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Chen W, Wu Y, Wang J, Yu W, Shen X, Zhao K, Liang B, Hu X, Wang S, Jiang H, Liu X, Zhang M, Xing X, Wang C, Xing D. Clinical advances in TNC delivery vectors and their conjugate agents. Pharmacol Ther 2024; 253:108577. [PMID: 38081519 DOI: 10.1016/j.pharmthera.2023.108577] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
Tenascin C (TNC), a glycoprotein that is abundant in the tumor extracellular matrix (ECM), is strongly overexpressed in tumor tissues but virtually undetectable in most normal tissues. Many TNC antibodies, peptides, aptamers, and nanobodies have been investigated as delivery vectors, including 20A1, α-A2, α-A3, α-IIIB, α-D, BC-2, BC-4 BC-8, 81C6, ch81C6, F16, FHK, Ft, Ft-NP, G11, G11-iRGD, GBI-10, 19H12, J1/TN1, J1/TN2, J1/TN3, J1/TN4, J1/TN5, NJT3, NJT4, NJT6, P12, PL1, PL3, R6N, SMART, ST2146, ST2485, TN11, TN12, TNFnA1A2-Fc, TNfnA1D-Fc, TNfnBD-Fc, TNFnCD-Fc, TNfnD6-Fc, TNfn78-Fc, TTA1, TTA1.1, and TTA1.2. In particular, BC-2, BC-4, 81C6, ch81C6, F16, FHK, G11, PL1, PL3, R6N, ST2146, TN11, and TN12 have been tested in human tissues. G11-iRGD and simultaneous multiple aptamers and arginine-glycine-aspartic acid (RGD) targeting (SMART) may be assessed in clinical trials because G11, iRGD and AS1411 (SMART components) are already in clinical trials. Many TNC-conjugate agents, including antibody-drug conjugates (ADCs), antibody fragment-drug conjugates (FDCs), immune-stimulating antibody conjugates (ISACs), and radionuclide-drug conjugates (RDCs), have been investigated in preclinical and clinical trials. RDCs investigated in clinical trials include 111In-DTPA-BC-2, 131I-BC-2, 131I-BC-4, 90Y-BC4, 131I81C6, 131I-ch81C6, 211At-ch81C6, F16124I, 131I-tenatumomab, ST2146biot, FDC 131I-F16S1PF(ab')2, and ISAC F16IL2. ADCs (including FHK-SSL-Nav, FHK-NB-DOX, Ft-NP-PTX, and F16*-MMAE) and ISACs (IL12-R6N and 125I-G11-IL2) may enter clinical trials because they contain components of marketed treatments or agents that were investigated in previous clinical studies. This comprehensive review presents historical perspectives on clinical advances in TNC-conjugate agents to provide timely information to facilitate tumor-targeting drug development using TNC.
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Affiliation(s)
- Wujun Chen
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China
| | - Yudong Wu
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China
| | - Jie Wang
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China
| | - Wanpeng Yu
- Qingdao Medical College, Qingdao University, Qingdao, Shandong 266071, China
| | - Xin Shen
- State Key Laboratory Base of Eco-chemical Engineering, College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao, Shandong 266042, China
| | - Kai Zhao
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China; Department of Neurosurgery, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Bing Liang
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China
| | - Xiaokun Hu
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China; Interventional Medicine Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Shuai Wang
- Department of Radiotherapy, Affiliated Hospital of Weifang Medical University, Key Laboratory of Precision Radiation Therapy for Tumors in Weifang City, School of Medical Imaging, Weifang Medical University, Weifang, Shandong 261031, China
| | - Hongfei Jiang
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China
| | - Xinlin Liu
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China
| | - Miao Zhang
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China
| | - Xiaohui Xing
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, Shandong 252000, China.
| | - Chao Wang
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China.
| | - Dongming Xing
- Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong 266000, China; School of Life Sciences, Tsinghua University, Beijing 100084, China.
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Walsh T, Macey R, Kerr AR, Lingen MW, Ogden GR, Warnakulasuriya S. Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions. Cochrane Database Syst Rev 2021; 7:CD010276. [PMID: 34282854 PMCID: PMC8407012 DOI: 10.1002/14651858.cd010276.pub3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Squamous cell carcinoma is the most common form of malignancy of the oral cavity, and is often proceeded by oral potentially malignant disorders (OPMD). Early detection of oral cavity squamous cell carcinoma (oral cancer) can improve survival rates. The current diagnostic standard of surgical biopsy with histology is painful for patients and involves a delay in order to process the tissue and render a histological diagnosis; other diagnostic tests are available that are less invasive and some are able to provide immediate results. This is an update of a Cochrane Review first published in 2015. OBJECTIVES Primary objective: to estimate the diagnostic accuracy of index tests for the detection of oral cancer and OPMD, in people presenting with clinically evident suspicious and innocuous lesions. SECONDARY OBJECTIVE to estimate the relative accuracy of the different index tests. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials to 20 October 2020. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. SELECTION CRITERIA We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting OPMD or oral cavity squamous cell carcinoma: vital staining (a dye to stain oral mucosa tissues), oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. MAIN RESULTS This update included 63 studies (79 datasets) published between 1980 and 2020 evaluating 7942 lesions for the quantitative meta-analysis. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (22 datasets), oral cytology (24 datasets), light-based detection or oral spectroscopy (24 datasets). Nine datasets assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis. Two studies were classed as being at low risk of bias across all domains, and 33 studies were at low concern for applicability across the three domains, where patient selection, the index test, and the reference standard used were generalisable across the population attending secondary care. The summary estimates obtained from the meta-analysis were: - vital staining: sensitivity 0.86 (95% confidence interval (CI) 0.79 to 0.90) specificity 0.68 (95% CI 0.58 to 0.77), 20 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; - oral cytology: sensitivity 0.90 (95% CI 0.82 to 0.94) specificity 0.94 (95% CI 0.88 to 0.97), 20 studies, sensitivity moderate-certainty evidence, specificity moderate-certainty evidence; - light-based: sensitivity 0.87 (95% CI 0.78 to 0.93) specificity 0.50 (95% CI 0.32 to 0.68), 23 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; and - combined tests: sensitivity 0.78 (95% CI 0.45 to 0.94) specificity 0.71 (95% CI 0.53 to 0.84), 9 studies, sensitivity very low-certainty evidence, specificity very low-certainty evidence. AUTHORS' CONCLUSIONS At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this updated review, further research into biomarkers may be warranted.
