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Damazo BJ, Punjabi NA, Liu YF, Inman JC. Histopathologic predictors of recurrence and survival in early T stage oral tongue squamous cell carcinoma. FRONTIERS IN ORAL HEALTH 2024; 5:1426709. [PMID: 39165677 PMCID: PMC11333445 DOI: 10.3389/froh.2024.1426709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 07/25/2024] [Indexed: 08/22/2024] Open
Abstract
Objectives Recurrence and survival in early T-stage oral tongue squamous cell carcinoma (OTSCC) may be impacted by histopathologic risk factors. This study aims to examine which of these factors predict long-term outcomes of T1 and T2 OTSCC. Methods A retrospective review of T1 and T2 OTSCC patients treated with surgery at a single tertiary care center was conducted. Multivariate regression and Kaplan-Meier survival plots were used to identify predictors of recurrence and compare disease-free survival respectively. Results 100 consecutive patients were studied. Of these, 51 were staged pT1, 49 pT2, 69 pN0, 10 pN1, and 21 pN2. Multivariate regression analysis revealed that >4 nodes was the strongest predictor of overall recurrence [odds ratio 1.68 (1.23-2.28), p = 0.001], while >4 nodes [odds ratio 1.14 (1.09-1.85), p = 0.008] and pT2 [odds ratio 1.15 (1.01-1.30), p = 0.033] were predictors of local recurrence (R2 = 0.112). Five-year disease-free survival was not significantly impacted by any risk factors except for the number of positive nodes-86% for ≤4 nodes vs. 20% for >4 nodes (p < 0.001)-and pathologic T-stage-90% for pT1 vs. 75% for pT2 (p = 0.035) regardless of adjuvant radiation and/or chemotherapy use. Conclusions Patients who underwent adjuvant radiation and/or chemotherapy had similar survival to those who did not despite having worse overall tumor prognostic factors. Adding adjuvant therapy may equalize some high-risk histopathologic factors. In the highest risk patients-specifically those with pathologic >4 nodes and pT2 staging-adjuvant therapy should be considered.
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Affiliation(s)
- Benjamin J. Damazo
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
| | - Nihal A. Punjabi
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
- Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Yuan F. Liu
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
| | - Jared C. Inman
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
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Yosefof E, Tsur N, Zavdy O, Kurman N, Dudkiewicz D, Yehuda M, Bachar G, Shpitzer T, Mizrachi A, Tzelnick S. Prognostic Significance of Regional Disease in Young Patients with Oral Cancer: A Comparative Study. Laryngoscope 2024; 134:2212-2220. [PMID: 37965942 DOI: 10.1002/lary.31187] [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: 06/13/2023] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Regional metastases are considered the most important prognostic factor in OSCC patients. We aimed to investigate the impact of regional disease among different age groups with OSCC. METHODS A retrospective comparison between patients 40 years old or younger, 41-69 years old, and 70 years or older treated for OSCC between 2000 and 2020 in a tertiary-care center. RESULTS 279 patients were included. The mean age was 65 ± 17.7 and 133 were male (47.7%). Thirty-six (12.9%) were 40 years old or younger, 101 (36.2%) were 41-69 years and 142 (50.9%) were 70 years or older. Five-year overall survival and disease-specific survival (DSS) were significantly better among patients younger than 40 compared to the mid-age group and patients 70 years or older (76.7% vs. 69.4% vs.48.2%, Log-rank p < 0.001, and 76.7% vs. 75.3% vs. 46.5%, Log-rank p < 0.001, respectively). While an association between regional spread and overall survival and DSS was demonstrated among all age groups, the odds ratio (OR) for death of any cause and death of disease regarding cervical metastasis was much higher among patients younger than 40 compared with the 41-69 and 70+ age groups (death of any cause-OR = 23, p-value = 0.008, OR = 2.6, p-value = 0.026, OR = 2.4, p-value = 0.13, respectively. Death of disease-OR = 23, p-value = 0.008, OR = 2.3, p-value = 0.082, OR = 4.1, p-value = 0.001, respectively). In univariate analysis, regional metastasis was associated with disease-free survival only among patients younger than 40 (p-value = 0.04). CONCLUSIONS Regional metastases correspond with worse prognosis in young patients compared to older patients. These patients may benefit from a comprehensive treatment approach with close post-treatment follow-up. LEVEL OF EVIDENCE 3 Laryngoscope, 134:2212-2220, 2024.
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Affiliation(s)
- Eyal Yosefof
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nir Tsur
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofir Zavdy
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noga Kurman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel
| | - Dean Dudkiewicz
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Yehuda
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gideon Bachar
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Thomas Shpitzer
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviram Mizrachi
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Tzelnick
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Devi P, Dwivedi R, Sankar R, Jain A, Gupta S, Gupta S. Unraveling the Genetic Web: H-Ras Expression and Mutation in Oral Squamous Cell Carcinoma-A Systematic Review. Head Neck Pathol 2024; 18:21. [PMID: 38502412 PMCID: PMC10951159 DOI: 10.1007/s12105-024-01623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/27/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) is a commonly occurring malignancy with complex genetic alterations contributing to its development. The H-Ras, a proto-oncogene, becomes an oncogene when mutated and has been implicated in various cancers. This systematic review aims to research to what extent H-Ras expression and mutation contribute to the development and progression of OSCC, and how does this molecular alteration impacts the clinical characteristics and prognosis in patients with OSCC. METHODS A thorough electronic scientific literature search was carried out in PUBMED, SCOPUS, and GOOGLE SCHOLAR databases from 2007 to 2021. The search strategy yielded 120 articles. Following aggregation and filtering all results through our inclusion and exclusion criteria total 9 articles were included in our literature review. It has also been registered with PROSPERO (CRD42023485202). RESULTS It was found that mutations in the Ras gene commonly reported in hotspots at codons 12, 13, and 61 resulting in the activation of downstream signaling pathways causing abnormal and uncontrolled cell growth. This systematic review has shown an increased prevalence of H-Ras mutation in well-differentiated OSCC and also the prevalence of H-Ras mutation in individuals engaging in multiple risk behaviors, particularly chewing tobacco, demonstrated a significant association with a higher prevalence of H-Ras positivity. CONCLUSION This review sheds light on the prevalence of H-Ras mutations, their association with clinical characteristics, and their potential implications for OSCC prognosis. It also enhances our comprehension of the molecular mechanisms that underlie OSCC and paves the way for further research into targeted treatments based on H-Ras alterations.
