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Ki SH, Chung DH, Park TJ. Reconstruction of Squamous Cell Carcinoma on Oral Commissure With Hatchet-Shaped Flap. J Craniofac Surg 2024; 35:e359-e361. [PMID: 38722546 DOI: 10.1097/scs.0000000000010108] [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: 12/15/2023] [Accepted: 01/25/2024] [Indexed: 06/04/2024] Open
Abstract
The mouth is a unique and prominent element of the lower face. Given the complex anatomy, aesthetic appearance, and function of the oral commissure, its reconstruction due to various causes presents a significant challenge for surgeons. Squamous cell carcinoma (SCC) of the lip is the most common type of oral cancer, accounting for approximately 25% to 30% of all oral cancers. Wide excision is the treatment of choice, and the prognosis is generally favorable. We encountered a case of SCC of the right oral commissure in a 69-year-old man. We designed a hatchet-shaped flap to minimize anatomical disruption and, as a result, achieved satisfactory outcomes in terms of both functionality and aesthetics.
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Affiliation(s)
- Sae Hwi Ki
- Department of Plastic and Reconstructive Surgery, Inha University Hospital, Incheon, Korea
- Department of Plastic and Reconstructive Surgery, Inha University School of Medicine, Incheon, Korea
| | - Do Hyuk Chung
- Department of Plastic and Reconstructive Surgery, Inha University Hospital, Incheon, Korea
| | - Tae Jun Park
- Department of Plastic and Reconstructive Surgery, Inha University Hospital, Incheon, Korea
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Kang J, Ma P, Xu H, Mao M, Han Z. Full-thickness nasolabial facial artery flap: A modified surgical approach for reconstruction of lower lip defects. Head Neck 2024; 46:1400-1405. [PMID: 38504603 DOI: 10.1002/hed.27744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/27/2024] [Accepted: 03/09/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVES Reconstruction of large lower lip defects remains challenging in terms of aesthetics, function and safety. The aim of this study is to explore a modified nasolabial flap to repair large lower lip defects. METHODS The full-thickness nasolabial facial artery flap was used for reconstruction of defects in lip squamous cell carcinoma (LSCC) patients after tumor ablation. The postoperative recovery of patients was obtained through clinical review and follow-up in the first and sixth month. RESULTS There were four LSCC patients who received tumor ablation at the Beijing Stomatological Hospital of Capital Medical University from November 2022 to March 2023, were included in our study. All patients did not suffer from postoperative infection, orocutaneous fistula, flap necrosis, and flap loss. One patient had the trapdoor deformity. These patients achieved better lip closure function. One patient developed cervical lymph node metastasis 2 months after surgery. CONCLUSIONS The modified nasolabial flap could achieve good outcomes in terms of aesthetics, function, and safety. It provided a supplementary strategy for the using of nasolabial flap in larger defects of lower lip.
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Affiliation(s)
- Jia Kang
- Department of Oral and Maxillofacial - Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Ping Ma
- Department of Stomatology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China
| | - Hanbing Xu
- Department of Oral and Maxillofacial - Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Minghui Mao
- Department of Oral and Maxillofacial - Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Zhengxue Han
- Department of Oral and Maxillofacial - Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
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Bogusiak K, Kozakiewicz M, Puch A, Mostowski R, Paneth P, Kobos J. Oral Cavity Cancer Tissues Differ in Isotopic Composition Depending on Location and Staging. Cancers (Basel) 2023; 15:4610. [PMID: 37760579 PMCID: PMC10526489 DOI: 10.3390/cancers15184610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this paper was to characterise the isotopic composition of oral squamous cell carcinoma (OSCC) specimens of different areas of the oral cavity. Secondly, we assessed whether there was a correlation between clinical stages of OSCC and isotopic abundance. The IRMS procedure was performed on 124 samples derived from 31 patients with OSCC of 15 N and 13 C to assess the isotopic composition. From each individual, four samples from the tumour, two from the margins, and two samples of healthy oral mucous membranes were derived. The two samples from the tumour and two samples from the margin were additionally subjected to histopathological assessment. Then, statistical analysis was conducted. Tumour infiltration tissues of the lower lip were characterised by higher mean δ13C values compared to samples derived from cancers of the other oral cavity regions (-23.82 ± 1.21 vs. -22.67 ± 1.35); (p = 0.04). The mean percentage of nitrogen content in tumour tissues was statistically higher in patients with the most advanced cancers (11.89 ± 0.03%) versus the group of patients with II and III stage cancers (11.12 ± 0.02%); (p = 0.04). In patients at stage IV, the mean δ13C value in the cancer samples equalled -22.69 ± 1.42 and was lower than that in patients at less severe clinical stages (p = 0.04). Lower lip cancer tissues differed in the isotopic abundance of carbon in comparison with tissues derived from the group of combined samples from other locations. Values of δ13C observed in specimens derived from lower lip cancers were similar to those observed in healthy oral mucous membranes. Cancer tissues obtained from patients in the last stage of OSCC had a different isotopic composition in comparison with those obtained from earlier stages. To confirm these observations, further research on larger groups of patients is needed.