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Affiliation(s)
- Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, USA
| | - Mark W Lingen
- Pritzker School of Medicine, Division of Biological Sciences, Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Graham R Ogden
- Division of Oral and Maxillofacial Clinical Sciences, School of Dentistry, University of Dundee, Dundee, UK
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Bhattacharyya S, Ray S, Saha D, Mustafi SM, Alam N, Sarkar A, Murmu N. Chewing tobacco may act as a risk factor for dysplastic transformation of squamous cells in Oral leukoplakia- A cytochemistry based approach. Pathol Res Pract 2020; 218:153287. [PMID: 33454586 DOI: 10.1016/j.prp.2020.153287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 11/18/2022]
Abstract
The use of chewing tobacco is a severe risk factor for oral mucosa related diseases including cancer in India as well as USA, although its relationship with Oral Leukoplakia (OL) or related carcinogenicity is still not clear. This work chose two oncogenic pathway proteins- the Epidermal Growth Factor Receptor and the WNT pathway among leukoplakia patients and established their correlation with the individuals' tobacco chewing habit. 89 fresh patients with OL were selected for the work. The samples were classified based on the individual's tobacco chewing habit. The divided samples were then immunostained with antibodies for both of the EGFR as well as WNT pathway proteins. The samples were further classified based on their proliferation status and the expression of these oncoproteins was also observed. In order to compare the cytological data with histological data, 30 OL patients undergoing biopsy were chosen and immunohistological analysis was performed for the same pathways. Results showed overexpressing EGFR and WNT pathway proteins in all OL samples. Structurally atypic cells had a tendency to overexpress these oncoproteins. However the immunocytochemistry data could not confirm any positive effect of chewing tobacco on the OL's proliferative state. Statistical data from the immunfluorescence finally revealed the overexpression of both EGFR and WNT pathway proteins on the proliferative population establishing chewing tobacco as a positive risk factor for the onset of OL. Data from biopsy samples followed the same trend of protein expression seen in the cytological samples. Dysplastic zones showed huge overexpression of EGFR and WNT pathway proteins among tobacco chewers. In conclusion, this is the first time report showing the effect of chewing tobacco on the EGFR and WNT pathway in OL and its possible role as a potential risk factor for its proliferative type.
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Affiliation(s)
- Sayantan Bhattacharyya
- Department of Signal Transduction & Biogenic Amines, Chittaranjan National Cancer Institute, India
| | - Sudipta Ray
- Department of Signal Transduction & Biogenic Amines, Chittaranjan National Cancer Institute, India
| | - Depanwita Saha
- Department of Signal Transduction & Biogenic Amines, Chittaranjan National Cancer Institute, India
| | | | - Neyaz Alam
- Department of Surgical Oncology, Chittaranjan National Cancer Institute, India
| | - Aniruddha Sarkar
- Department of Head and Neck Oncology, Chittaranjan National Cancer Institute, India
| | - Nabendu Murmu
- Department of Signal Transduction & Biogenic Amines, Chittaranjan National Cancer Institute, India.
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H. Alsarraf A, Kujan O, Farah CS. The utility of oral brush cytology in the early detection of oral cancer and oral potentially malignant disorders: A systematic review. J Oral Pathol Med 2017; 47:104-116. [DOI: 10.1111/jop.12660] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2017] [Indexed: 12/20/2022]
Affiliation(s)
| | - Omar Kujan
- UWA Dental School; University of Western Australia; Nedlands WA Australia
| | - Camile S. Farah
- UWA Dental School; University of Western Australia; Nedlands WA Australia
- Australian Centre for Oral Oncology Research & Education; UWA Dental School; University of Western Australia; Nedlands WA Australia
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Tenascin-C and fibronectin expression divide early stage tongue cancer into low- and high-risk groups. Br J Cancer 2017; 116:640-648. [PMID: 28095396 PMCID: PMC5344290 DOI: 10.1038/bjc.2016.455] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/18/2016] [Accepted: 12/20/2016] [Indexed: 12/23/2022] Open
Abstract
Background: Oral tongue squamous cell carcinoma (OTSCC) metastasises early, especially to regional lymph nodes. There is an ongoing debate on which early stage (T1-T2N0) patients should be treated with elective neck dissection. We need prognosticators for early stage tongue cancer. Methods: Mice immunisation with human mesenchymal stromal cells resulted in production of antibodies against tenascin-C (TNC) and fibronectin (FN), which were used to stain 178 (98 early stage), oral tongue squamous cell carcinoma samples. Tenascin-C and FN expression in the stroma (negative, moderate or abundant) and tumour cells (negative or positive) were assessed. Similar staining was obtained using corresponding commercial antibodies. Results: Expression of TNC and FN in the stroma, but not in the tumour cells, proved to be excellent prognosticators both in all stages and in early stage cases. Among early stages, when stromal TNC was negative, the 5-year survival rate was 88%. Correspondingly, when FN was negative, no cancer deaths were observed. Five-year survival rates for abundant expression of TNC and FN were 43% and 25%, respectively. Conclusions: Stromal TNC and, especially, FN expressions differentiate patients into low- and high-risk groups. Surgery alone of early stage primary tumours might be adequate when stromal FN is negative. Aggressive treatments should be considered when both TNC and FN are abundant.