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Affiliation(s)
- Priya Devi
- Department of Oral Pathology and Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ruby Dwivedi
- Department of Oral Pathology and Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Roshna Sankar
- Department of Oral Pathology and Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ayushi Jain
- Department of Oral Pathology and Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sameer Gupta
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shalini Gupta
- Department of Oral Pathology and Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
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Janović A, Bracanović Đ, Antić S, Marković-Vasiljković B. Demographic and imaging features of oral squamous cell cancer in Serbia: a retrospective cross-sectional study. BMC Oral Health 2024; 24:141. [PMID: 38287310 PMCID: PMC10823646 DOI: 10.1186/s12903-024-03869-8] [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: 11/07/2023] [Accepted: 01/06/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The mortality of oral squamous cell cancer (OSCC) in Serbia increased in the last decade. Recent studies on the Serbian population focused mainly on the epidemiological aspect of OSCC. This study aimed to investigate the demographic and imaging features of OSCC in the Serbian population at the time of diagnosis. METHODS We retrospectively analyzed computed tomography (CT) images of 276 patients with OSCC diagnosed between 2017 and 2022. Age, gender, tumor site, tumor volume (CT-TV, in cm3), depth of invasion (CT-DOI, in mm), and bone invasion (CT-BI, in %) were evaluated. TNM status and tumor stage were also analyzed. All parameters were analyzed with appropriate statistical tests. RESULTS The mean age was 62.32 ± 11.39 and 63.25 ± 11.71 for males and females, respectively. Male to female ratio was 1.63:1. The tongue (36.2%), mouth floor (21.0%), and alveolar ridge (19.9%) were the most frequent sites of OSCC. There was a significant gender-related difference in OSCC distribution between oral cavity subsites (Z=-4.225; p < 0.001). Mean values of CT-TV in males (13.8 ± 21.5) and females (5.4 ± 6.8) were significantly different (t = 4.620; p < 0.001). CT-DOI also differed significantly (t = 4.621; p < 0.001) between males (14.4 ± 7.4) and females (10.7 ± 4.4). CT-BI was detected in 30.1%, the most common in the alveolar ridge OSCC. T2 tumor status (31.4%) and stage IVA (28.3%) were the most dominant at the time of diagnosis. Metastatic lymph nodes were detected in 41.1%. CONCLUSION Our findings revealed significant gender-related differences in OSCC imaging features. The predominance of moderate and advanced tumor stages indicates a long time interval to the OSCC diagnosis.
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Affiliation(s)
- Aleksa Janović
- School of Dental Medicine, Center of Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11000, Republic of Serbia.
| | - Đurđa Bracanović
- School of Dental Medicine, Center of Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11000, Republic of Serbia
| | - Svetlana Antić
- School of Dental Medicine, Center of Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11000, Republic of Serbia
| | - Biljana Marković-Vasiljković
- School of Dental Medicine, Center of Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11000, Republic of Serbia
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Batistella EÂ, Gondak R, Rivero ERC, Warnakulasuriya S, Guerra E, Porporatti AL, De Luca Canto G. Comparison of tobacco and alcohol consumption in young and older patients with oral squamous cell carcinoma: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:6855-6869. [PMID: 36131100 DOI: 10.1007/s00784-022-04719-z] [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: 03/03/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the proportion of young (up to 45 years of age) and older (over 45 years of age) oral squamous cell carcinoma (OSCC) patients who report tobacco and alcohol consumption. METHODS Observational studies reporting tobacco and alcohol consumption among young and older OSCC patients were selected in a two-phase process. Search strategies were conducted on five main electronic databases and complemented by grey literature. The risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data. Synthesis of results was calculated with the software R Statistics version 4.0.2 (The R Foundation). RESULTS From 6675 records identified, 38 studies met the eligibility criteria and were selected for qualitative synthesis and meta-analysis, encompassing 2439 young and 13,393 older patients. Tobacco smoking was reported by 39.5% (confidence interval (CI) = 31.7% to 47.9%, I2 = 78%) of the young patients and 48.4% (CI = 37.8% to 59.2%, I2 = 94%) of the older patients. Alcohol consumption was reported by 30.9% (CI = 22.7% to 40.5%, I2 = 83%) of the young and 45.8% (CI = 35.6% to 56.5%, I2 = 95%) of the older patients (P < 0.05). CONCLUSION The comparison in the proportion of individuals reporting tobacco and alcohol consumption demonstrated that these habits were more prevalent in the older group (48.4% and 45.8% respectively) than in the young group (39.5% and 30.9%, respectively). CLINICAL RELEVANCE As a significant proportion of patients with OSCC reported no habits, novel risk factors for OSCC need to be investigated in further research.
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Affiliation(s)
- Elis Ângela Batistella
- Health Sciences Center, Federal University of Santa Catarina, Rector David Ferreira Lima Campus, Trindade, Florianopolis, SC, 88037150, Brazil.
| | - Rogério Gondak
- Department of Pathology, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Elena Riet Correa Rivero
- Department of Pathology, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Saman Warnakulasuriya
- Department of Oral Medicine and Experimental Oral Pathology, King's College Dental Institute, Bessemer Road, London, SE5 9RS, UK.,WHO Collaborating Centre for Oral Cancer and Precancer in the United Kingdom, Denmark Hill Campus, London, SE5 9RS, UK
| | - Eliete Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia (UnB), Brasilia, DF, Brazil
| | - André Luís Porporatti
- Laboratoire de Neurobiologie OroFaciale, Université de Paris, France and GHPS Assitance Publique Hopitaux de Paris, Paris, France
| | - Graziela De Luca Canto
- Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianopolis, SC, Brazil
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Panda S, Mohanty N, Panda S, Mishra L, Gopinath D, Sahoo A, Nagraj SK, Lapinska B. Are Survival Outcomes Different for Young and Old Patients with Oral and Oropharyngeal Squamous Cell Carcinoma? A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14081886. [PMID: 35454794 PMCID: PMC9029651 DOI: 10.3390/cancers14081886] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Oral cancer was considered a disease of old age. However, there has been a recent surge in the incidence of oral cancer in young individuals. Age dependence on survival outcomes such as overall survival, disease-free survival, recurrence, distant metastasis and second primary in surgically treated oral cancer has been investigated several times and the results differ. This systematic review and meta-analysis has been conducted to address this concern. The results of the present research may facilitate age-dependent prognosis stratification, which would assist in treatment planning in oral cancer patients. Abstract This systematic review and meta-analysis aims to address whether age can be a determinant of overall survival (OS), disease-free survival (DFS), recurrence, distant metastasis (DM) and second primary (SP) in surgically treated oral and oropharyngeal squamous cell carcinoma (OOPSCC). A total of 4981 cases and 44254 controls from 25 comparative observational studies were included in the analysis. A significantly better OS (matched subgroup analysis: OR 1.64; 95% CI 1.31–2.04, overall analysis: OR 1.48; 95% CI 1.09–2.01) was observed in young patients compared to older adults, with heterogeneity ranging from moderate to severe. Worse DFS (unmatched subgroup analysis OR 0.43; 95% CI 0.27–0.68) was observed in young patients compared to older adults with minimal to moderate heterogeneity. The frequency of recurrence (OR 1.49; 95% CI 1.10–2.02) and DM (OR 1.83; 95% CI 1.10–3.03) was significantly higher in the young patients, as found in unmatched and matched subgroup analysis, with the least heterogeneities. Young age can be considered as an independent prognostic factor for recurrence and distant metastases in OOP-SCC. Larger and methodologically robust observational studies with longer follow-up are needed to establish the definitive role of age as an independent prognostic factor on OS and DFS in OOPSCC.
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Affiliation(s)
- Swagatika Panda
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar 751030, India; (N.M.); (A.S.)