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Affiliation(s)
- Katarzyna Bogusiak
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego, 90-549 Lodz, Poland
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego, 90-549 Lodz, Poland
| | - Aleksandra Puch
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego, 90-549 Lodz, Poland
| | - Radosław Mostowski
- Institute of Food Technology and Analysis, Faculty of Biotechnology and Food Sciences, Lodz University of Technology, 4/10 Stefanowskiego, 90-924 Lodz, Poland
| | - Piotr Paneth
- Institute of Applied Radiation Chemistry, Lodz University of Technology, 116 Żeromskiego, 90-924 Lodz, Poland
| | - Józef Kobos
- Department of Histology and Embryology, Medical University of Lodz, 7/9 Żeligowskiego, 90-752 Lodz, Poland
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Alshami ML, Al‐Maliky MA, Alsagban AA, Alshaeli AJ. Epidemiology and incidence of oral squamous cell carcinoma in the Iraqi population over 5 years (2014-2018). Health Sci Rep 2023; 6:e1205. [PMID: 37064317 PMCID: PMC10090270 DOI: 10.1002/hsr2.1205] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/12/2023] [Accepted: 03/21/2023] [Indexed: 04/18/2023] Open
Abstract
Background Oral squamous cell carcinoma is one of the most common and life-threatening neoplasms worldwide, and is responsible for approximately 90% of all oral malignancies. Aim This study was aimed at providing updated information on oral squamous cell carcinoma in all Iraqi governorates for the 5-year period from 2014 to 2018, including the annual incidence and demographic variables. Materials and Methods The total number of oral squamous cell carcinoma cases in Iraq, along with associated demographic information (age, sex, and site), for the 5-year period from 2014 to 2018 was obtained. The statistical analysis consisted of descriptive analysis, including frequency, percentage, and mean ± standard deviation. A χ 2 test was performed to compare frequencies between male and female patients, among age groups, and among different OSCC sites. The χ 2 test was also used to assess the association of each OSCC site with age and sex. The significance threshold was set at p < 0.05, and the confidence interval was set at 95%. The incidence rate of oral squamous cell carcinoma for each year was calculated by dividing the number of OSCC cases per year by the population of Iraq, then multiplying the result by 100,000. Results A total of 722 cases were recorded. Statistically, oral squamous cell carcinoma was found to be more prevalent in males and individuals over 40 years of age. The tongue was the most common site of occurrence. Lip squamous cell carcinoma cases were high in males. The incidence rate of oral squamous cell carcinoma was estimated to be 0.4 per 100,000 people. Conclusion Males and older people are at relatively higher risk of developing oral cancer. The tongue is the most affected site, but any site in the oral cavity may be involved. Further exploration of the causes of oral malignancy in Iraq is necessary to improve prevention strategies.