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Abstract
Tenascin-C is a large, multimodular, extracellular matrix glycoprotein that exhibits a very restricted pattern of expression but an enormously diverse range of functions. Here, we discuss the importance of deciphering the expression pattern of, and effects mediated by, different forms of this molecule in order to fully understand tenascin-C biology. We focus on both post transcriptional and post translational events such as splicing, glycosylation, assembly into a 3D matrix and proteolytic cleavage, highlighting how these modifications are key to defining tenascin-C function.
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Key Words
- AD1/AD2, additional domain 1/ additional domain 2
- ADAMTS, a disintegrin and metalloproteinase with thrombospondin motifs
- ASMCs, aortic smooth muscle cells
- BDNF, brain derived neurotrophic factor
- BHKs, baby hamster kidney cells
- BMP, bone morphogenetic protein
- CA19–9, carbohydrate antigen 19–9
- CALEB, chicken acidic leucine-rich EGF-like domain containing brain protein
- CEA, carcinoembryonic antigen
- CNS, central nervous system
- CRC, colorectal carcinomas
- CTGF, connective tissue growth factor
- DCIS, ductal carcinoma in-situ
- ECM, extracellular matrix
- EDA-FN, extra domain A containing fibronectin
- EDB-FN, extra domain B containing fibronectin
- EGF-L, epidermal growth factor-like
- EGF-R, epidermal growth factor receptor
- ELISPOT, enzyme-linked immunospot assay
- FBG, fibrinogen-like globe
- FGF2, fibroblast growth factor 2
- FGF4, fibroblast growth factor 4
- FN, fibronectin
- FNIII, fibronectin type III-like repeat
- GMEM, glioma-mesenchymal extracellular matrix antigen
- GPI, glycosylphosphatidylinositol
- HB-EGF, heparin-binding EGF-like growth factor
- HCEs, immortalized human corneal epithelial cell line
- HGF, hepatocyte growth factor
- HNK-1, human natural killer-1
- HSPGs, heparan sulfate proteoglycans
- HUVECs, human umbilical vein endothelial cells
- ICC, immunocytochemistry
- IF, immunofluorescence
- IFNγ, interferon gamma
- IGF, insulin-like growth factor
- IGF-BP, insulin-like growth factor-binding protein
- IHC, immunohistochemistry
- IL, interleukin
- ISH, in situ hybridization
- LPS, lipopolysaccharide
- MMP, matrix metalloproteinase
- MPNSTs, malignant peripheral nerve sheath tumors
- Mr, molecular mass
- NB, northern blot
- NF-kB, nuclear factor kappa-light-chain-enhancer of activated B cells
- NK, natural killer cells
- NSCLC, non-small cell lung carcinoma
- NSCs, neural stem cells
- NT, neurotrophin
- PAMPs, pathogen-associated molecular patterns
- PDGF, platelet derived growth factor
- PDGF-Rβ, platelet derived growth factor receptor β
- PIGF, phosphatidylinositol-glycan biosynthesis class F protein
- PLCγ, phospholipase-C gamma
- PNS, peripheral nervous system
- PTPRζ1, receptor-type tyrosine-protein phosphatase zeta
- RA, rheumatoid arthritis
- RCC, renal cell carcinoma
- RD, rhabdomyosarcoma
- RGD, arginylglycylaspartic acid
- RT-PCR, real-time polymerase chain reaction
- SB, Southern blot
- SCC, squamous cell carcinoma
- SMCs, smooth muscle cells
- SVZ, sub-ventricular zone
- TA, tenascin assembly domain
- TGFβ, transforming growth factor β
- TIMP, tissue inhibitor of metalloproteinases
- TLR4, toll-like receptor 4
- TNFα, tumor necrosis factor α
- TSS, transcription start site
- UBC, urothelial bladder cancer
- UCC, urothelial cell carcinoma
- VEGF, vascular endothelial growth factor
- VSMCs, vascular smooth muscle cells
- VZ, ventricular zone
- WB, immunoblot/ western blot
- bFGF, basic fibroblast growth factor
- biosynthesis
- c, charged
- cancer
- ccRCC, clear cell renal cell carcinoma
- chRCC, chromophobe-primary renal cell carcinoma
- development
- glycosylation
- mAb, monoclonal antibody
- matrix assembly
- mitogen-activated protein kinase, MAPK
- pHo, extracellular pH
- pRCC, papillary renal cell carcinoma
- proteolytic cleavage
- siRNA, small interfering RNA
- splicing
- tenascin-C
- therapeutics
- transcription
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Affiliation(s)
- Sean P Giblin
- a Nuffield Department of Orthopaedics; Rheumatology and Musculoskeletal Sciences ; Kennedy Institute of Rheumatology; University of Oxford ; Oxford , UK
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Nanayakkara PGCL, Dissanayaka WL, Nanayakkara BG, Amaratunga EAPD, Tilakaratne WM. Comparison of spatula and cytobrush cytological techniques in early detection of oral malignant and premalignant lesions: a prospective and blinded study. J Oral Pathol Med 2015; 45:268-74. [PMID: 26403502 DOI: 10.1111/jop.12357] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND The use of oral cytology to diagnose malignant and premalignant lesions at an early stage is considered crucial. The aim of this study was to evaluate the diagnoses of the spatula and the cytobrush techniques compared with the gold standard histopathological findings, analysed according to different diagnostic criteria. METHODS Cytological smears were obtained from 76 suspicious oral malignant lesions and 116 oral leukoplakia lesions using two techniques: cytobrush plus cell collector and metal spatula. Subsequently, a surgical biopsy was performed on each lesion to achieve a histopathological diagnosis. Evaluation was conducted with respect to three different diagnostic criteria. RESULTS The sensitivity for diagnosing carcinoma in clinically malignant cases was 89.58% and 60.42% for cytobrush and spatula techniques, respectively. Inclusion of severe dysplastic cases for 'high-risk' lesions increased the sensitivity up to 96.36% and 78.18% for two techniques, respectively. In leukoplakia lesions, malignant and severely dysplastic cells were diagnosed at a sensitivity of 88.89% in the cytobrush and 55.56% in the spatula techniques. Extending the criteria by defining malignant or any dysplastic findings as positive, sensitivity was increased to 98.02% and 89.11% for the spatula and the cytobrush techniques, respectively. Specificity for both techniques increased to 100%. The difference between the diagnoses of histopathology and the spatula cytology was statistically significant (P < 0.01), while no such difference was found with the cytobrush technique (P > 0.1). CONCLUSION The cytobrush, unlike the spatula, is a useful screening instrument for early diagnosis of suspicious oral lesions and could therefore contribute to improved oral cancer prognosis.