- Correspondence: (S.P.); (B.L.); Tel.: +91-876-333-4097 (S.P.); +85-42-675-74-61 (B.L.)
| | - Neeta Mohanty
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar 751030, India; (N.M.); (A.S.)
| | - Saurav Panda
- Department of Periodontics and Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar 751030, India;
| | - Lora Mishra
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar 751030, India;
| | - Divya Gopinath
- Department of Oral Diagnostics and Surgical Sciences, School of Dentistry, International Medical University, Kuala Lumpur 57000, Malaysia;
- Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India
| | - Alkananda Sahoo
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar 751030, India; (N.M.); (A.S.)
| | - Sumanth Kumbargere Nagraj
- Head of the Department, Oral Medicine and Oral Radiology, Faculty of Dentistry, Manipal University College, Melaka 75150, Malaysia;
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland
- Correspondence: (S.P.); (B.L.); Tel.: +91-876-333-4097 (S.P.); +85-42-675-74-61 (B.L.)
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Rossi R, Gissi DB, Gabusi A, Fabbri VP, Balbi T, Tarsitano A, Morandi L. A 13-Gene DNA Methylation Analysis Using Oral Brushing Specimens as an Indicator of Oral Cancer Risk: A Descriptive Case Report. Diagnostics (Basel) 2022; 12:diagnostics12020284. [PMID: 35204376 PMCID: PMC8870863 DOI: 10.3390/diagnostics12020284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
Analysis of genetic or epigenetic markers from saliva or brushing specimens has been proposed as a diagnostic aid to identify patients at risk of developing oral cancer. However, no reliable non-invasive molecular method for this purpose is commercially available. In the present report, we describe the potential application of a procedure based on a 13-gene DNA methylation analysis using oral brushing samples from a patient affected by oral leukoplakia who developed two metachronous oral carcinomas during the follow-up period. A positive or a negative score was calculated for each brushing sample based on a predefined cut-off value. In this patient, a positive score was detected in the oral leukoplakia diagnosed more than 2 years before the development of oral squamous cell carcinoma and subsequently in clinically healthy mucosa 8 months before the appearance of a secondary tumor. This suggests a potential role of our procedure as an indicator of oral cancer risk.
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Affiliation(s)
- Roberto Rossi
- Section of Oral Sciences, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy; (R.R.); (A.G.)
| | - Davide B. Gissi
- Section of Oral Sciences, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy; (R.R.); (A.G.)
- Correspondence: ; Tel.: +39-05-1208-8123 (ext. 40125)
| | - Andrea Gabusi
- Section of Oral Sciences, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy; (R.R.); (A.G.)
| | - Viscardo Paolo Fabbri
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology “M. Malpighi”, Bellaria Hospital, 40125 Bologna, Italy;
| | - Tiziana Balbi
- Unit of Anatomic Pathology S. Orsola Hospital, IRCCS Azienda Ospedaliero Universitaria, 40138 Bologna, Italy;
| | - Achille Tarsitano
- Maxillo-Facial Surgery Unit, Department of Biomedical and Neuromotor Sciences, IRCCS Azienda Ospedaliero Universitaria Bologna, University of Bologna, 40138 Bologna, Italy;
| | - Luca Morandi
- Functional and Molecular Neuroimaging Unit, Bellaria Hospital, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40139 Bologna, Italy;
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
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Mohideen K, Krithika C, Jeddy N, Balakrishnan T, Bharathi R, Sankari SL. A Meta-analysis of Oral Squamous Cell Carcinoma in Young Adults with a Comparison to the Older Group Patients (2014-2019). Contemp Clin Dent 2021; 12:213-221. [PMID: 34759676 PMCID: PMC8525813 DOI: 10.4103/ccd.ccd_466_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/22/2020] [Accepted: 08/13/2020] [Indexed: 12/24/2022] Open
Abstract
Background: The oral squamous cell carcinoma (OSCC) often affects elderly aged adults, who had long-term tobacco exposure. In the recent past decade, there is an increasing incidence of OSCC in younger individuals, who had less tobacco association. Aim: The aim of this study is to examine the risk factors and to assess and compare the clinicopathological features and prognosis of OSCC in young patients with the older group patients. Materials and Methods: We included studies that addressed the OSCC involving young patients during the period between 2014 and 2019. Initially, we found 679 articles; after refined evaluation, 92 works had their titles matching to the present work. After extraction of case reports, reviews, and studies with un-matched objectives or inadequate data, we have chosen only 24 presentations matching to the abstract. The statistical analysis performed by Chi-square tests using SPSS 20.0 version for windows. Results: Of the total OSCC, 10% of patients belonged to the younger age group, and 90% were the older aged group. Both the groups showed male gender predominance and tongue as the predominant site of involvement. The younger patients tend to have significantly reduced tobacco exposure. The highly reported tumors were advanced staged and moderately differentiated tumors in both groups. There was a statistically evident high recurrence reported in the younger group. The overall survival seems to be similar for both groups. Conclusion: The identification of the potential risk factors, along with unique molecular mechanisms, and biological behavior of the disease is mandatory to control the incidence of OSCC in young adults.
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Affiliation(s)
- Khadijah Mohideen
- Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India
| | - C Krithika
- Department of Oral Medicine and Radiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Nadeem Jeddy
- Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Thayumanavan Balakrishnan
- Department of Oral Pathology and Microbiology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - R Bharathi
- Department of Oral Pathology and Microbiology, The Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - S Leena Sankari
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
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PRKCA Overexpression Is Frequent in Young Oral Tongue Squamous Cell Carcinoma Patients and Is Associated with Poor Prognosis. Cancers (Basel) 2021; 13:cancers13092082. [PMID: 33923093 PMCID: PMC8123332 DOI: 10.3390/cancers13092082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 12/24/2022] Open
Abstract
Oral tongue squamous cell carcinomas (OTSCCs) have an increasing incidence in young patients, and many have an aggressive course of disease. The objective of this study was to identify candidate prognostic protein markers associated with early-onset OTSCC. We performed an exploratory screening for differential protein expression in younger (≤45 years) versus older (>45 years) OTSCC patients in The Cancer Genome Atlas (TCGA) cohort (n = 97). Expression of candidate markers was then validated in an independent Austrian OTSCC patient group (n = 34) by immunohistochemistry. Kaplan-Meier survival estimates were computed, and genomic and mRNA enrichment in silico analyses were performed. Overexpression of protein kinase C alpha (PRKCA) was significantly more frequent among young patients of both the TCGA (p = 0.0001) and the Austrian cohort (p = 0.02), associated with a negative anamnesis for alcohol consumption (p = 0.009) and tobacco smoking (p = 0.02) and poorer overall survival (univariate p = 0.02, multivariate p< 0.01). Within the young subgroup, both overall and disease-free survival were significantly decreased in patients with PRKCA overexpression (both p < 0.001). TCGA mRNA enrichment analysis revealed 332 mRNAs with significant differential expression in PRKCA-upregulated versus PRKCA-downregulated OTSCC (all FDR ≤ 0.01). Our findings suggest that PRKCA overexpression may be a hallmark of a novel molecular subtype of early-onset alcohol- and tobacco-negative high-risk OTSCC. Further analysis of the molecular PRKCA interactome may decipher the underlying mechanisms of carcinogenesis and clinicopathological behavior of PRKCA-overexpressing OTSCC.
