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Kokubun K, Nakajima K, Akashi Y, Yamamoto K, Katakura A, Matsuzaka K. Clinicopathological evaluation of oral leukoplakia: a single-center study of 676 cases in Japan. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:529-536. [PMID: 38553305 DOI: 10.1016/j.oooo.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/04/2024] [Accepted: 02/21/2024] [Indexed: 06/19/2024]
Abstract
OBJECTIVES To analyze the clinical and histopathological characteristics of oral leukoplakia (OL) in the Japanese population and investigate the prevalence and risk factors for epithelial dysplasia (ED) and carcinoma within lesions. STUDY DESIGN Data, including age, sex, lesion site, and histopathological features, of 676 cases diagnosed with OL over the previous 10 years were analyzed. Dysplasia and carcinoma prevalence were determined. RESULTS In male patients, the most affected site was the gingiva (42.7%), whereas in females, it was the tongue (47.6%). Moreover, ED was more prevalent in males (41.9%), whereas epithelial hyperplasia was more common in females (44.7%). A significant difference was observed between affected sites with regard to the presence of dysplasia. The ED rates by site were 64.6% and 33.7% for the tongue and gingiva, respectively (P < 0.05). The squamous cell carcinoma rates by site were 23.4%, 5.4%, and 3.4% for the tongue, buccal mucosa, and gingiva, respectively (P < 0.05). Logistic regression analysis revealed a higher prevalence of dysplasia in males than it did in females and that the risk for both dysplasia and carcinoma was highest in the tongue. CONCLUSIONS Dysplasia is common in OL cases, often showing carcinoma. Early biopsy and interventions are key in OL management.
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Affiliation(s)
- Katsutoshi Kokubun
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan.
| | - Kei Nakajima
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
| | - Yoshihiko Akashi
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
| | - Kei Yamamoto
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
| | - Kenichi Matsuzaka
- Department of Pathology, Tokyo Dental College, Chiyoda-ku, Tokyo, Japan
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Khan AS, Khan ZA, Nisar M, Saeed S, Maryam H, Haq M, Naushin T, Issrani R. Description of clinicopathological characteristics of oral potentially malignant disorders with special focus on two histopathologic grading systems and subepithelial inflammatory infiltrate. J Cancer Res Ther 2023; 19:S724-S730. [PMID: 38384046 DOI: 10.4103/jcrt.jcrt_969_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/06/2022] [Indexed: 02/23/2024]
Abstract
OBJECTIVE This study was conducted to evaluate the clinicopathological features of oral potentially malignant disorders (OPMDs) with a focus on two histologic grading systems and subepithelial inflammatory infiltrates. MATERIALS AND METHODS This cross-sectional and multicenter study was conducted from April 2016 to September 2021 and comprised patients diagnosed with OPMDs. Hematoxylin and eosin-stained slides of 127 cases were assessed based on the World Health Organization (WHO) 2005 classification system, namely, epithelial precursor lesions and binary system of oral epithelial dysplasia (OED). Chi-square test and Fisher's exact test were used to compare different categorical variables related to OPMDs. RESULTS The mean age of OPMD cases at presentation was 54.72 13.30 (P < 0.01) with a male to female ratio of 1.6:1. Oral leukoplakia (52.8%) was the most commonly diagnosed form of OPMD. Most OPMDs were classified as oral epithelial hyperplasia (59.1%) and the remaining (40.9%) as OED (P < 0.01). Of the 52 OPMDs with OED, all cases of mild dysplasia (36.5%) and carcinoma in situ (9.6%) were categorized as low-risk and high-risk lesions, respectively. Chronic inflammatory infiltrate (79.5%) was the most common subepithelial inflammatory alteration observed among OPMDs. CONCLUSIONS Early detection of OPMDs is vital due to increased risk of developing into oral cancer. Timely clinicopathological risk assessment of OPMD is desirable for improving the prognosis and preventing the malignant transformation in oral premalignancy. Besides the epithelial precursor lesions' classification by the WHO, binary system of grading OED use can be encouraged. Also, subepithelial inflammatory infiltrate can be of importance in future research regarding OPMDs.