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Affiliation(s)
| | - W L Dissanayaka
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - B G Nanayakkara
- Faculty of Medicine, University of Ruhuna, Karapitiya, Sri Lanka
| | - E A P D Amaratunga
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - W M Tilakaratne
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Hijazi M, Jentsch H, Al-Sanabani J, Tawfik M, Remmerbach TW. Clinical and cytological study of the oral mucosa of smoking and non-smoking qat chewers in Yemen. Clin Oral Investig 2015; 20:771-9. [PMID: 26319978 DOI: 10.1007/s00784-015-1569-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/13/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The study was conducted to investigate the role of qat and smoking habits on the prevalence of visible and cytological abnormalities in the oral mucosa among Yemenites. METHODS We recruited 30 non-smoking and 30 smoking Yemenites chewing qat unilaterally for at least 5 years. We inspected oral cavities for the presence of lesions and took brush biopsies from the buccal mucosa/gingiva of the chewing/non-chewing region. RESULTS All visible oral lesions were flat and homogeneous, and cytological changes were detected frequently. Among both non-smokers and smokers, white lesions and cytological changes were detected in 77% of all cases. On the chewing area, the proportion with white lesions ranged--depending on anatomical area and smoking status--between 47 and 93% and was significantly more frequent than on the non-chewing side (range 3-47%). The proportion of regions with changes was similar in non-smokers and smokers. Kappa statistics for "interobserver" agreement between visual inspection and cytological specimens of brush biopsies was at best fair (≤0.25). CONCLUSIONS The high prevalence of visible lesions and cytological abnormalities among qat chewers was independent of smoking status. CLINICAL RELEVANCE The moderate level of agreement between visual inspection and exfoliative cytology demonstrates the still challenging clinical management of chronic qat chewers, though brush biopsies including adjuvant techniques like DNA cytometry may support the clinical decision-making process in future.
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Affiliation(s)
- M Hijazi
- Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - H Jentsch
- Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - J Al-Sanabani
- Department of Oral Medicine, Faculty of Dentistry, University of Thamar, Thamar, Republic of Yemen
| | - M Tawfik
- Joint Practice for Pathology, IPO Institute for Pathology, Berlin, Germany
| | - T W Remmerbach
- Section of Oral Medicine, Department of Head Medicine and Oral Health, Leipzig University Hospital, Liebigstraße 10-14, 04103, Leipzig, Germany.
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Macey R, Walsh T, Brocklehurst P, Kerr AR, Liu JLY, Lingen MW, Ogden GR, Warnakulasuriya S, Scully C. Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions. Cochrane Database Syst Rev 2015; 2015:CD010276. [PMID: 26021841 PMCID: PMC7087440 DOI: 10.1002/14651858.cd010276.pub2] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Oral squamous cell carcinoma is the most common form of malignancy of the lip and oral cavity, often being proceeded by potentially malignant disorders (PMD). Early detection can reduce the malignant transformation of PMD and can improve the survival rate for oral cancer. The current standard of scalpel biopsy with histology is painful for patients and involves a delay whilst histology is completed; other tests are available that are unobtrusive and provide immediate results. OBJECTIVES PRIMARY OBJECTIVE To estimate the diagnostic accuracy of index tests for the detection of oral cancer and PMD of the lip and oral cavity, in people presenting with clinically evident lesions. SECONDARY OBJECTIVE To estimate the relative accuracy of the different index tests. SEARCH METHODS The electronic databases were searched on 30 April 2013. We searched MEDLINE (OVID) (1946 to April 2013) and four other electronic databases (the Cochrane Diagnostic Test Accuracy Studies Register, the Cochrane Oral Health Group's Trials Register, EMBASE (OVID) and MEDION (Ovid)). There were no restrictions on language in the searches of the electronic databases. We conducted citation searches and screened reference lists of included studies for additional references. SELECTION CRITERIA We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting PMD or oral squamous cell carcinoma of the lip or oral cavity: vital staining, oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using QUADAS-2. Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. MAIN RESULTS We included 41 studies, recruiting 4002 participants, in this review. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (14 studies), oral cytology (13 studies), light-based detection or oral spectroscopy (13 studies). Six studies assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis.The summary estimates for vital staining obtained from the meta-analysis were sensitivity of 0.84 (95% CI 0.74 to 0.90) with specificity of 0.70 (0.59 to 0.79), with 14 studies were included in the meta-analysis. For cytology, sensitivity was 0.91 (0.81 to 0.96) and specificity was 0.91 (0.81 to 0.95) with 12 studies included in the meta-analysis. For light-based detection, sensitivity was 0.91 (0.77 to 0.97) and specificity was 0.58 (0.22 to 0.87) with 11 studies included in the meta-analysis. The relative test accuracy was assessed by adding covariates to the bivariate analysis, no difference in model fit was observed. AUTHORS' CONCLUSIONS The overall quality of the included studies was poor. None of the adjunctive tests can be recommended as a replacement for the currently used standard of a scalpel biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation.