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Rathee R, Devi A, Narwal A, Kamboj M, Singh S. Immunohistochemical Coexpression of MUC1 and MUC4 in Oral Leukoplakia and Oral Squamous Cell Carcinoma. Head Neck Pathol 2021; 15:831-842. [PMID: 33544383 PMCID: PMC8384999 DOI: 10.1007/s12105-021-01291-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/09/2021] [Indexed: 02/04/2023]
Abstract
MUC1 and MUC4 are two transmembranous proteins, which have been seen to express aberrantly in various human neoplasms and advocated as independent prognostic markers. Till now no extensive studies have been carried out on combined expression of MUC1 and MUC4 in oral leukoplakia and Oral squamous cell carcinoma. This study is an endeavour to evaluate Immunohistochemical coexpression of MUC1 and MUC4 in Oral Leukoplakia and Oral squamous cell carcinoma and furthr establish them as prognostic markers. Immunohistochemical analysis of MUC1 and MUC4 was done on 24 cases of Oral squamous cell carcinoma, 24 cases of leukoplakia and 12 normal oral mucosal tissues. Chi square test and one way ANOVA test were employed for statistical analysis. Normal oral mucosa and leukoplakia group showed higher frequency of negative immunoexpression compared to oral squamous cell carcinoma group. Furthur in Oral squamous cell carcinoma group, higher frequency of double positive coexpression in well and moderately differentiated oral squamous cell carcinoma and single positive coexpression in poorly differentiated oral squamous cell carcinoma was obtained. A definite rise of immunoexpression of MUC1 and MUC4 was observed from normal oral mucosa to leukoplakia to oral squamous cell carcinoma indicative of their contribution as diagnostic and prognostic markers.
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Affiliation(s)
- Renu Rathee
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt.BD. Sharma University, Rohtak, Haryana India
| | - Anju Devi
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt.BD. Sharma University, Rohtak, Haryana India
| | - Anjali Narwal
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt.BD. Sharma University, Rohtak, Haryana India
| | - Mala Kamboj
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt.BD. Sharma University, Rohtak, Haryana India
| | - Sunita Singh
- Department of Pathology, Post Graduate Institute of Medical Sciences, Pt.BD. Sharma University, Rohtak, Haryana India
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Tomo S, Neto SC, Collado FU, Sundefeld ML, Bernabé DG, Biasoli ÉR, Miyahara GI. Head and neck squamous cell carcinoma in young patients: a 26-year clinicopathologic retrospective study in a Brazilian specialized center. Med Oral Patol Oral Cir Bucal 2020; 25:e416-e424. [PMID: 32134900 PMCID: PMC7211379 DOI: 10.4317/medoral.23461] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/20/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To describe the clinicopathologic profile of young patients with head and neck squamous cell carcinoma (HNSCC) and compare to middle-aged and elderly adults. MATERIAL AND METHODS Patients' individual records were reviewed for clinicopathologic data. Eighty-nine patients with age 18-45 years old met the inclusion criteria of the study. Two additional groups of middle-aged (n=89) and old (n=89) adults were set to comparative analysis. RESULTS Young patients represented 11.9% of all patients diagnosed with HNSCC. Women were more affected by HNSCC in the young and elder groups (p= 0.04), and young patients were more prone to be non-smokers (p= 0.01) and have lymph node metastasis at the time of diagnosis (p=0.04). In the young group, patients diagnosed with the disease in advanced stages were more prone to have a positive familial history of cancer (p= 0.04), a positive status of alcohol consumption (p= 0.03), and to be heavy drinkers (p= 0.01). Survival was not different for the young group in comparison to the other groups. CONCLUSIONS HNSCC in young patients had a different profile when compared to older patients, especially regarding sex and exposure to the classic risk factors for this disease. The survival of the young group is similar to the older groups and advanced clinical stage is predictor of worse survival.
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Affiliation(s)
- S Tomo
- Oral Oncology Center, Araçatuba Dental School São Paulo State University - UNESP José Bonifácio Street, 1193, Araçatuba São Paulo, 16015-050, Brazil
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12
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Ahuja US, Puri N, Bagewadi A, Keluskar V, Ahuja A, Singh HP. Comparative evaluation of serum alpha-1antitrypsin levels in patients with oral squamous cell carcinoma and in subjects with tobacco habit without carcinoma. J Family Med Prim Care 2019; 8:3657-3663. [PMID: 31803669 PMCID: PMC6881917 DOI: 10.4103/jfmpc.jfmpc_571_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/21/2019] [Accepted: 09/10/2019] [Indexed: 11/23/2022] Open
Abstract
Aim/Objectives: To evaluate serum levels of Alpha-1 antitrypsin in patients with oral squamous cell carcinoma and compare them with that of healthy subjects with and without tobacco habits. Materials and Method: The sample of 83 subjects was divided into three groups: 30 subjects with oral squamous cell carcinoma formed Group A. The age, sex, habit matched 23 healthy subjects with tobacco habit formed Group B and 30 healthy without history of consumption of tobacco formed Group C. Analysis of the samples was done using Alpha 1 antitrypsin kit and spectrophotometer. Results: There was a 2.33-fold rise in serum levels of Alpha 1 antitrypsin in Group A compared to Group B, 3.71-fold rise in Group A compared to Group C and 1.59-fold rise in Group B compared to Group C (P < 0.001). A definite rise in serum Alpha 1 antitrypsin levels in patients with oral squamous cell carcinoma as compared with healthy subjects with and without tobacco habits was observed. Conclusion: Alpha1-antitrypsin can be used as an adjunct to various diagnostic procedures implied for the evaluation of oral squamous cell carcinoma.
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Affiliation(s)
- Upasana S Ahuja
- Department of Oral Medicine and Radiology, I.T.S Dental College, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Nidhi Puri
- Department of Oral Medicine and Radiology, I.T.S Dental College, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Anjana Bagewadi
- Department of Oral Medicine and Radiology, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Vaishali Keluskar
- Department of Oral Medicine and Radiology, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Anshuman Ahuja
- Department of Oral and Maxillofacial Surgery, ITS Dental College, Greater Noida, Uttar Pradesh, India
| | - Harkanwal P Singh
- Department of Oral Pathology and Microbiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
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13
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Sproll CK, Holtmann H, Schorn LK, Jansen TM, Reifenberger J, Boeck I, Rana M, Kübler NR, Lommen J. Mandible handling in the surgical treatment of oral squamous cell carcinoma: lessons from clinical results after marginal and segmental mandibulectomy. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:556-564. [PMID: 32102765 DOI: 10.1016/j.oooo.2019.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 11/14/2019] [Accepted: 11/21/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The aim of this retrospective, single-center study was to analyze long-term results after marginal and segmental mandibulectomies in patients with oral squamous cell carcinoma (OSCC). STUDY DESIGN The study included 259 patients treated for OSCC with mandibulectomy between 1996 and 2010. Data acquisition consisted of analysis of operation reports, re-evaluation of histologic bone specimens, and collection of clinical follow-up data. RESULTS Of the included patients, 86.5% had received segmental and 13.5% marginal mandibulectomies. Patients who received segmental mandibulectomy generally displayed a higher TNM (tumor-node-metastasis) stage; 47% of patients who received segmental mandibulectomy and 14% of those receiving marginal mandibulectomy showed bone infiltration (pT4 a). Of all patients with bone infiltration, 49% showed an invasive histologic infiltration pattern, and 35% showed an erosive histologic infiltration pattern. We found healthy residual crestal bone height in 43% of all segmental mandibulectomies. Only 8% of all patients were prosthodontically rehabilitated. With regard to prognostic parameters, there was no significant difference between patients receiving marginal mandibulectomy and those receiving segmental mandibulectomy. CONCLUSIONS Because healthy residual crestal bone height was found in 43% of all patients who had received segmental mandibulectomies, it is conceivable that a significant number of patients would profit from marginal mandibulectomy, at least in cases of absent or erosive bone infiltration pattern, because the residual crestal bone is functionally stable.