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Affiliation(s)
- Abbas Saleem Khan
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Zafar Ali Khan
- Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Kingdom of Saudi Arabia
| | - Muhammad Nisar
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Saleha Saeed
- Department of Oral Pathology, Faryal Dental College, Lahore, Pakistan
| | - Hoor Maryam
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Mohsina Haq
- Department of Microbiology, Peshawar Medical College, Riphah International University, Islamabad, Pakistan
| | - Tehmina Naushin
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Rakhi Issrani
- Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
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Ellonen R, Suominen A, Kelppe J, Willberg J, Rautava J, Laine H. Histopathological findings of oral epithelial dysplasias and their relation to malignant transformation. Cancer Treat Res Commun 2023; 34:100664. [PMID: 36481601 DOI: 10.1016/j.ctarc.2022.100664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Oral squamous cell carcinomas (OSCCs) are often diagnosed late. This study aimed to determine how frequently oral epithelial dysplasia (OED) transforms to OSCC and to identify histological features that could influence the rate of malignant transformation. MATERIALS AND METHODS The study was a retrospective analysis of OED over 29 years at the Institute of Dentistry, University of Turku, Finland. OEDs with co-existing carcinomas were excluded from the data (5.8%). OED patients who developed carcinoma were identified from the Finnish Cancer Registry database. RESULTS Altogether 681 OED patients had a mean age of 59.0 years, and the male:female ratio was 0.67. Of all OED samples, 21.8% were on the tongue, followed by lining mucosa (21.3%), lip (5.3%), and masticatory mucosa (4.85%). In addition, 46.7% had no location cited. The prevalence of mild dysplasia was 62.4%, moderate dysplasia 29.1%, and severe dysplasia 3.2%. Of the patients, 94.7% had an additional histological diagnosis alongside OED. Candidiasis, lichenoid inflammation, and ulcer were found in 18.2%, 0.0%, and 22.7% of severe dysplasias, in 12.1%, 12.2%, and 22.7% of moderate dysplasias, and in 6.6%, 12.2%, and 15.8% of mild dysplasias, respectively. An additional histopathological diagnosis did not increase the risk for OED to transform to OSCC. In a mean time of 5.2 (range 0.7-29.0) years, 7.5% of OED patients developed OSCC. CONCLUSIONS Location on the tongue and the more severe OED grades increased the risk of malignant transformation of OED. These patients may benefit from an intensified follow-up schedule to ensure early diagnosis of OSCC.
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Affiliation(s)
- Riikka Ellonen
- Department of Oral Pathology and Radiology, University of Turku and Turku University Hospital, Turku, Finland.
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Jetta Kelppe
- Department of Pathology, HUSLAB, Helsinki, Finland
| | - Jaana Willberg
- Department of Oral Pathology and Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jaana Rautava
- Department of Oral Pathology and Radiology, University of Turku and Turku University Hospital, Turku, Finland; Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland; Department of Pathology, HUSLAB, Helsinki, Finland
| | - Hanna Laine
- Department of Oral Pathology and Radiology, University of Turku and Turku University Hospital, Turku, Finland; Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, Helsinki, Finland
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Costa AM, Pontes FS, Souza LL, Lopes MA, Santos-Silva AR, Vargas PA, Andrade BA, Bezerra KT, Romañach MJ, Gomez RS, Costa RF, Júnior DD. What is the frequency of floor of the mouth lesions? A descritive study of 4,016 cases. Med Oral Patol Oral Cir Bucal 2021; 26:e738-e747. [PMID: 34704985 PMCID: PMC8601650 DOI: 10.4317/medoral.24537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 09/06/2021] [Indexed: 01/07/2023] Open
Abstract
Background The aim of this study was to investigate the frequency of oral lesions in the floor of the mouth from representative oral pathology centres in Latin America. Material and Methods This study was conducted on biopsies obtained from January of 1978 to December of 2018 at nine Latin America oral and maxillofacial pathology centres. Gender, age and histopathological diagnosis were evaluated. Data were analysed using descriptive methods. Chi-square test was used for pairwise comparisons. Results From 114,893 samples, 4,016 lesions (3.49%) occurred in the floor of the mouth. Brazil showed 3,777 cases (94%), Mexico 182 cases (4.5%) and Argentina 57 cases (1.4%). Benign lesions represented 65.1% (2,617 cases), followed by 34.9% (1,404 cases) of malignant disorders. Lesions of epithelial origin were more frequent (1,964 cases; 48.9%), followed by salivary glands (1,245 cases; 31%) and soft tissue lesions (475 cases; 11.7%). The most common histological subtypes were oral squamous cell carcinoma (1,347 cases; 33.5%), ranula (724 cases; 18%), oral leukoplakia (476 cases; 11.8%) and inflammatory fibrous hyperplasia (239 cases; 5.9%). The lesion affected males in 2,129 cases and females in 1,897 cases. Conclusions In the current study, lesions in the floor of the mouth represented 3.49% of biopsies submitted to oral pathology services and oral squamous cell carcinoma, ranula and leukoplakia were the most common lesions. Key words:Epidemiology, floor of the mouth, benign, malignant.