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Affiliation(s)
- Richard Macey
- School of Dentistry, The University of ManchesterCoupland 3 BuildingOxford RoadManchesterUKM13 9PL
| | - Tanya Walsh
- School of Dentistry, The University of ManchesterCoupland 3 BuildingOxford RoadManchesterUKM13 9PL
| | - Paul Brocklehurst
- Bangor UniversityNWORTH CTUY Wern (Normal Site)Holyhead RoadBangorUKLL57 2PZ
| | - Alexander R Kerr
- New York University College of DentistryDepartment of Oral and Maxillofacial Pathology, Radiology and Medicine345 East 24th StreetSchwartz BuildingNew YorkUSA10010
| | - Joseph LY Liu
- Scottish Dental Clinical Effectiveness Programme, NHS Education for ScotlandUniversity of Dundee, Dental Health Services Research UnitFrankland Building, Small's WyndDundeeUKDD1 4HN
| | - Mark W Lingen
- University of ChicagoPritzker School of Medicine, Division of Biological Sciences, Department of Pathology5841 South Maryland AvenueChicagoIllinoisUSA60637‐1470
| | - Graham R Ogden
- University of DundeeDivision of Oral and Maxillofacial Clinical Sciences, School of DentistryPark PlaceDundeeScotlandUKDD1 4HR
| | - Saman Warnakulasuriya
- King's College LondonClinical and Diagnostic SciencesBessemer RoadDenmark Hill CampusLondonUKSE5 9RW
| | - Crispian Scully
- University College London256 Gray's Inn RoadLondonUKWC1X 8LD
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10
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Berndt A, Richter P, Kosmehl H, Franz M. Tenascin-C and carcinoma cell invasion in oral and urinary bladder cancer. Cell Adh Migr 2015; 9:105-11. [PMID: 25793577 PMCID: PMC4422813 DOI: 10.1080/19336918.2015.1005463] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 01/08/2023] Open
Abstract
Carcinoma invasion is a complex process regulated by genetic and epigenetic factors as well. A relevant supportive condition for cancer cell migration is the reorganization of the extracellular matrix (ECM), which is realized in an orchestrated multicellular manner including carcinoma cells and stromal fibroblasts. An important key player in the process of ECM reorganization is Tenascin-C (Tn-C). The molecule occurs as different isoforms generated by alternative splicing and de novo glycosylation. Large variants of Tn-C are abundantly re-expressed in the invasive front of many carcinoma types. A special role for initiating migration and accompanied epithelial to mesenchymal transition has been suggested. Here, we review the current knowledge concerning the tumor biological importance of Tn-C, the synthesis and alternative splicing during the invasive process in general, and give an overview on the impact of Tn-C in urothelial carcinoma of the urinary bladder (UBC) and oral squamous cell carcinoma (OSCC).
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Key Words
- 3D, 3 dimensional
- BM, basement membane
- CAF, cancer associated fibroblast
- ECM reorganization
- ECM, extracellular matrix
- EMT, epithelial – mesenchymal transition
- FGF2, fibroblast growth factor 2
- FNIII, fibronectin type III like repeats
- Fn, fibronectin
- Ln, laminin
- Lnγ2, laminin gamma 2 chain
- MMP, matrix metalloproteinase
- OSCC, oral squamous cell carcinoma
- PDGF, platelet derived growth factor
- RNA, ribonucleic acid
- TGFβ1, transforming growth factor beta 1
- TPA, tetradecanoylphorbol acetate
- Tn-C, tenascin-C
- UBC, urothelial carcinoma of the urinary bladder
- alternative splicing
- carcinoma invasion
- hnRNPs, heterogeneous nuclear ribonucleoproteins
- mRNA, messenger RNA
- oncFn, oncofetal fibronectin
- oncTn-C, oncofetal tenascin-C
- oral squamous cell carcinoma
- tenascin-C
- urothelial carcinoma of the urinary bladder
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Affiliation(s)
| | - Petra Richter
- Institute of Pathology; Jena University Hospital; Jena, Germany
| | - Hartwig Kosmehl
- Institute of Pathology; HELIOS Klinikum Erfurt, Erfurt, Germany
| | - Marcus Franz
- Department of Internal Medicine I; Jena University Hospital, Jena, Germany
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11
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Use of endoscopy with narrow-band imaging system in detecting squamous cell carcinoma in oral chronic non-healing ulcers. Clin Oral Investig 2013; 18:949-59. [PMID: 23835583 DOI: 10.1007/s00784-013-1027-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 06/26/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study seeks to analyze the factors associated with the occurrence of squamous cell carcinoma in oral non-healing ulcers for more than 3 weeks and investigate the role of endoscopy with narrow-band imaging system (NBI) in detecting carcinoma in these lesions. METHODS The demographic and clinicopathological data of patients receiving surgical interventions for chronic oral non-healing ulcers, and the intraepithelial papillary capillary loop patterns shown by NBI were retrospectively reviewed and analyzed. RESULTS A total of 63 patients (41 males and 22 females) with mean age of 57.9 ± 16.7 years were enrolled. In univariate analysis, ulcers with induration, history of oral cancer, and intraepithelial microvasculature of NBI were factors associated with the occurrence of squamous cell carcinoma in oral non-healing ulcers. Multivariate analysis showed that the intraepithelial microvasculature of NBI was the only independent factor predicting the occurrence of carcinoma in oral chronic non-healing ulcers with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 93.75 %, 91.49 %, 78.95 %, 97.73 %, and 92.06 %, respectively. CONCLUSIONS Morphology of intraepithelial microvasculature of NBI, or twisted, elongated, and destructive pattern of intraepithelial papillary capillary loop, is the only independent factor associated with the occurrence of squamous cell carcinoma in oral chronic non-healing ulcers. Endoscope with NBI is a rapid, safe, and promising tool in detecting squamous cell carcinoma in oral chronic non-healing ulcers.