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Immunohistochemical comparative analysis of IMP-3 and KI-67 in actinic cheilitis and lower lip squamous cell carcinoma. Oral Maxillofac Surg 2022; 26:587-593. [PMID: 34817714 DOI: 10.1007/s10006-021-00990-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 07/18/2021] [Indexed: 12/31/2022]
Abstract
Actinic cheilitis (AC) and lower lip squamous cell carcinoma (LLSCC) exhibit epithelial alterations mainly associated with chronic ultraviolet ray exposure. Currently, it is impossible to predict which AC cases will progress to LLSCC; thus, biomolecular markers have been studied. The aim of this study was to evaluate the immunoexpression of IMP-3 and KI-67 in AC and LLSCC. Forty AC and 40 LLSCC cases were submitted to peroxidase method and quantitatively analyzed, using the following scores: 0 (0% positive cells), + 1(≤ 30%), + 2 (> 30% to ≤ 60%), and + 3 (> 60%). Results were submitted to non-parametric Mann-Whitney (U) test. A p value < 0.05 was considered to indicate statistical significance. IMP-3 immunoexpression was observed in 26 AC cases, with predominance of the score 1 (35% of cases). This protein was also positive in 22 LLSCC cases, with predominance of the score 3 (37.5% of cases). Immunoexpression of KI-67 was observed in all studied cases, with predominance of the score 2 (70% of AC cases and 57.5% LLSCC cases). The association between IMP-3 and Ki-67 immunoexpression, AC dysplastic severity and LLSCC tumoral grade revealed no significant differences. The present results demonstrate that IMP-3 and Ki-67 immunoexpression are frequent in AC and in LLSCC. Moreover, these proteins could be involved in lower lip carcinogenesis process.
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Yang Y, Shen S, Wang P, Wang X. Efficacy of photodynamic therapy in actinic cheilitis: a systematic review. Photodiagnosis Photodyn Ther 2022; 38:102782. [PMID: 35218940 DOI: 10.1016/j.pdpdt.2022.102782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/10/2022] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) has gradually developed into a promising modality for actinic cheilitis (AC), and many new PDT strategies are emerging. However, comprehensive reviews evaluating the efficacy of PDT strategies for AC are lacking. OBJECTIVE To systematically review the safety and efficacy of PDT strategies for AC. METHODS A systematic review was conducted using three databases to compare several types of PDT for AC in terms of clinical response (CR), histopathology response (HR), cosmetic result, and adverse events. RESULTS A total of 19 studies were included, and 292 subjects were finally enrolled. The complete CR rate of ALA-patch PDT, traditional photodynamic therapy (T-PDT), and daylight photodynamic therapy (DL-PDT) was 80.00% (24/30), 65.14% (114/179), and 76.74% (33/43), respectively. The rate of painless patients was 87.10% (27/31) in DL-PDT, whereas the rate was only 31.25% (15/48) in T-PDT. The rates of moderate and severe local phototoxicity were 47.78% (43/90) in T-PDT, 0.00% (0/23) in DL-PDT, and 21.05% (4/19) in ALA-patch PDT. CONCLUSION Published literature suggests that ALA-patch PDT seem to achieve high complete CR rate. Besides, DL-PDT might be a well-tolerated therapy compared with T-PDT and ALA-patch PDT. However, these assumptions are made based on very limited data. It is necessary to conduct a long-term larger sample randomized controlled trial to further evaluate the efficacy and adverse events of various PDT schemes for AC.
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Affiliation(s)
- Yuling Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai
| | - Shuzhan Shen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai.
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai.
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Demographic and Clinicopathologic Features of Actinic Cheilitis and Lip Squamous Cell Carcinoma: a Brazilian Multicentre Study. Head Neck Pathol 2020; 14:899-908. [PMID: 32077056 PMCID: PMC7669919 DOI: 10.1007/s12105-020-01142-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/02/2020] [Accepted: 02/04/2020] [Indexed: 01/08/2023]
Abstract
Data on the occurrence and clinicopathological characteristics of actinic cheilitis (AC) and lip squamous cell carcinoma (LSCC) are well studied; however, they are based on studies limited to a single centre. Herein, we described the frequency of AC and LSCC submitted to microscopic examination from representative geographic regions of Brazil. A retrospective multicentre study was performed on biopsies obtained from 1953 to 2018 at 10 Brazilian oral and maxillofacial pathology centres. A total of 198,709 biopsy specimens were surveyed. Sociodemographic data and clinicopathologic characteristics were analysed. A total of 2017 cases of ACs (1.0%) and 850 cases of LSCCs (0.4%) were recorded. A strong fair-skinned (> 87%) male (> 70%) predilection was observed in both conditions. The mean age was 54.8 ± 18.7 for individuals with AC and 57.8 ± 19.0 for individuals with LSCC. The most commonly affected site was the lower lip (> 90%). This is a large multicentre study of AC and LSCC from Brazil. The frequency and clinicopathological features of AC and LSCC were similar to those described worldwide. This study provides robust and representative epidemiological data of these conditions for the scientific community.