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Affiliation(s)
- A-M Costa
- João de Barros Barreto University Hospital Department of Surgery and Oral Pathology Mundurucus Street, nº 4487 Zip Code 66073-000, Belém, Pará, Brazil
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Sahoo PK, Sarkar S, Ghosh D, Mahata S, Pal R, Mistry T, Ghosh S, Roy A, Bucha H, Mandal S, Nasare VD. Premalignant and malignant lesions of oral cavity in eastern India: a hospital-based study. Eur J Cancer Prev 2021; 30:393-399. [PMID: 33252366 DOI: 10.1097/cej.0000000000000640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Oral carcinoma and precancers are major public health challenges in India and other developing countries. OBJECTIVES Aim of the study was to assess the associations of demographic characteristics, addictions, chief complaints of mouth/oral and clinical diagnosis by cytology smear and punch biopsy in early detection of oral premalignant and malignant lesions. Methods Study was designed on retrospective data of case files of CDC, CNCI, Kolkata, from patients attended from January 1996 to September 2016. History was taken, histopathology and Pap smear were performed. Descriptive statistical analysis, cross-tabulation and Pearson's Chi-square test were done. RESULTS Total participants (n = 692); 110 (15.9%) having history of swallowing betel leaf, nut lime, dokta, jarda, catecheu with an average of 11 years. Three hundred twenty-five (46.9%) had multiple addiction (cigarette/bidi/tobacco/all). Ninety-eight (12.1%), 99 (12.2%) and 68 (8.4%) were addicted to cigarette, bidi and chewing tobacco, respectively. Twenty-nine participants were addicted to alcohol; 18 (2.6%) and 11 (1.5%) took country and foreign alcohol correspondingly. Clinicians thoroughly examined lips (4.1%), buccal mucosa (27.3%), gingival (2.8%), tongue (23.1%), hard and soft palate (4.9%), mouth loor (5.2%) and other parts (32.3%); diagnosed participants as normal (22.8%)/benign (23.1%)/premalignant (39.1%)/malignant (14.8%). Smears confirmed 60, 131, 42, 9 and 8 cases as carcinoma, mild, moderate, severe dysplasia and inflammation, respectively. The punch biopsy identified 11 carcinomas, two severe, two moderate and seveeen mild dysplasia's. Chi-square test showed significant association between smear and examination (P = 0.022), diagnosis and examinations of the oral cancer patients (P = 0.0001). CONCLUSION The study provided strong evidence that betel leaf, chewing tobacco, smoking and alcohol are independent risk factors for oral cancer. Cytological smear and biopsy are cost-effective approaches for early detection.
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Affiliation(s)
| | | | | | | | - Ranita Pal
- Departments of Pathology and Cancer Screening
| | | | | | - Asoke Roy
- Departments of Pathology and Cancer Screening
| | | | - Syamsundar Mandal
- Epidemiology and Biostatistics, Chittaranjan National Cancer Institute, Kolkata, India
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Torabi M, Afshar MK, Afshar HM, Mohammahzadeh I. Correlation Between Clinical and Histopathologic Diagnosis of Oral Potentially Malignant Disorder and Oral Squamous Cell Carcinoma. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Molook Torabi
- Kerman University of Medical Sciences, Iran; Kerman University of Medical Sciences, Iran
| | - Marzieh Karimi Afshar
- Kerman University of Medical Sciences, Iran; Kerman University of Medical Sciences, Iran
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Singh S, Singh J, Chandra S, Samadi FM. Prevalence of oral cancer and oral epithelial dysplasia among North Indian population: A retrospective institutional study. J Oral Maxillofac Pathol 2020; 24:87-92. [PMID: 32508454 PMCID: PMC7269288 DOI: 10.4103/jomfp.jomfp_347_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/03/2020] [Accepted: 02/07/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Despite our sincere and serious efforts, oral cancer (particularly oral squamous cell carcinoma [OSCC]) is the major cause of morbidity and mortality in the Indian population. Oral precancerous lesions show quite high malignant transformation rate. Epidemiological data of oral epithelial dysplasia (OED) and OSCC could help in early diagnosis and thus may improve the prognosis. The current study aims to retrospectively analyze the epidemiological profile of patients with different grades of OED and OSCCs. MATERIALS AND METHODS The current study is a retrospective analysis of OED and OSCC reported in 5 years in our institution from 2014 to 2018. Data for the analysis were attained from the case sheets from the patients diagnosed with OED and OSCC. RESULTS The mean prevalence of OED and OSCC was 5.71% and 9.85%, respectively. Among the dysplastic lesions, severe dysplasia was more common, while well-differentiated squamous cell carcinoma was more common among the carcinomatous lesions. The peak age prevalence of both the lesions was third to fifth decade. Males were more frequently affected than females, with buccal mucosa being the most common site. CONCLUSION The data attained from this study highlight the need for community-based screening and awareness programs for general population and thus obtain a healthier society.
