher levels of dental caries experience compared to FPL. The mean DMFS score for SPL was 28.8(±25.43) while for FPL was 18.71(± 18.34). This difference remained significant after adjustment for confounders(P<0.001). SPL exhibited a significantly higher mean score for the "M" component(P <0.001) while no significant difference in the mean score of the "D"(P = 0.076) and "F"(P = 0.272) components was observed when compared to FPL.

CONCLUSION

The current findings provide new insight into a possible relationship between the preferred oral processing behavior and an individual's caries experience. A relationship in which the preferred oral processing behavior can potentially affect and/or be affected by the dental caries experience.

Perioperative nutritional risk and its influencing factors in patients with oral cancer: a longitudinal study

Introduction

We aimed to investigate the nutritional risk status and dynamic changes in patients with perioperative oral cancer at different stages and analyze the factors influencing nutritional risk and the correlation among body mass index, nutrition-related symptoms, and nutritional risk.

Methods

In total, 198 patients with oral cancer who were hospitalized in the Head & Neck Surgery Departments of a tertiary cancer hospital in Hunan Province, China, from May 2020 to January 2021, were selected as participants. The Nutritional Risk Screening 2002 scale and Head and Neck Patient Symptom Checklist were used to assess patients on admission day, 7 days post-surgery, and 1 month post-discharge. Multivariate analysis of variance, paired t-test, and generalized estimating equation were used to analyze the trajectory and influencing factors of nutritional risk in patients with perioperative oral cancer. Spearman's correlation analysis was used to explore the correlation among body mass index, symptoms, and nutritional risk.

Results

The nutritional risk scores of patients with oral cancer at the three time points were 2.30 ± 0.84, 3.21 ± 0.94, and 2.11 ± 0.84, respectively, and the differences were significant (p < 0.05). The incidences of nutritional risk were 30.3, 52.5, and 37.9%, respectively. The factors influencing nutritional risk included education level, smoking status, clinical stage, flap repair, and tracheotomy (β = -0.326, 0.386, 0.387, 0.336, and 0.240, respectively, p < 0.05). Nutritional risk was negatively correlated with body mass index (r_s = -0.455, p < 0.01) and positively correlated with pain, loss of appetite, sore mouth, bothersome smells, swallowing difficulty, taste changes, depression, chewing difficulty, thick saliva, and anxiety (r_s = 0.252, 0.179, 0.269, 0.155, 0.252, 0.212, 0.244, 0.384, 0.260, and 0.157, respectively, p < 0.05).

Conclusion

The incidence of nutritional risk in patients with perioperative oral cancer was high, and the trajectory of nutritional risk changed over time. Strengthening the nutritional monitoring and management of postoperative patients or those with low education level, advanced-stage cancer, flap repair, tracheotomy, and low body mass index; strengthening tobacco control management; and controlling nutrition-related discomfort symptoms in perioperative oral cancer patients are necessary.

Oral Dysfunction in Patients with Oral Cancer Could Occur Before Treatment and Require Early Nutritional Improvement: A Cross-Sectional Study

Patients with oral cancer have poor nutritional status before treatment. However, there have been no reports of the detailed evaluation of preoperative oral function in patients with oral squamous cell carcinoma (OSCC). Therefore, this study aimed to evaluate the preoperative oral function of patients with OSCC and examine the relationship with nutritional status. Oral function measurements (microorganisms, oral dryness, occlusal force, tongue pressure, masticatory function, Eating Assessment Tool, and Postoperative Oral Dysfunction Scale) and Mini Nutritional Assessment-Short Form (MNA-SF) data were collected from 51 patients with OSCC (men: 37, women: 14, mean age: 72.1 years) who visited the Shimane University Hospital, Department of Oral and Maxillofacial Surgery, from September 2019 to September 2021. The tongue was the most prevalent primary gingiva site [22 patients (43.1%)], and 36 patients (70.6%) had advanced cancer. Comparisons between nutritional status and each related factor revealed significant differences in the number of individuals in the household, cancer stage, presence of pulmonary disease, number of teeth, microorganisms (grade), and masticatory function (mg/dL) (p < 0.05). Multiple regression analysis using the total MNA-SF score as the dependent variable with adjustment for confounding factors showed significant association between oral dryness and tongue pressure (p < 0.05). No significant association was found for the Eating Assessment Tool or Postoperative Oral Dysfunction scale. Patients with OSCC may have decreased oral function because of the tumor at the time of diagnosis, which causes a decline in nutritional status. Preoperative interventions are necessary to improve nutrition based on the state of oral function.