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Mello FW, Melo G, Modolo F, Rivero ERC. Actinic cheilitis and lip squamous cell carcinoma: Literature review and new data from Brazil. J Clin Exp Dent 2019; 11:e62-e69. [PMID: 30697396 PMCID: PMC6343992 DOI: 10.4317/jced.55133] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 12/10/2018] [Indexed: 12/19/2022] Open
Abstract
Background To investigate the prevalence of malignant and potentially malignant lesions of the lip in an oral pathology service and to compare these data with a literature review. Material and Methods A total of 3173 biopsy reports and histopathological records were analyzed. Cases with a histological diagnosis of actinic cheilitis (AC) with or without epithelial dysplasia, in situ carcinoma, or lip squamous cell carcinoma (LSCC) were included. A comprehensive literature review was conducted to investigate the prevalence of AC and/or LSCC. Results 124 cases (3.91%) were included, 75 (60.5%) had some degree of epithelial dysplasia and 31 (25.0%) were LSCC. Clinically, most of the lesions were diagnosed as AC (50.8%); however, eight cases clinically reported as AC were histologically diagnosed as LSCC. Regarding clinical characteristics, most individuals were fair-skinned male, with mean age of 54.3±12.3 years, and with a history of long-term solar exposure. Furthermore, 18 articles were selected from the literature, showing that the lower lip was predominantly affected and that most individuals were males, fair-skinned, and older than 40 years. Conclusions Since most of the cases diagnosed clinically as AC presented some degree of epithelial dysplasia, it is important to emphasize the value of biopsy and the histological evaluation of this lesion. Key words:Actinic cheilitis, Precancerous conditions, In situ carcinoma, Oral diagnosis, Mouth neoplasms.
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Affiliation(s)
- Fernanda-Weber Mello
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Gilberto Melo
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Filipe Modolo
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Elena-Riet-Correa Rivero
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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de Morais EF, Santos HBDP, Cavalcante IL, Rabenhorst SHB, Dos Santos JN, Galvão HC, Freitas RDA. Twist and E-cadherin deregulation might predict poor prognosis in lower lip squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:318-329. [PMID: 30598410 DOI: 10.1016/j.oooo.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/02/2018] [Accepted: 11/08/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the expression of Twist and E-cadherin in lower lip squamous cell carcinoma (LLSCC) and their association with clinicopathologic parameters. STUDY DESIGN Fifty-nine cases of LLSCC were analyzed by applying immunohistochemistry techniques in a semiquantitative manner. The systems proposed by Bryne etal., Brandwein-Gensler etal., and Almangush etal. were applied for analysis of the histopathologic malignancy grading system. RESULTS Higher E-cadherin expression (general and membrane) was observed in cases presenting with disease-free survival after 5years of follow-up (P < .05). Higher Twist expression was observed in lesions classified as being in advanced stages, displaying recurrence, and having a high degree of malignancy. A significant negative correlation was detected between cytoplasmic Twist expression and membrane E-cadherin expression (P = .028). A statistically significant relationship was detected between high total Twist expression in tumors classified as high risk by Brandwein-Gensler etal., and no significant difference was observed among total, membrane, and cytoplasmic E-cadherin expressions in LLSCC cases and the 3 applied grading systems (P > .05). CONCLUSIONS The results of the present study suggest the potential involvement of Twist and E-cadherin in the modulation of events related to worse prognoses in LLSCC cases.