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Affiliation(s)
- Shruti Singh
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Jaya Singh
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shaleen Chandra
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Fahad Mansoor Samadi
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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Pires FR, Barreto ME, Nunes JG, Carneiro NS, Azevedo AB, Dos Santos TC. Oral potentially malignant disorders: clinical-pathological study of 684 cases diagnosed in a Brazilian population. Med Oral Patol Oral Cir Bucal 2020; 25:e84-e88. [PMID: 31880285 PMCID: PMC6982984 DOI: 10.4317/medoral.23197] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/16/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The frequency and distribution of oral potentially malignant disorders (OPMD) may vary among different populations. The aim of the present study was to evaluate the clinical-pathological characteristics of OPMD diagnosed in a Brazilian oral pathology laboratory over a period of 11 years. MATERIAL AND METHODS All cases diagnosed as leukoplakia, speckled leukoplakia, erythroplakia, and actinic cheilitis from 2005 to 2015 were analyzed. Clinical information was obtained from laboratory forms and histological information was obtained from histological slides stained with hematoxylin and eosin. RESULTS the final sample was comprised of 684 cases, of which 292 were males and 392 were females. The mean age was 58 years. The anatomical site most often involved was the lateral border of the tongue (23%), followed by the lower lip (20%), and by the buccal mucosa/vestibule (18%). Leukoplakia accounted for 82% of the sample (564 cases). The mean size of the leukoplakia and speckled leukoplakia lesions was 13 mm (ranging from 1 to 100 mm) and 15 mm (ranging from 5 to 30 mm), respectively (p=0.460). Males reported smoking and drinking alcohol more frequently than females (p=0.001 and p<0.0001, respectively). In half of the cases, dysplasia was not histologically detected, while slight dysplasia was detected in 28% of the cases. The lesions from patients aged from 41 to 80 years presented moderate and severe dysplasia more often than lesions from patients in other age groups. CONCLUSIONS OPMD were more common in females in their sixties. Females were more frequently affected in all anatomical sites, except for the lips. Leukoplakia lesions were the most common OPMD, followed by actinic cheilitis. The lateral border of the tongue was the most affected anatomical site. OPMD located in the floor of the mouth/sublingual mucosa and lesions from older patients presented severe epithelial dysplasia with greater frequency.
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Mustafa MB, Hassan MO, Alhussein A, Mamoun E, El Sheikh M, Suleiman AM. Oral leukoplakia in the Sudan: clinicopathological features and risk factors. Int Dent J 2019; 69:428-435. [DOI: 10.1111/idj.12509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Tilakaratne WM, Jayasooriya PR, Jayasuriya NS, De Silva RK. Oral epithelial dysplasia: Causes, quantification, prognosis, and management challenges. Periodontol 2000 2019; 80:126-147. [PMID: 31090138 DOI: 10.1111/prd.12259] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Oral epithelial dysplasia is a spectrum of architectural and cytological epithelial changes caused by accumulation of genetic changes, and is associated with an increased risk of progression to squamous cell carcinoma. It is a microscopic diagnosis of immense clinical importance. The initial reports of oral potentially malignant disorders with oral epithelial dysplasia transforming to oral cancer helped in understanding the nature of oral malignancies. Since then, clinical studies on oral potentially malignant disorders have combined microscopic findings of oral epithelial dysplasia to assess the malignant transformation potential of different grades of epithelial dysplasia. A significant amount of scientific literature has amassed on oral epithelial dysplasia relating to aspects of its diagnosis and management. However, the evidence base is weak as a result of the significant variability of published research. Poorly described study methods, variability in different oral epithelial dysplasia grading systems, inter- and intra-examiner variability causing issues of reliability, inadequate sample size, and inconsistent durations of follow-up are some of the methodological issues contributing to the failure to provide dependable information. Randomized clinical trials on the malignant transformation potential of oral epithelial dysplasia and its treatment outcomes are limited. This comprehensive literature review on oral epithelial dysplasia summarizes the scientific knowledge published in the scientific literature in English since its first description. The historical development, etiological factors, grading systems, diagnostic criteria, assessment of risk factors and prevention of malignant transformation, management principles of different grades of oral epithelial dysplasia (surgical and nonsurgical), recommendations on follow-up, and prognostic indicators are discussed in detail.