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Affiliation(s)
- Christoph K Sproll
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Düsseldorf, Germany
| | - Henrik Holtmann
- Department of Oral and Maxillofacial Surgery, Malteser Clinic St. Johannes, Duisburg, Germany.
| | - Lara K Schorn
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Düsseldorf, Germany
| | - Theresa M Jansen
- Department of Dermatology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Julia Reifenberger
- Department of Dermatology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Inga Boeck
- Institute for Pathology, Cytology and Molecular Pathology GbR, Wetzlar, Germany
| | - Majeed Rana
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Düsseldorf, Germany
| | - Norbert R Kübler
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Düsseldorf, Germany
| | - Julian Lommen
- Department of Oral and Maxillofacial Surgery, Heinrich-Heine-University, Düsseldorf, Germany
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Paderno A, Morello R, Piazza C. Tongue carcinoma in young adults: a review of the literature. ACTA ACUST UNITED AC 2019; 38:175-180. [PMID: 29984792 DOI: 10.14639/0392-100x-1932] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/09/2018] [Indexed: 12/15/2022]
Abstract
SUMMARY A recent reduction in the number of smoke-related tumours has been observed thanks to the diffusion of anti-tobacco campaigns carried out in the majority of developed countries. Nevertheless, as demonstrated by recent global epidemiologic studies, squamous cell carcinoma of the mobile tongue appears to be progressively increasing in incidence, particularly among young adults and especially in females. The driving mechanism responsible for such changes is still to be precisely defined. Several genetic studies have compared the mutational pattern of tongue squamous cell carcinoma in young adults to that of more elderly patients, without identifying significant differences that may help in better characterising this subgroup of subjects. Tongue squamous cell carcinomas in young adults have been historically considered as particularly aggressive clinical entities, with a high risk of loco-regional relapse, survival rates inferior to those of the general head and neck cancer group and need for a more aggressive therapy. However, considering the most recent studies, prognostic results in this patient group are heterogeneous and it is not possible to confirm this tendency. Thus, it is not justified to embrace different therapeutic approaches according to patient age. Eventually, an additional element to consider when examining young subjects affected by tongue cancer is the possibility of genetic predisposition. Alterations affecting pathways involved in DNA repair, surveillance of genetic stability or regulation of cellular growth may determine an increased likelihood of developing head and neck cancers.
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Affiliation(s)
- A Paderno
- Department of Otolaryngology, Head and Neck Surgery, University of Brescia, Italy
| | - R Morello
- Department of Otolaryngology, Head and Neck Surgery, University of Brescia, Italy
| | - C Piazza
- Department of Otolaryngology, Head and Neck Surgery, Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, University of Milan, Italy
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15
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Mohideen K, Krithika C, Jeddy N, Bharathi R, Thayumanavan B, Sankari SL. Meta-analysis on risk factors of squamous cell carcinoma of the tongue in young adults. J Oral Maxillofac Pathol 2019; 23:450-457. [PMID: 31942130 PMCID: PMC6948024 DOI: 10.4103/jomfp.jomfp_118_19] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Tongue squamous cell carcinoma (TSCC) generally affects the older age group exposed to tobacco for an extended period. However, recent research points out that there is an increased incidence of TSCC in the younger age group without any traditional risk factors making TSCC as a distinct biological entity in this group. This study aims to assess the prevalence and risk factors of tongue carcinoma in the younger group of patients. This article included studies that addressed the TSCC involving young patients and that which are PubMed indexed. Initially, 390 articles were considered; but after refined evaluation, 123 articles had their titles and abstracts matching to this present work. After the extraction of the case reports, review articles and the articles without the assessment of the parameter of harmful habits, we have included only 23 articles in the sample matching the title. The statistical analysis was formed by using chi-square tests using IBM SPSS ver. 20.0. The cohort of the younger population in these studies was mostly in the 35- to the 45-year age group. The majority of reports (64%) classified the patients below 40 years of age as a young group. Though male predominance is reported to be 55%, female patients are also more affected (40%) in the younger age group compared with, the more typical and usual group of head and neck carcinoma patients. TSCC in older adults predominantly reported in tobacco users (70%) whereas in young adults, TSCC was associated with a higher incidence in nonsmokers (53%); the causes of these cancers in young adults remain unclear. The identification of the potential risk factors aside from traditional factors is vital to control the incidence of TSCC in young patients.
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Affiliation(s)
- Khadijah Mohideen
- Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India
| | - C Krithika
- Department of Oral Medicine and Radiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Nadeem Jeddy
- Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - R Bharathi
- Department of Oral Pathology and Microbiology, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - B Thayumanavan
- Department of Oral Pathology and Microbiology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - S Leena Sankari
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
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Toscano de Brito R, França Perazzo M, Santos Peixoto T, Weege-Nonaka CF, de Melo Brito Costa EM, Granville-Garcia AF. Profile of patients and factors related to the clinical staging of oral squamous cell carcinoma. ACTA ACUST UNITED AC 2018; 20:221-225. [PMID: 30570005 DOI: 10.15446/rsap.v20n2.49508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 11/08/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of the present study was to identify the profile of patients diagnosed with oral squamous cell carcinoma (SCC) and factors associated with the clinical stage of the disease. MATERIALS AND METHOD A cross-sectional study was conducted with a sample of 293 medical charts of patients with SCC treated at an oncology reference center in the city of Campina Grande (Brazil) between 2000 and 2006. Descriptive and inferential statistics were performed with robust Poisson regression (α=5%). RESULTS Males (56.6%), non-white individuals (49.0%) and individuals over than 60 years of age (74.1%) were the most affected by SCC. The tongue (35.1%) and palate (21.5%) were the most common sites. A large portion of the patients were smokers (37.6%) and 60.2% were in an advanced stage of the disease. Clinical staging was not associated with sex, age, skin color or drinking and/or smoking habits. CONCLUSION There was a higher incidence of SCC in men, older patients, non-white individuals and smokers. Clinical staging was not associated with the variables analyzed.