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Affiliation(s)
- Everton Freitas de Morais
- PhD Student, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Hellen Bandeira de Pontes Santos
- PhD Student, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Israel Leal Cavalcante
- PhD Student, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Silvia Helena Barem Rabenhorst
- Professor, Postgraduate Program in Biological Sciences, Molecular Genetics Laboratory, Department of Pathology and Forensic Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Jean Nunes Dos Santos
- Professor, Postgraduate Program in Oral Pathology, Department of Oral Pathology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Hébel Cavalcanti Galvão
- Professor, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Roseana de Almeida Freitas
- Professor, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Squamous Cell Carcinoma of the Lip—A Review of Squamous Cell Carcinogenesis of the Mucosal and Cutaneous Junction. Dermatol Surg 2017; 43:494-506. [DOI: 10.1097/dss.0000000000001020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Singer S, Zeissig SR, Emrich K, Holleczek B, Kraywinkel K, Ressing M. Incidence of lip malignancies in Germany-data from nine population-based cancer registries. J Oral Pathol Med 2017; 46:780-785. [DOI: 10.1111/jop.12559] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics; Epidemiology and Informatics; University Medical Centre; Johannes Gutenberg University Mainz; Mainz Germany
- University Cancer Centre Mainz (UCT); Mainz Germany
| | - Sylke Ruth Zeissig
- Institute of Medical Biostatistics; Epidemiology and Informatics; University Medical Centre; Johannes Gutenberg University Mainz; Mainz Germany
- Cancer Registry Rhineland-Palatinate; Mainz Germany
| | - Katharina Emrich
- Institute of Medical Biostatistics; Epidemiology and Informatics; University Medical Centre; Johannes Gutenberg University Mainz; Mainz Germany
- Cancer Registry Rhineland-Palatinate; Mainz Germany
| | | | - Klaus Kraywinkel
- German Centre of Cancer Registry Data; Department of Epidemiology & Health Monitoring; Robert Koch Institute; Berlin Germany
| | - Meike Ressing
- Institute of Medical Biostatistics; Epidemiology and Informatics; University Medical Centre; Johannes Gutenberg University Mainz; Mainz Germany
- Cancer Registry Rhineland-Palatinate; Mainz Germany
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Strieder L, Coutinho-Camillo CM, Costa V, da Cruz Perez DE, Kowalski LP, Kaminagakura E. Comparative analysis of three histologic grading methods for squamous cell carcinoma of the lip. Oral Dis 2016; 23:120-125. [PMID: 27667675 DOI: 10.1111/odi.12586] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/30/2016] [Accepted: 09/11/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate three histologic grading methods for squamous cell carcinoma (SCC) of the lip, the conventional three-grade model proposed by the World Health Organization, tumor budding and depth of invasion (BD) model, and histologic risk assessment (HRA) model, and to correlate them with prognosis. MATERIALS AND METHODS Fifty-three patients with lip SCC were evaluated. RESULTS The mean age was 65 years, 69.8% of the participants were men, and 66.0% of the patients had early-stage tumors. Using the BD and conventional three-grade methods, 52.8% and 64.2% of the cases were graded as low risk, respectively. The HRA model graded 54.7% of the cases as medium risk. In the BD model, the higher histologic grade was associated with worse prognosis (P = 0.045). Overall survival at 5 years was 87.8%. Tumor size (T3 + T4) and lymph node involvement (N+) were associated with reduced overall survival and recurrence-free survival (RFS) (P = 0.002 and 0.005; 0.007 and 0.01, respectively). Surgical treatment combined with radiotherapy was associated with lower RFS (P = 0.03). CONCLUSIONS High-grade lip SCC in advanced stages is associated with a poor prognosis. The BD model is a simple and effective tool for the prognostic evaluation of lip SCC.