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12
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Fontes KBFDC, Cunha KSG, Rodrigues FR, Silva LED, Dias EP. Concordance between cytopathology and incisional biopsy in the diagnosis of oral squamous cell carcinoma. Braz Oral Res 2013; 27:122-7. [PMID: 23538424 DOI: 10.1590/s1806-83242013000100018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 01/08/2013] [Indexed: 11/21/2022] Open
Abstract
Oral cytopathology is a simple, non-invasive technique that could be used for early detection of oral premalignant and malignant lesions, but the effectiveness of this diagnostic approach remains controversial. The aim of this study was to evaluate the sensitivity, specificity, positive and negative predictive values, and accuracy of cytopathology for diagnosing oral squamous cell carcinoma (OSCC) and the diagnostic concordance between cytopathological and histopathological diagnoses. The study enrolled 172 patients at outpatient clinics who presented with oral lesions suspicious of malignancy. All patients underwent oral cytological scrapes followed by an incisional biopsy. Of 148 cases that were histopathologically diagnosed with OSCC, the cytopathological method diagnosed 123 positive cases and resulted in a suspicion of OSCC in 16 patients. Based on these data, the sensitivity was 83.1%, the specificity was 100.0%, the positive predictive value was 100.0%, the negative predictive value was 49.0%, and the accuracy was 85.5%. The diagnostic concordance between histopathological and cytopathological examinations was 83.1% for OSCC and 85.7% for non-neoplastic lesions. The results indicate that cytopathological diagnosis had good concordance with histopathological diagnosis and showed high sensitivity, specificity, positive predictive value, and accuracy. We conclude that the sensitivity of oral cytopathology is sufficient to justify its use as a diagnostic screening test and to confirm the malignant nature of epithelial cells, mainly for the classification of OSCC. Therefore, cytopathology may be a reliable method for referring patients who require diagnosis of suspected oral cancer for starting treatment.
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Scheer M, Neugebauer J, Derman A, Fuss J, Drebber U, Zoeller JE. Autofluorescence imaging of potentially malignant mucosa lesions. ACTA ACUST UNITED AC 2011; 111:568-77. [DOI: 10.1016/j.tripleo.2010.12.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 12/15/2010] [Accepted: 12/19/2010] [Indexed: 10/18/2022]
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14
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Mehrotra R. The role of cytology in oral lesions: A review of recent improvements. Diagn Cytopathol 2011; 40:73-83. [PMID: 21442772 DOI: 10.1002/dc.21581] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 09/29/2010] [Indexed: 11/08/2022]
Affiliation(s)
- Ravi Mehrotra
- Department of Pathology, Division of Cytopathology, Moti Lal Nehru Medical College, Allahabad, Uttar Pradesh, India. rm8509@rediffmail. com
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15
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Mendes SF, Ramos GDO, Rivero ERC, Modolo F, Grando LJ, Meurer MI. Techniques for precancerous lesion diagnosis. JOURNAL OF ONCOLOGY 2011; 2011:326094. [PMID: 21318165 PMCID: PMC3026985 DOI: 10.1155/2011/326094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 12/20/2010] [Accepted: 12/23/2010] [Indexed: 01/14/2023]
Abstract
The development of the oral squamous cell carcinoma (OSCC) is a multistep process that requires the accumulation of multiple genetic alterations usually preceded by detectable mucosal changes, most often leukoplakias and erythroplakias. The clinical appearance of oral precancerous lesions and their degree of epithelium dysplasia suggests the malignization potential. Several techniques have been developed to improve the clinical and cytological diagnosis of oral precancerous lesions. The present paper reviews the main techniques used to improve premalignant lesion diagnosis.
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Affiliation(s)
- Sarah Freygang Mendes
- Postgraduate Program of the Federal University of Santa Catarina, 88040-370 Florianopolis, SC, Brazil
| | | | - Elena Riet Correa Rivero
- Department of Pathology, Center of Health Sciences, Federal University of Santa Catarina, Trindade University Campus, 88040-370 Florianópolis, SC, Brazil
| | - Filipe Modolo
- Department of Pathology, Center of Health Sciences, Federal University of Santa Catarina, Trindade University Campus, 88040-370 Florianópolis, SC, Brazil
| | - Liliane Janete Grando
- Department of Pathology, Center of Health Sciences, Federal University of Santa Catarina, Trindade University Campus, 88040-370 Florianópolis, SC, Brazil
| | - Maria Inês Meurer
- Department of Pathology, Center of Health Sciences, Federal University of Santa Catarina, Trindade University Campus, 88040-370 Florianópolis, SC, Brazil
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16
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Zygogianni AG, Kyrgias G, Karakitsos P, Psyrri A, Kouvaris J, Kelekis N, Kouloulias V. Oral squamous cell cancer: early detection and the role of alcohol and smoking. HEAD & NECK ONCOLOGY 2011; 3:2. [PMID: 21211041 PMCID: PMC3022893 DOI: 10.1186/1758-3284-3-2] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 01/06/2011] [Indexed: 02/07/2023]
Abstract
Objective Oral squamous cell carcinoma has a remarkable incidence worldwide and a fairly onerous prognosis, encouraging further research on factors that might modify disease outcome. Data sources A web-based search for all types of articles published was initiated using Medline/Pub Med, with the key words such as oral cancer, alcohol consumption, genetic polymorphisms, tobacco smoking and prevention. The search was restricted to articles published in English, with no publication date restriction (last update 2010). Review Methods In this review article, we approach the factors for a cytologic diagnosis during OSCC development and the markers used in modern diagnostic technologies as well. We also reviewed available studies of the combined effects of alcohol drinking and genetic polymorphisms on alcohol-related cancer risk. Results The interaction of smoking and alcohol significantly increases the risk for aero-digestive cancers. The interaction between smoking and alcohol consumption seems to be responsible for a significant amount of disease. Conclusion Published scientific data show promising pathways for the future development of more effective prognosis. There is a clear need for new prognostic indicators, which could be used in diagnostics and, therefore a better selection of the most effective treatment can be achieved.