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Affiliation(s)
- Rodrigo Toscano de Brito
- RT: Dentist. Specialist Bucco-Maxillofacial Surgery and Trauma. Federal University of Paraíba. João Pessoa. Brazil.
| | - Matheus França Perazzo
- MP: Dentist. M. Sc. Clinical Dentistry. Ph. D. student in Pediatric Dentistry. Federal University of Minas Gerais. Belo Horizonte. Brazil.
| | - Tony Santos Peixoto
- TP: Specialist Bucco-Maxillofacial Surgery and Trauma. M. Sc. Clinical Dentistry. Ph. D. student in Bucomaxillofacial Surgery and Traumatology. University of Campinas. Campinas. Brazil.
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Troeltzsch M, Haidari S, Boser S, Troeltzsch M, Probst FA, Ehrenfeld M, Otto S. What Factors Are Associated With Regional Recurrence After Operative Treatment of Oral Squamous Cell Carcinoma? J Oral Maxillofac Surg 2018; 76:2650-2659. [DOI: 10.1016/j.joms.2018.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/08/2018] [Accepted: 07/08/2018] [Indexed: 12/25/2022]
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18
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Nakamura K, Akiba J, Ogasawara S, Naito Y, Nakayama M, Abe Y, Kusukawa J, Yano H. SUOX is negatively associated with multistep carcinogenesis and proliferation in oral squamous cell carcinoma. Med Mol Morphol 2017; 51:102-110. [PMID: 29280012 DOI: 10.1007/s00795-017-0177-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 12/18/2017] [Indexed: 12/15/2022]
Abstract
Oral squamous cell carcinoma (OSCC) is the most common malignant tumor in the head and neck region. The aim of this study was to identify the key molecules and to elucidate the molecular mechanisms of OSCC carcinogenesis through a microarray analysis of RNA extracted from normal epithelium, dysplasia, and squamous cell carcinoma components. Out of molecules that showed changes in gene expression in the microarray analysis, we focused on Sulfite oxidase (SUOX), which correlated significantly with carcinogenic process and exhibited a stepwise decrease in expression. The expression of SUOX was evaluated in detail at the protein level using samples from 58 patients with cancer of the tongue, and correlating clinicopathological factors were also comprehensively examined. SUOX expression declined significantly from normal epithelium to dysplasia to squamous cell carcinoma components in line with carcinogenic process. With regard to squamous cell carcinoma, SUOX expression was significantly lower when T classification was high. Our findings indicated that SUOX is negatively associated with the progression and proliferation of tongue cancer, and suggest that SUOX may be a key molecule in tongue tumors.
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Affiliation(s)
- Ken Nakamura
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Japan
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Jun Akiba
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Japan.
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.
| | - Sachiko Ogasawara
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Japan
| | - Yoshiki Naito
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Masamichi Nakayama
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Japan
| | - Yushi Abe
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Japan
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Jingo Kusukawa
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Hirohisa Yano
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Japan
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Advanced-stage tongue and mouth floor cancer is related to tobacco and alcohol abuse. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-017-0859-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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20
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Sundermann BV, Uhlmann L, Hoffmann J, Freier K, Thiele OC. The localization and risk factors of squamous cell carcinoma in the oral cavity: A retrospective study of 1501 cases. J Craniomaxillofac Surg 2017; 46:177-182. [PMID: 29242026 DOI: 10.1016/j.jcms.2017.10.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/20/2017] [Accepted: 10/23/2017] [Indexed: 01/08/2023] Open
Abstract
Head and neck cancer is the tenth leading cause of cancer mortality. Ninety percent of tumours in the oral cavity are squamous cell carcinomas. Information about the exact localisation of OSCC is missing in the literature. In the present study, we retrospectively analysed a total of 1501 OSCC patients, who were treated between 1975 and 2009. The purpose of this study was to examine the localisation of OSCC tumours and to analyse the influence of various parameters on tumour localisation. 71.5% of these patients were male and 28.5% were female. The mean age was 60 years. The most common sites of OSCC occurrence were the floor of the mouth and the anterior base of the mouth. The hard palate was the most affected anatomical area of the maxilla. Descriptive statistical analysis, chi-square testing and a multivariate analysis using a multinomial logistical model showed a significant correlation of younger age and female gender with tumour occurrence in the maxilla and the tongue. We provide a very detailed anatomical mapping of OSCC.
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Affiliation(s)
- Britta V Sundermann
- Department of Oral and Maxillofacial Surgery (Head: Prof. J. Hoffmann, MD, DDS), University Hospital Heidelberg, Germany.
| | - Lorenz Uhlmann
- Department of Medical Biometry and Informatics (Head: Prof. M. Kieser MD), Heidelberg, Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery (Head: Prof. J. Hoffmann, MD, DDS), University Hospital Heidelberg, Germany
| | - Kolja Freier
- Department of Oral and Maxillofacial Surgery (Head: Prof. J. Hoffmann, MD, DDS), University Hospital Heidelberg, Germany
| | - Oliver C Thiele
- Department of Oral and Maxillofacial Surgery (Head: Prof. J. Hoffmann, MD, DDS), University Hospital Heidelberg, Germany
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de Morais EF, Mafra RP, Gonzaga AKG, de Souza DLB, Pinto LP, da Silveira ÉJD. Prognostic Factors of Oral Squamous Cell Carcinoma in Young Patients: A Systematic Review. J Oral Maxillofac Surg 2017; 75:1555-1566. [DOI: 10.1016/j.joms.2016.12.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 12/09/2016] [Accepted: 12/09/2016] [Indexed: 10/24/2022]
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22
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Burian E, Schulz C, Probst F, Palla B, Tröltzsch M, Maglitto F, Califano L, Ehrenfeld M, Otto S. Fluorescence based characterization of early oral squamous cell carcinoma using the Visually Enhanced Light Scope technique. J Craniomaxillofac Surg 2017; 45:1526-1530. [PMID: 28688861 DOI: 10.1016/j.jcms.2017.05.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 05/11/2017] [Accepted: 05/29/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Several diagnostic tools have been developed to assess benign and potentially malignant disorders of soft tissues. In this study, we aimed to assess the value of the VELscope® (Visually Enhanced Light Scope) imaging device as a technical tool to investigate malignant lesions of the oral cavity. MATERIAL AND METHODS In this retrospective study we analyzed the photographs of 90 patients who suffered from malignant oral soft tissue lesions or carcinoma in situ (CIS) from 2008 to 2014 in the Clinic of Oral and Maxillofacial Surgery of LMU in Munich. RESULTS In 85.6% of the cases fluorescence quenching/loss could be detected. The average value for the colour red shows a significant difference in pathologic and physiologic tissues (p = 0.007) with a higher median for pathologic tissues. For the colours green and blue our measurements show significantly higher values in the healthy tissue (p < 0.001.). The shade of red showed significantly higher values for pathologic tissues when compared to all three colours (p < 0.001). Furthermore, the shades of green and blue showed significantly lower values in the pathologic tissue (p < 0.001). CONCLUSION In the near future, VELscope® could help to a greater extent than visual observation alone in identifying the margins of tumor resections. VELscope® still lacks the ability to identify the overall risk level of oral lesions.