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Affiliation(s)
- L Strieder
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP - Univ. Estadual Paulista, São José dos Campos, Brazil
| | | | - V Costa
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP - Univ. Estadual Paulista, São José dos Campos, Brazil
| | - D E da Cruz Perez
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - L P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - E Kaminagakura
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP - Univ. Estadual Paulista, São José dos Campos, Brazil
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Gonçalves AS, Oliveira JP, Oliveira CFP, Silva TA, Mendonça EF, Wastowski IJ, Batista AC. Relevance of HLA-G, HLA-E and IL-10 expression in lip carcinogenesis. Hum Immunol 2016; 77:785-90. [PMID: 26723902 DOI: 10.1016/j.humimm.2015.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 11/20/2015] [Accepted: 12/01/2015] [Indexed: 11/20/2022]
Abstract
HLA-G, HLA-E and IL-10 are molecules which can provide tumor immunosuppression as well as the capacity of evasion to the immune system host. This study set out to evaluate HLA-G, HLA-E and IL-10 expression in lip squamous cell carcinoma (LSCC) and in a potentially malignant disorder (actinic cheilitis - AC), correlating the expression of these proteins with the degree of epithelial dysplasia. Immunohistochemistry was undertaken to identify HLA-G, HLA-E and IL-10 in samples from patients with LSCC (n=20), AC (n=30) and healthy lip mucosa (control) (n=10). A semiquantitative scoring system was used for analysis. Differences between the groups were evaluated using the Pearson Chi-Squared test. The percentage of LSCC samples showing high immunoreactivity (IRS>2) for HLA-G, HLA-E and IL-10 (neoplastic/epithelial cells) and HLA-E (stroma/connective tissue) was significantly higher that of the control (P<0.05). A tendency for a progressive increase in the proteins analyzed was observed from the control to AC and to LSCC. The degree of dysplasia in the AC samples was not significantly associated with the proteins evaluated (P>0.05). The high expression of HLA-G, HLA-E and IL-10 in AC and LSCC reflects the capacity that these pathologies have for evasion and progression.
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Affiliation(s)
- Andréia Souza Gonçalves
- Department of Stomatology (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil.
| | - Jéssica Petini Oliveira
- Department of Stomatology (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil.
| | | | - Tarcília Aparecida Silva
- Department of Oral Surgery and Pathology, Dental School, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | | | | | - Aline Carvalho Batista
- Department of Stomatology (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil.
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Gomes JO, de Vasconcelos Carvalho M, Fonseca FP, Gondak RO, Lopes MA, Vargas PA. CD1a+ and CD83+ Langerhans cells are reduced in lower lip squamous cell carcinoma. J Oral Pathol Med 2016; 45:433-9. [PMID: 26661374 DOI: 10.1111/jop.12389] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Actinic cheilitis (AC) is a potentially malignant lesion diagnosed in the lip of patients chronically exposed to the sun that may give rise to a fully invasive lower lip squamous cell carcinoma (LLSCC). It is known that ultraviolet radiation causes dendritic cells (DCs) depletion in the epidermis, but the role of this cellular population in lip cancer progression remains uncertain. Therefore, this study investigated the distribution of DCs in normal, dysplastic and neoplastic tissues of the lower lip. METHODS Thirteen cases of lower lip mucocele, 42 of ACs and 21 of LLSCC were retrieved and original diagnoses confirmed by two oral pathologists, who further classified ACs as low- and high-risk lesions. Immunoreactions against CD1a and CD83 identified immature and mature DCs, respectively. RESULTS Immature CD1a+ Langerhans cells (LCs) were significantly decreased in LLSCC when compared to morphologically normal (P < 0.009) and dysplastic epitheliums (P < 0.003), whereas mature CD83+ LCs were significantly decreased in LLSCC when compared to normal epithelium (P = 0.038). There was no significant difference between low- and high-risk ACs regarding CD1a+ and CD83+ LCs (P > 0.05), but ACs demonstrated a lower concentration of CD1a+ LCs than normal epithelium (P < 0.009). There was no significant difference in the distribution of CD1a+ and CD83+ interstitial dendritic cells (IDCs) in the connective tissue among the studied groups (P > 0.05). CONCLUSION These results suggest that depletion of epithelial LCs, but not IDCs in the connective tissue, would represent an important step for lip cancer development.
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Affiliation(s)
| | | | | | | | | | - Pablo Agustin Vargas
- Department of Oral Diagnosis, University of Campinas, Piracicaba, Brazil
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
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