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Reychler H, Weynand B. [Screening and diagnosis of precancerous oral mucosa lesions]. REVUE DE STOMATOLOGIE ET DE CHIRURGIE MAXILLO-FACIALE 2010; 111:203-7. [PMID: 20797741 DOI: 10.1016/j.stomax.2010.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2009] [Accepted: 07/19/2010] [Indexed: 10/19/2022]
Abstract
The screening and early diagnosis of cancerous oral mucosa lesions are still key elements for a better prognosis. Therefore, it is of tremendous importance to try to determine how and when to diagnose precancerous oral mucosa lesions. Usually, clinical examination data must be completed by a pathological examination. This study, based on an exhaustive literature review, has for purpose to determine the sensitivity and specificity of complementary diagnostic tools currently available.
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Affiliation(s)
- H Reychler
- Service de stomatologie et chirurgie maxillo-faciale, cliniques universitaires Saint-Luc, université catholique de Louvain, 10, avenue Hippocrate, B-1200, Bruxelles, Belgique.
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18
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Diagnostic efficiency of differentiating small cancerous and precancerous lesions using mucosal brush smears of the oral cavity--a prospective and blinded study. Clin Oral Investig 2010; 15:763-9. [PMID: 20593209 DOI: 10.1007/s00784-010-0434-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Accepted: 06/07/2010] [Indexed: 12/19/2022]
Abstract
The aim of this study was to evaluate the diagnostic accuracy of oral brush biopsy to identify early malignancy. One hundred and eighty-six brush biopsies of suspicious mucosal lesions were obtained, haematoxilin and eosin (H&E)-stained and compared with the histology of conventional excision biopsies of the same site performed concomitantly. The sensitivity for identifying squamous cell carcinoma (SCC) was 88.5%. High-risk lesions including squamous intraepithelial neoplasia (SIN II, SIN III) and SCC were identified with a sensitivity of 86.4%, using a pap-analogous classification, which is considered to be carcinomatous, as well as moderate and severe dysplastic cells positive. Depending on the cytopathologic definition for malignancy and the tumour size, the test accuracy varied: Extending the cytopathologic criteria for malignancy by defining all dysplastic or malignant cytopathologic findings as positive, the sensitivity was increased to 95.2% at the expense of the specificity, which was reduced from 94.9% to 82.3%. Separately analysing SCCs of less than 20 mm, the sensitivity was reduced by 9.5% to 78%. Although small malignant lesions seem to be less reliable by the conventional oral brush biopsy, it is a useful screening instrument for early diagnosis of suspicious, epithelial lesions and could therefore contribute to improved cancer prognosis.
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19
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Arduino PG, Carrozzo M, Pagano M, Broccoletti R, Scully C, Gandolfo S. Immunohistochemical expression of basement membrane proteins of verrucous carcinoma of the oral mucosa. Clin Oral Investig 2010; 14:297-302. [PMID: 19506920 DOI: 10.1007/s00784-009-0296-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Accepted: 05/26/2009] [Indexed: 10/20/2022]
Abstract
Squamous cell carcinoma (SCC) of the oral cavity is an extremely invasive tumour of stratified squamous epithelium that spreads throughout degradation of the basement membrane (BM) and extra-cellular matrix. Oral verrucous carcinoma (VC) is a rare low-grade variant of oral SCC that penetrates into the subepithelial connective tissue. It also has a different clinical behaviour from classical oral SCC. We investigated the immunohistochemical expression of laminin, laminin-5, collagen IV and fibronectin in VC, severe epithelial dysplasia (SED) and SCC in order to analyse if the pattern of these molecules expression contributes to the differences in the biological behaviour of these diseases. The staining pattern of laminin was less intensive in SCC compared with SED and VC, and collagen IV expression was increased in VC compared with SED. Discontinuities of laminin, collagen IV and fibronectin were more evident in SED than in VC. This study indicates that VC has a biological behaviour different from SED or SCC, observable by immunohistochemistry in the BM zone.
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Affiliation(s)
- Paolo G Arduino
- Division of Otorhinolaryngology, Department of Clinical Physiopathology, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute, Via Nizza 230, 10126 Turin, Italy.