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Affiliation(s)
- Egon Burian
- Department of Oral and Maxillofacial Surgery (Chair: M. Ehrenfeld MD, DDS, PhD), Ludwig-Maximilians-University, Lindwurmstraße 2a, 80336 Munich, Germany.
| | - Caterina Schulz
- Department of Oral and Maxillofacial Surgery (Chair: M. Ehrenfeld MD, DDS, PhD), Ludwig-Maximilians-University, Lindwurmstraße 2a, 80336 Munich, Germany
| | - Florian Probst
- Department of Oral and Maxillofacial Surgery (Chair: M. Ehrenfeld MD, DDS, PhD), Ludwig-Maximilians-University, Lindwurmstraße 2a, 80336 Munich, Germany
| | - Benjamin Palla
- Harvard School of Dental Medicine (Chair: R. Bruce Donoff MD, DMD), 188 Longwood Ave, Boston, MA, 02115 USA
| | - Matthias Tröltzsch
- Department of Oral and Maxillofacial Surgery (Chair: M. Ehrenfeld MD, DDS, PhD), Ludwig-Maximilians-University, Lindwurmstraße 2a, 80336 Munich, Germany
| | - Fabio Maglitto
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science (Chair: L. Califano MD, PhD), Frederico II University of Naples, Via s. Pansini 5, 80138 Napoli, Italy
| | - Luigi Califano
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science (Chair: L. Califano MD, PhD), Frederico II University of Naples, Via s. Pansini 5, 80138 Napoli, Italy
| | - Michael Ehrenfeld
- Department of Oral and Maxillofacial Surgery (Chair: M. Ehrenfeld MD, DDS, PhD), Ludwig-Maximilians-University, Lindwurmstraße 2a, 80336 Munich, Germany
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery (Chair: M. Ehrenfeld MD, DDS, PhD), Ludwig-Maximilians-University, Lindwurmstraße 2a, 80336 Munich, Germany
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Nobis CP, Otto S, Grigorieva T, Alnaqbi M, Troeltzsch M, Schöpe J, Wagenpfeil S, Ehrenfeld M, Wolff KD, Kesting MR. Elective neck dissection in unilateral carcinomas of the tongue: Unilateral versus bilateral approach. J Craniomaxillofac Surg 2017; 45:579-584. [PMID: 28216228 DOI: 10.1016/j.jcms.2017.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/12/2016] [Accepted: 01/09/2017] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Elective neck dissection (END) is a common primary treatment strategy for oral tongue squamous cell carcinoma (OTSCC), although uncertainty remains regarding the necessary extent of END for strictly unilateral early stage OTSCC. The authors evaluated two END variations, unilateral and bilateral, to determine the optimal extent. MATERIALS AND METHODS A retrospective cohort study was performed on patient data from two departments of oral and maxillofacial surgery. All previously untreated patients from both clinics who were diagnosed with early-stage (pT1-2) unilateral OTSCC were included. The following variables were collected: age, gender, END type/extent, tumor localization, later nodal metastasis, and TNM status. Statistical analyses were performed (p < 0.05). RESULTS A total of 150 patients were identified, 105 receiving unilateral END and 45 bilateral END. The rates of postoperative positive lymph nodes were 21.9% for ipsilateral END and 26.7% for bilateral END (bilateral END: all positive nodes ipsilateral). In all, 14 patients in the ipsilateral group developed nodal metastasis during tumor aftercare (11 patients ipsilateral, 3 patients contralateral neck). In the bilateral group, nodal metastasis was later observed in 4 cases (8.9%; 3 cases ipsilateral, 1 case contralateral neck). Statistical analysis could not detect significant differences between the END procedures. CONCLUSION As both procedures lead to similar results in preventing or omitting possible later nodal metastasis, the two methods seem to be valuable alternatives. In conclusion, we recommend bilateral END because of advantages with regard to oncologic safety and esthetic outcome, but the decision for END should always be according to the patient's general health status, comorbidities, and individual tumor risk profile.
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Affiliation(s)
- Christopher-Philipp Nobis
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität Munich, Ismaninger Str. 22, D-81675 Munich, Germany.
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-Universität München, Lindwurmstraße 2a, D-80337 Munich, Germany.
| | - Tamara Grigorieva
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-Universität München, Lindwurmstraße 2a, D-80337 Munich, Germany.
| | - Mohamed Alnaqbi
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-Universität München, Lindwurmstraße 2a, D-80337 Munich, Germany.
| | - Matthias Troeltzsch
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-Universität München, Lindwurmstraße 2a, D-80337 Munich, Germany.
| | - Jakob Schöpe
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Universität des Saarlandes, Homburg/Saar, Germany.
| | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Universität des Saarlandes, Homburg/Saar, Germany.
| | - Michael Ehrenfeld
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-Universität München, Lindwurmstraße 2a, D-80337 Munich, Germany.
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität Munich, Ismaninger Str. 22, D-81675 Munich, Germany.
| | - Marco Rainer Kesting
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität Munich, Ismaninger Str. 22, D-81675 Munich, Germany.
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Association of periodontitis and human papillomavirus in oral rinse specimens: Results from the National Health and Nutrition Survey 2009-2012. J Am Dent Assoc 2017; 146:382-9. [PMID: 26025825 DOI: 10.1016/j.adaj.2015.01.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 01/20/2015] [Accepted: 01/20/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinomas are increasing in incidence and are becoming significant public health concerns. Periodontitis is a chronic condition in which the affected tissue may facilitate oral HPV infection and persistence. The purpose of this study was to determine if an association of the presence of HPV in oral rinse specimens and periodontal disease exists. METHODS The authors combined the National Health and Nutrition Examination Survey (NHANES) data for years 2009-2010 and 2011-2012. The authors included participants aged 30-69 years who had clinically assessed periodontal and HPV data (n = 6,004). The authors analyzed the data using the Rao-Scott χ(2) test and logistic regression. RESULTS There were 498 participants who had the presence of HPV in oral rinse specimens. The adjusted odds ratio for the presence of HPV in oral rinse specimens with relation to periodontal disease was 1.04 (95% confidence interval, 0.63-1.73), adjusting for sex, race and ethnicity, education, age, income-to-poverty ratio, smoking, alcohol use, and number of sex partners during their lifetime. CONCLUSIONS The authors failed to reject the hypothesis of no association of the presence of HPV in oral rinse specimens and periodontitis. PRACTICAL IMPLICATIONS Although oral HPV infection is a serious concern, the authors found that periodontitis was not shown to be related to the presence of HPV in oral rinse specimens in adjusted analyses in this study.