Oral Health Management and Rehabilitation for Patients with Oral Cancer: A Narrative Review

Surgery is the current first choice for oral cancer treatment. Intensity-modulated radiation therapy, molecular targeted drugs, and immune checkpoint inhibitors are still used as adjuvant therapy for advanced cancer. In addition, postoperative rehabilitation and multidisciplinary treatment have also been developed in recent years. Multidisciplinary team approaches and supportive care in oral cancer treatment reportedly shorten the time to treatment and improve outcomes. Although there is enough evidence confirming the role of oral and maxillofacial surgeons, dentists, and dental hygienists in supportive care in oral cancer treatment, there are very few systematic studies. In particular, oral health management is a concept that encompasses oral function management, oral hygiene management, and oral care during oral cancer treatment. We provide a narrative review focusing on oral health management from a multidisciplinary and supportive care perspective, applicable in oral cancer treatment.

CDH3 is associated with a poor prognosis by promoting the malignance and chemoresistance in oral squamous cell carcinoma

BACKGROUND

CDH3 is recognized as an oncogene in various malignancies. Here, we aim to explore the association of CDH3 expression and prognostic implication in oral squamous cell carcinoma (OSCC).

METHODS

Bioinformatics was used to analyze differentially expressed genes in the TCGA database. The OSCC tissues of 136 cases were used for immunohistochemistry. Cox proportional hazard analysis was used to analyze the relationship between prognostic factors, CDH3 expression and patient survival. Kaplan-Meier analysis was adopted to calculate survival rates. RT-qPCR and Western blot were performed to detect the expression levels of CDH3 in oral squamous cell lines. The cell viability and colony formation abilities were examined by CCK-8 and colony formation assays, respectively. Wound healing assay was performed to examine the invasion ability of cells.

RESULTS

CDH3 is up-regulated in oral squamous cell carcinoma and related to bad prognosis. Knock-down of CDH3 limited cell viability, colony formation ability, migration, invasion and chemoresistance of OSCC cells.

CONCLUSION

CDH3 is associated with a poor prognosis through promoting migration, invasion and chemoresistance in oral squamous cell carcinoma.

BASP1 is up-regulated in tongue squamous cell carcinoma and associated with a poor prognosis

OBJECTIVE

To study the relationship between expression of brain acid soluble protein 1 (BASP1) in tongue squamous cell carcinoma (TSCC) tissue and the clinicopathological characteristics and prognosis of patients with TSCC.

METHODS

Western blotting was performed to detect BASP1 expression in fresh-frozen specimens of tumor tissue and adjacent normal tissue obtained from 6 patients with TSCC. Immunohistochemical methods were used to detect BASP1 expression in 100 paraffin-embedded specimens of TSCC tissue. The chi-square test was used to analyze the association between BASP1 expression and a variety of clinicopathological parameters. A Kaplan-Meier analysis and the Cox proportional hazard model were used to further evaluate the impact of BASP1 on patient survival.

RESULTS

The Oncomine database showed that BASP1 expression was increased in TSCC tissues. The PrognoScan and GEPIA databases suggested that a high level of BASP1 expression is related to a poor prognosis for patients with head and neck cancer. Experimental results showed that when compared to normal tissues adjacent to a cancer, BASP1 was more highly expressed in the TSCC tissues. Univariate and multivariate Cox regression analyses showed that BASP1 expression and the tumor's stage may be independent risk factors that affect the growth and prognosis of TSCC. A survival analysis showed that patients with a low level of BASP1 expression had a higher survival rate.

CONCLUSION

Overexpression of BASP1 was found to be associated with distant node metastasis and a poor prognosis among patents with TSCC. BASP1 could possibly serve as a molecular marker for diagnosing and treating the disease.

Masticatory Adaptation to Occlusal Changes

This review deals with the frequent wide variability of masticatory capacity/incapacity. Neither researchers nor clinicians have taken sufficient account of this variability despite its implications for nutrition. Mastication in normal healthy oral conditions is first described, followed by a short presentation of the mechanisms of masticatory adaptation in the nervous system. Capacity, incapacity, and successful compensatory adaptation of mastication are then defined, along with the different methods used for their evaluation. Examples of adaptation needs are given, such as those concomitant with dental wear or occlusal changes. Finally, given its vital importance for deeply impaired mastication/deglutition function, the impact of masticatory adaptation processes on nutrition is examined.