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Affiliation(s)
- Wanninayake M Tilakaratne
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Primali R Jayasooriya
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Nadeena S Jayasuriya
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Rohana Kumara De Silva
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Patil S, Alamir AWH, Arakeri G, Awan KH, Bhandi SH, Aljabab A, Maddur N, Gomez RS, Brennan PA. The relationship of shammah (Arabian snuff) chewing to the risk of oral cancer and oral potentially malignant disorders. J Oral Pathol Med 2019; 48:425-432. [PMID: 30883922 DOI: 10.1111/jop.12850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Shammah is a form of smokeless tobacco commonly used in the Arabian Peninsula. The data on the harmful effects of shammah on oral health, particularly oral malignancies, are scarce. The aim of this review was to explore the association between shammah use and development of oral potentially malignant disorders (OPMD) and/or oral cancer. MATERIALS AND METHODS PubMed, EMBASE, Scopus, Web of Science and grey literature from January 1990 up to and including April 2018 were searched. Two independent reviewers performed the study selection according to eligibility criteria. RESULTS A total of 10 studies that met the eligibility criteria were included. The odds of developing OPMD and/or oral cancer in relation to shammah use varied, with one study reporting a 39 increased risk (39, 95% CI: 14-105). The associated increased risk was relatively low among those that have stopped using shammah and ranged from threefold (3.65; 95% CI: 1.40-9.50) to 12-fold (12.6; 95% CI: 3.3-48.2). CONCLUSION Shammah use seems to increase the risk of development of OPMD and/or oral cancer.
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Affiliation(s)
- Shankargouda Patil
- Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abdul Wahab H Alamir
- Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Gururaj Arakeri
- Department of Oral and Maxillofacial Surgery, King Fahad Medical City, Riyadh, Saudi Arabia.,Department of Maxillofacial Surgery, Navodaya Dental College and Hospital, Raichur, Karnataka, India
| | - Kamran Habib Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah
| | - Shilpa H Bhandi
- Division of Operative Dentistry, Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abdulsalam Aljabab
- Department of Oral and Maxillofacial Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Nagaraj Maddur
- Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, Kalaburagi, Karnataka, India
| | - Ricardo S Gomez
- Departament of Oral Surgery and Pathology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Peter A Brennan
- Department of Oral & Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
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Souto GR, Matias MDP, Nunes LFM, Ferreira RC, Mesquita RA. Mature dendritic cell density is affected by smoking habit, lesion size, and epithelial dysplasia in oral leukoplakia samples. Arch Oral Biol 2018; 95:51-57. [PMID: 30056280 DOI: 10.1016/j.archoralbio.2018.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/24/2018] [Accepted: 07/12/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To compare the densities of CD1a + immature and CD83+ mature dendritic cells, and inflammatory infiltrate cells between smokers and non-smokers with oral leukoplakia. Parameters associated with malignant transformation were also evaluated. DESIGN 21 smokers and 23 non-smokers diagnosed with oral leukoplakia were obtained. Densities of inflammatory infiltrate cells were calculated in H&E sections. Immunohistochemistry using anti-CD1a and anti-CD83 was performed and densities were calculated. Comparisons and statistical analyses were performed among the groups and parameters as gender, lesion size, site, and presence of cell dysplasia were analyzed. RESULTS A lower density of CD83+ cells was observed in smokers compared to non-smokers (P < 0.05). For samples of smokers, a lower density of CD1a + cells, CD83+ cells, and inflammatory infiltrate cells was observed in samples with <10 mm compared to samples ≥10 mm of diameter (P < 0.05), and a lower density of CD83+ cells was also observed between samples without dysplasia compared to samples with dysplasia (P < 0.05). CONCLUSION In oral leukoplakia samples, dendritic cell density decreases in the presence of smoking habit, and increases in larger lesions and with epithelial dysplasia. Smoking habit is an external factor that contribute to alteration of the anti-tumoral immune defense system in lesions of oral leucoplakia, reinforcing that smoking elimination is important to control the development of this disease.
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Affiliation(s)
- Giovanna Ribeiro Souto
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Hospital Público Regional de Betim, Betim, Minas Gerais, Brasil.
| | - Michelle Danielle Porto Matias
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Laiz Fernandes Mendes Nunes
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Raquel Conceição Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Idris A, Vani N, Saleh S, Tubaigy F, Alharbi F, Sharwani A, Tadrus N, Warnakulasuriya S. Relative Frequency of Oral Malignancies and Oral Precancer in the Biopsy Service of Jazan Province, 2009-2014. Asian Pac J Cancer Prev 2017; 17:519-25. [PMID: 26925637 DOI: 10.7314/apjcp.2016.17.2.519] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to report the types and relative frequency of oral malignancies and precancer in the Jazan region of Saudi Arabia during the period 2009-2014. MATERIALS AND METHODS Pathology reports were retrieved from the archives of Histopathology Department, King Fahd hospital in Jazan. Demographic data on tobacco habits, clinical presentation and histologic grading of oral precancer and cancer cases were transcribed from the files. RESULTS 303 (42.7%) oral pre-malignant and malignant cases were found out of 714 oral biopsy lesions. A pathology diagnosis of squamous cell carcinoma (85.1%) was most frequent, followed by premalignant lesions/epithelial dysplasia (8.6%), verrucous carcinoma (3.3%) and malignancy of other histological types (3%) such as ameloblastic carcinoma, salivary gland malignancy and sarcomas. Oral squamous cell carcinoma was predominant in females with a male to female ratio of 1:1.9. Patient age ranged from 22 to 100 years with a mean of 65±13.9. Almost 44.6% of oral cancer had occurred after 65 years of age. Only 16.3% cases were reported in patients younger than 50 years, predominantly females. The majority of female patients had the habit of using shammah with a long duration of usage for more than 45 years. Bucco- alveolar mucosa (52.3%) was the common site of involvement followed by tongue/ floor of the mouth (47.7%) and clinically presented mostly as ulceration/swelling clinically. Moderately differentiated tumours (53.9%) were common followed by well differentiated (32.2%) and poorly differentiated tumours (5.8%). The prevalence of oral verrucous carcinoma (3.3%) was comparatively low with an equal distribution in both males and females. Both bucco-alveolar mucosa and tongue were predominantly affected. Oral precancer/epithelial dysplasia (8.6%) was common in females with a shammah habit. Bucco-alveolar mucosa was commonly involved and clinically presented mostly as white/red patches. Most cases were mild followed by moderate and severe dysplasia. Tumours of other histological types (3%) include 1 ameloblastic carcinoma, 3 malignant salivary gland tumours and 5 sarcomas. CONCLUSIONS In this study, it was found that oral cancers reported in the pathology service to be a common occurrence. This study reconfirms previous reports of the high burden of oral cancer in this population This indicates that conventional preventive programs focused on oral cancer are in need of revision. In addition, further research into identifying new risk factors and molecular markers for oral cancer are needed for screening high risk individuals.