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20
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Yang WCV, Chung HR, Wu JY, Yi C, Wang DJ, Lee SY. Potential biomarkers for the cytologic diagnosis of oral squamous cell carcinoma. J Dent Sci 2010. [DOI: 10.1016/s1991-7902(10)60010-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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21
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MAGE-A antigens in lesions of the oral mucosa. Clin Oral Investig 2010; 15:315-20. [PMID: 20174843 DOI: 10.1007/s00784-010-0387-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 01/28/2010] [Indexed: 01/31/2023]
Abstract
Oral squamous cell carcinoma develops continuously out of predamaged oral mucosa. For the physician and pathologist, difficulties arise in distinguishing precancerous from cancerous lesions. MAGE-A antigens are tumor antigens that are found solely in malignant transformed cells. These antigens might be useful in distinguishing precancerous from cancerous lesions. The aim of this study was to verify this assumption by comparing MAGE-A expression in benign, precancerous, and cancerous lesions of the oral mucosa. Retrospectively, biopsies of different oral lesions were randomly selected. The lesions that were included are 64 benign oral lesions (25 traumatic lesions (oral ulcers), 13 dental follicles, and 26 epulis), 26 oral lichen planus, 123 epithelial precursor lesions (32 epithelial hyperplasia found in leukoplakias, 24 epithelial dysplasia found in leukoplakias, 26 erythroplasia with oral epithelial dysplasia, and 41 carcinomas in situ in erythroleukoplakias). The lesions were immunohistochemically stained with the poly-MAGE-A antibody 57B, and the results were compared. Biopsies of oral lichen planus, oral ulcers, dental follicles, epulis, and leukoplakia without dysplasia showed no positive staining for MAGE-A antigens. Leukoplakia with dysplasia, dysplasia, and carcinomata in situ displayed positive staining in 33%, 65%, and 56% of the cases, respectively. MAGE-A antigens were not detectable via immunohistochemistry in benign lesions of the oral mucosa. The staining rate of dysplastic precancerous lesions or malignant lesions ranged from 33% to 65%. The MAGE-A antigens might facilitate better differentiation between precancerous and cancerous lesions of the oral mucosa.
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Hullmann M, Kunkel M, Reichert T. Diagnostik und Therapie oraler präkanzeröser Läsionen. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s12285-009-0102-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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23
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Hohlweg-Majert B, Deppe H, Metzger MC, Schumm S, Hoefler H, Kesting MR, Hölzle F, Wolff KD. Sensitivity and Specificity of Oral Brush Biopsy. Cancer Invest 2009; 27:293-7. [DOI: 10.1080/07357900802266515] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
During the last decade, oral cytology has once again become the focus of scientific research. This new interest is due to the introduction of a cytobrush for cell collection as well as a computer-assisted analysis (Oral CDx). Although promising, the sensitivity and specificity of conventional oral brush cytology remains limited. To circumvent the problems and improve the accuracy, various adjunctive analytical methods have been attempted. DNA analysis, immunocytochemical and molecular analysis are suggested methodological cytology approaches to improve the validity of oral brush cytology. An increase in sensitivity (up to 100%) and specificity (up to 100%) of oral brush biopsy has been reported on localized pre-malignant and malignant lesions. Oral brush biopsy probably will not replace histopathology in the definitive diagnosis of oral cancer, but it might be valuable for the prevention of misdiagnosis of clinically doubtful oral lesions and for the monitoring of lesions that might proceed on to oral cancer.
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Affiliation(s)
- R Mehrotra
- Department of Pathology, Moti Lal Nehru Medical College, Allahabad, India.
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25
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Abstract
Despite advances in understanding the underlying genetics, squamous cell carcinoma of the head and neck (SCCHN) remains a major health risk and one of the leading causes of mortality in the world. Current standards of treatment have significantly improved long-term survival rates of patients, but second tumors and metastases still remain the most frequent cause of high mortality in SCCHN patients. A better understanding of the underlying genetic mechanisms of SCCHN tumorigenesis will help in developing better diagnostics and, hence, better cures. In this article we will briefly outline the current state of diagnostics and treatment and our understanding of the molecular causes of SCCHN.
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Affiliation(s)
- Amit M Deshpande
- School of Dentistry and Dental Research Institute, University of California Los Angeles, CA, USA.
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Driemel O, Kunkel M, Hullmann M, Eggeling FV, Müller-Richter U, Kosmehl H, Reichert TE. Diagnosis of oral squamous cell carcinoma and its precursor lesions. J Dtsch Dermatol Ges 2007; 5:1095-100. [DOI: 10.1111/j.1610-0387.2007.06397.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Hullmann M, Reichert TE, Dahse R, von Eggeling F, Pistner H, Kosmehl H, Driemel O. [Oral cytology: historical development, current status, and perspectives]. MUND-, KIEFER- UND GESICHTSCHIRURGIE : MKG 2007; 11:1-9. [PMID: 17177045 DOI: 10.1007/s10006-006-0041-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Oral cytology has aroused new interest caused by introduction of the cytobrush as a sampling device and the use of additional analytical methods. By brushing it is possible to reach deeper layers of the oral mucosa where squamous intraepithelial neoplasia (SIN) begins. The biological potential of the oral epithelial cells obtained can be evaluated by the following additional methods: computer-assisted image analysis (OralCDx), DNA cytometry, immunohistochemistry, monolayer cytology, and molecular biological analysis. All of those methods can increase sensitivity (up to 100%) and specificity (up to 100%) of oral brush biopsy. Nevertheless, there are reports that oral epithelial carcinomas were not identified. No comparative study exists allowing conclusions to be drawn about the value of the single methods. Immunocytochemistry with commercial antibodies against laminin-5 is generally available and methodologically easy. Oral brush biopsy as a non invasive diagnostic method can be useful for the early detection of oral mucosal lesions. Positive findings or progression of the lesion despite negative findings are indications to refer the patient to a specialized clinic where a surgical biopsy should be performed, followed by histopathological analysis. Histopathology remains the gold standard for the definitive diagnosis of oral malignant lesions.
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Affiliation(s)
- M Hullmann
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Klinikum der Universität Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
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