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Affiliation(s)
- Am Idris
- College of Dentistry, Jazan University, Jazan, Saudi Arabia E-mail :
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Maia HCDM, Pinto NAS, Pereira JDS, de Medeiros AMC, da Silveira ÉJD, Miguel MCDC. Potentially malignant oral lesions: clinicopathological correlations. EINSTEIN-SAO PAULO 2016; 14:35-40. [PMID: 27074232 PMCID: PMC4872915 DOI: 10.1590/s1679-45082016ao3578] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 01/15/2016] [Indexed: 12/02/2022] Open
Abstract
Objective To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects. Methods The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05). Results Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each). Conclusion In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.
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Gopinath D, Thannikunnath BV, Neermunda SF. Prevalence of Carcinomatous Foci in Oral Leukoplakia: A Clinicopathologic Study of 546 Indian Samples. J Clin Diagn Res 2016; 10:ZC78-83. [PMID: 27656569 PMCID: PMC5028553 DOI: 10.7860/jcdr/2016/16815.8305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 02/23/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Oral Leukoplakia (OL), the most common potentially malignant disorder, is diagnosed clinically on the basis of exclusion of other lesions. In a country like India, where prevalence of oral cancer is very high, the issue of carcinomatous foci within OL at the time of initial diagnosis of leukoplakia has never been addressed before. AIM To estimate the prevalence and risk factors for epithelial dysplasia as well as carcinoma within OL lesions at the time of initial clinical presentation in an Indian population with high prevalence of tobacco use. MATERIALS AND METHODS Clinical and pathologic data (age, sex, lesion location and histopathologic grading) of 546 cases of leukoplakia were analyzed. The prevalence rate of dysplasia and carcinoma in 546 oral leukoplakia cases was calculated. Univariate analysis was performed to examine risk factors associated with the presence of carcinoma and dysplasia within the lesions. RESULTS The male to female ratio in this study was 2:1. Majority of the patients irrespective of sex had a history of tobacco use. Of the total 85% of non-homogeneous lesions and 70% for the homogeneous lesions were illustrating, features of epithelial dysplasia. The prevalence rate of carcinoma was 11.9%. In univariate analysis it was found that lesion site, clinical appearance, tobacco use were strongly correlated with the presence of carcinoma within OL. CONCLUSION Our results demonstrate that majority of leukoplakia irrespective of its clinical appearance contain a dysplastic component and significant proportion contains carcinomatous foci. Lesions with certain features are more prone to have carcinomatous foci. However there is always a chance of finding foci of carcinoma in OL anywhere in the oral cavity. Therefore, excision biopsy is always mandatory before long term follow-up and treatment is planned.
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Affiliation(s)
- Divya Gopinath
- Senior Lecturer, Department of Oral Pathology and Microbiology, Malabar Dental College and Research Centre Edappal, Malappuram, Kerala, India
| | - Beena Valappil Thannikunnath
- Professor and Head, Department of Oral and Maxillofacial Pathology, Government Dental College, Kottayam, Kerala, India
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16
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Molecular Pathology Signatures in Predicting Malignant Potentiality of Dysplastic Oral Pre-cancers. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s40362-015-0033-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Field EA, McCarthy CE, Ho MW, Rajlawat BP, Holt D, Rogers SN, Triantafyllou A, Field JK, Shaw RJ. The management of oral epithelial dysplasia: The Liverpool algorithm. Oral Oncol 2015. [PMID: 26198978 DOI: 10.1016/j.oraloncology.2015.06.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E A Field
- Department of Oral Medicine, Liverpool University Dental Hospital, UK; The University of Liverpool, Cancer Research Centre, Department of Molecular and Clinical Cancer Medicine, UK.
| | - C E McCarthy
- Department of Oral Medicine, Liverpool University Dental Hospital, UK; The University of Liverpool, Cancer Research Centre, Department of Molecular and Clinical Cancer Medicine, UK
| | - M W Ho
- Leeds Teaching Hospitals NHS Foundation Trust, West Yorkshire, UK
| | - B P Rajlawat
- Department of Oral Medicine, Liverpool University Dental Hospital, UK
| | - D Holt
- Department of Oral Medicine, Liverpool University Dental Hospital, UK
| | - S N Rogers
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK; Evidence-Based Practice Research Centre (EPRd), Faculty of Health, Edge Hill University, Ormskirk, UK
| | - A Triantafyllou
- The University of Liverpool, Cancer Research Centre, Department of Molecular and Clinical Cancer Medicine, UK; Oral & Maxillofacial Pathology, Pathology Department, Liverpool Clinical Laboratories, UK
| | - J K Field
- Department of Oral Medicine, Liverpool University Dental Hospital, UK; The University of Liverpool, Cancer Research Centre, Department of Molecular and Clinical Cancer Medicine, UK
| | - R J Shaw
- The University of Liverpool, Cancer Research Centre, Department of Molecular and Clinical Cancer Medicine, UK; Regional Maxillofacial Unit, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
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Carreras-Torras C, Gay-Escoda C. Techniques for early diagnosis of oral squamous cell carcinoma: Systematic review. Med Oral Patol Oral Cir Bucal 2015; 20:e305-15. [PMID: 25662554 PMCID: PMC4464918 DOI: 10.4317/medoral.20347] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/01/2014] [Indexed: 02/04/2023] Open
Abstract
Background and objectives The diagnosis of early oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) is of paramount clinical importance given the mortality rate of late stage disease. The aim of this study is to review the literature to assess the current situation and progress in this area. Material and Methods A search in Cochrane and PubMed (January 2006 to December 2013) has been used with the key words “squamous cell carcinoma”, “early diagnosis” “oral cavity”, “Potentially Malignant Disorders” y “premalignant lesions”. The inclusion criteria were the use of techniques for early diagnosis of OSCC and OPMD, 7 years aged articles and publications written in English, French or Spanish. The exclusion criteria were case reports and studies in other languages. Results Out of the 89 studies obtained initially from the search 60 articles were selected to be included in the systematic review: 1 metaanalysis, 17 systematic reviews, 35 prospective studies, 5 retrospective studies, 1 consensus and 1 semi-structured interviews. Conclusions The best diagnostic technique is that which we have sufficient experience and training. Definitely tissue biopsy and histopathological examination should remain the gold standard for oral cancer diagnose. In this systematic review it has not been found sufficient scientific evidence on the majority of proposed techniques for early diagnosis of OSCC, therefore more extensive and exhaustive studies are needed. Key words:
Squamous cell carcinoma, early diagnosis, oral cavity, potentially malignant disorders, premalignant lesions.
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Almoznino G, Zadik Y, Vered M, Becker T, Yahalom R, Derazne E, Aframian DJ, Czerninski R. Oral and maxillofacial pathologies in young- and middle-aged adults. Oral Dis 2015; 21:493-500. [PMID: 25580799 DOI: 10.1111/odi.12308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 12/05/2014] [Accepted: 12/18/2014] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To evaluate the distribution of oral and maxillofacial pathologies (OMFPs) and its association with patient age in young- and middle-aged adults. METHODS Distribution of histopathologically diagnosed OMFPs (n = 385) treated during 2007-2010 was recorded and the association with patient age was retrospectively analyzed. RESULTS The main diagnostic categories included benign exophytic lesions (45.3%), white benign lesions (13.5%), potentially malignant lesions/disorders (10.1%), intrabony lesions (9.8%), mucosal discoloration (7.8%), benign pigmented lesions (7.3%), chronic trauma/inflammation (3.9%), and oral malignancy (2.1%). Potentially malignant lesions/disorders as a diagnostic category were positively associated with age (OR = 1.07 for 1 year; P < 0.001) and specifically the diagnoses of oral lichen planus (OR = 1.04 for 1 year; P = 0.037) and dysplastic changes (OR = 1.08 for 1 year; P = 0.013) that comprised this category. Pigmented melanocytic lesions were negatively associated with age (OR = 0.94 for 1 year; P = 0.039) as well as benign/reactive exophytic lesions (OR = 0.98 for 1 year; P = 0.038), the latter included the histopathological diagnosis of benign salivary gland pathologies (OR = 0.90 for 1 year; P < 0.001). CONCLUSION This study provided baseline information regarding the distribution OMFPs among young- and middle-aged adults. It is important to highlight the high frequency of potentially malignant lesions/disorders and oral malignancy in young- and middle-aged adults, as these lesions require lifelong follow-up.
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Affiliation(s)
- G Almoznino
- Department of Oral Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel; Department of Oral Medicine, Oral and Maxillofacial Center, Tel-Hashomer, Medical Corps, Israel Defense Forces, Tel Aviv, Israel
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SOUTO MLS, PIVA MR, MARTINS-FILHO PRS, TAKESHITA WM. Lesões maxilofaciais: um levantamento de 762 casos da Universidade Federal de Sergipe, Brasil. REVISTA DE ODONTOLOGIA DA UNESP 2014. [DOI: 10.1590/rou.2014.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introdução : A pesquisa epidemiológica de lesões maxilofaciais em determinada região estabelece as necessidades populacionais e orienta os profissionais da saúde na definição de ações preventivas e tratamento adequado. Objetivo: Analisar os laudos histopatológicos de lesões maxilofaciais do período de 1996 a 2011 do Laboratório de Patologia Oral do Departamento de Odontologia da Universidade Federal de Sergipe (UFS), Brasil. Material e método: Estudo retrospectivo das biópsias realizadas de 1996 a 2011, recuperando-se os dados referentes ao gênero e à idade dos pacientes, à localização das lesões e ao diagnóstico histopatológico. As lesões foram agrupadas em: neoplasias benignas, lesões potencialmente malignas, neoplasias malignas, lesões inflamatórias, lesões odontogênicas, lesões ósseas, lesões de glândulas salivares e anomalias de desenvolvimento. Resultado: Foram analisados 762 laudos, havendo maior prevalência das lesões inflamatórias (n=205, 26,9%). O diagnóstico mais comum entre as neoplasias benignas foi a lesão periférica de células gigantes (n=15); entre as lesões potencialmente malignas, foi a displasia epitelial (n=80), e entre as neoplasias malignas, foi o carcinoma de células escamosas (n=29). Dentre as lesões inflamatórias, a lesão mais prevalente foi a hiperplasia fibrosa inflamatória (n=74). O granuloma periapical (n=62) foi a lesão mais comum dentre as lesões odontogênicas. A lesão mais prevalente dentre as lesões ósseas foi o fibroma ossificante central (n=08); entre as lesões de glândulas salivares, foi o fenômeno de retenção de muco (n=64), e entre as anomalias de desenvolvimento, foi a mácula melanocítica (n=04). Conclusão: Os achados deste levantamento salientam a importância de planos de tratamento e medidas educativas que diminuam e previnam a exposição dos pacientes a fatores de risco.
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A retrospective analysis of clinical features of oral malignant and potentially malignant disorders with and without oral epithelial dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:725-33. [DOI: 10.1016/j.oooo.2013.08.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/05/2013] [Accepted: 08/07/2013] [Indexed: 12/20/2022]
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de Vasconcelos Carvalho M, Pereira JDS, Alves PM, Silveira EJDD, de Souza LB, Queiroz LMG. Alterations in the immunoexpression of galectins-1, -3 and -7 between different grades of oral epithelial dysplasia. J Oral Pathol Med 2012; 42:174-9. [PMID: 22845866 DOI: 10.1111/j.1600-0714.2012.01199.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Oral epithelial dysplasia (OED) is a potentially malignant lesion characterized by a combination of cytological and architectural anomalies, which are essential for its diagnosis. Galectins are proteins that participate in cell cycle, adhesion and differentiation, apoptosis, and immune responses, as well as in cancer development and progression. MATERIALS AND METHODS The aim of this study was to analyze the immunohistochemical expression of galectins-1, -3, and -7 in the OED (21 low risk and 29 high risk) and normal oral mucosa (NOM). The binary grading system was used. RESULTS Galectin-1 was expressed in the middle/lower third in most OED cases. Nuclear/cytoplasmic staining was observed in most low-risk and high-risk OEDs. All cases of NOM were negative for galectin-1. Galectin-3 was expressed in the middle/lower third in most low-risk cases. Nuclear/cytoplasmic staining was noted in most low-risk and high-risk OEDs. Middle/lower third and in membrane staining was detected in four cases of NOM for galectin-3. Galectin-7 was expressed in the upper/middle third in most of OED cases. Nuclear/cytoplasmic staining predominated in low-risk and high-risk OEDs. Galectin-7 was detected in four cases of NOM, all of them presenting staining in the upper/middle third and in the membrane. CONCLUSION The differences in the immunoexpression of galactin-1, -3, and -7 between different grades of OEDs suggest the involvement of this protein in the progression of dysplasias.
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