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Is There Evidence for the Presence and Relevance of the PD-1/PD-L1 Pathway in Oral Squamous Cell Carcinoma? Hints From an Immunohistochemical Study. J Oral Maxillofac Surg 2016; 75:969-977. [PMID: 27916470 DOI: 10.1016/j.joms.2016.11.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/05/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE To examine oral squamous cell carcinoma (OSCC) specimens for programmed death ligand-1 (PD-L1) expression and presence of programmed death-1 (PD-1)-positive tumor-infiltrating lymphocytes (TILs) and to determine possible clinicopathologic implications. It was hypothesized that PD-L1 expression and PD-1-positive TIL presence in OSCC would have no clinical relevance. MATERIALS AND METHODS The authors implemented a retrospective cohort study design. The study cohort was chosen in compliance with predefined inclusion criteria. Demographic, clinical, and histopathologic data were gathered. Tissue microarrays were obtained from paraffin-embedded OSCC specimens and analyzed immunohistochemically for PD-L1 expression and PD-1-positive TIL infiltration. PD-L1 positivity of OSCC specimens served as the predictor variable and neck node metastasis served as the primary outcome variable. Descriptive and inferential statistics were computed and the significance level was set at a P value less than or equal to .05. RESULTS The study sample was composed of 88 patients (48 men, 40 women; mean age, 61.34 yr). Marked PD-L1 expression was detected in 29% of OSCC specimens (26 of 88) and 83% of specimens (73 of 88) exhibited a high rate of PD-1-positive TIL infiltration. PD-L1 positivity of OSCC samples was significantly associated with the anatomic origin of OSCC (P = .039), presence of cervical metastasis (P = .039), and high PD-L1-positive TIL infiltration (P = .033). CONCLUSION A considerable proportion of OSCCs exhibited marked PD-L1 expression. This could be associated with clinical parameters. PD-L1 expression in OSCC might differ depending on its anatomic origin. PD-1-positive TILs could be detected in most OSCC specimens. These findings might indicate a potential role for the PD-1 and PD-L1 pathway in OSCC.
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Marchiano E, Patel TD, Eloy JA, Baredes S, Park RCW. Impact of Nodal Level Distribution on Survival in Oral Cavity Squamous Cell Carcinoma: A Population-Based Study. Otolaryngol Head Neck Surg 2016; 155:99-105. [PMID: 26980921 DOI: 10.1177/0194599816636356] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 02/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Regional lymph node metastasis is an important prognostic factor in squamous cell carcinoma of the head and neck, decreasing survival by up to 50%. Oral cavity squamous cell carcinoma (OC-SCCa) most commonly spreads to levels I, II, and III. STUDY DESIGN Retrospective analysis of a population-based tumor registry. SETTING Academic medical center. SUBJECTS AND METHODS The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of OC-SCCa from 2004 to 2011 (22,973 cases). Resulting data including patient demographics, clinicopathological features, topographical distribution of nodal metastasis, and survival based on lymph node level involvement were analyzed. RESULTS In total, 8281 patients were identified with OC-SCCa who underwent neck dissection. Level I, closely followed by levels II and III, represented the most commonly involved nodal basins. The 5-year disease-specific survival (DSS) for patients with only level I, II, or III was 42.0% compared with 30.6% for the level IV group (P < .0001) and 26.4% for the level V group (P < .0001). Surgery with adjuvant radiotherapy improved 5-year DSS for patients with level I to III, level IV, and level V neck disease compared with surgery alone (50.7% vs 48.6%, P = .0109; 39.9% vs 23.2%, P < .0001; and 33.3% vs 9.1%, P = .0005, for levels I-III, IV, and V, respectively). CONCLUSION Oral cavity squamous cell carcinoma most commonly involves nodal levels I, II, and III. Involvement of nodal level IV or V portends a worse prognosis than patients with only level I to III disease, and multimodality therapy should be considered for these patients.
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Affiliation(s)
- Emily Marchiano
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Tapan D Patel
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Richard Chan Woo Park
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Santos HBDP, dos Santos TKG, Paz AR, Cavalcanti YW, Nonaka CFW, Godoy GP, Alves PM. Clinical findings and risk factors to oral squamous cell carcinoma in young patients: A 12-year retrospective analysis. Med Oral Patol Oral Cir Bucal 2016; 21:e151-6. [PMID: 26827057 PMCID: PMC4788792 DOI: 10.4317/medoral.20770] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 11/13/2015] [Indexed: 11/06/2022] Open
Abstract
Background In recent years have been observed an increased incidence of OSCC in young individuals. Based on this, the aim this study was to describe the clinical characteristics of all cases of OSCC in younger patients, diagnosed in two oncology referral hospitals, at the northeast region of Brazil within a 12-year period. Material and Methods Data regarding general characteristics of patients (age, gender and tobacco and/or alcohol habits) and information about the lesions (tumor location, size, regional lymph node metastasis, distant metastasis and clinical stage) were submitted to descriptive and inferential analysis. Statistical analysis included Chi-square and Fisher’s exact tests (P<0.05). Results Out of 2311 registered cases of OSCC, 76 (3.3%) corresponded to OSCC in patients under 45 years old. Most of them were male (n=62, 81.6%) and tobacco and/or alcohol users (n=40, 52.8%). The most frequent site was the tongue (n=31, 40.8%), with predominance of cases classified at advanced clinical stage (III and IV, n = 46, 60.5%). The advanced stage of OSCC (III and IV) was statistically associated with male gender (P=0.035), lower education level (P=0.007), intraoral site(P<0.001), presence of pain symptomatology (P=0.006), and consumption of tobacco and/or alcohol (P=0.001). Conclusions The profile of OSCC in young patients resembles to the commonly characteristics reported for overall population. The late diagnosis in young patients usually results in poor prognosis, associated with gender, harmful habits and tumor location. Although prevalence is low, stimulus to prevention and to early diagnosis should be addressed to young individuals exposed to risk factors. Key words:Squamous cell carcinoma, head and neck neoplasms, risk factors, young patients, prognosis.
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Affiliation(s)
- Hellen-Bandeira-de-Pontes Santos
- State University of Paraiba, Dentistry Department, Rua das Baraúnas, 351, Bairro Universitário, Campina Grande, Paraíba, Brazil. CEP: 58429-500,
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Expression of p16 in squamous cell carcinoma of the mobile tongue is independent of HPV infection despite presence of the HPV-receptor syndecan-1. Br J Cancer 2015; 113:321-6. [PMID: 26057450 PMCID: PMC4506391 DOI: 10.1038/bjc.2015.207] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/07/2015] [Accepted: 05/13/2015] [Indexed: 02/03/2023] Open
Abstract
Background: Tongue squamous cell carcinoma (TSCC) is increasing in incidence, especially among young patients and preferably females. Infection with human papilloma virus (HPV) has been suggested as a cause of SCC in the head and neck, and the proportion of oropharyngeal cancers caused by HPV has steadily increased. Methods: Samples from 109 patients with primary TSCC were analysed for the presence of HPV16 by in situ hybridisation and for expression of its surrogate marker p16 and the HPV receptor syndecan-1 by immunhistochemistry. Results: No evidence of HPV16 DNA was observed in the tumours, although one-third showed p16 staining. There was no difference in the expression of the primary HPV receptor, syndecan-1, between TSCC and a group of tonsil SCC. Conclusion: Whereas p16 is expressed in some TSCCs, HPV16 is undetectable, therefore, p16 cannot be used as a surrogate marker for high-risk HPV-infection in this tumour. Despite presence of the HPV-receptor syndecan-1 in TSCC, HPV prefers the tonsillar environment. Lack of p16 associates with worse prognosis primarily in patients aged ⩽40 years with tongue SCC. The improved prognosis seen in p16-positive TSCC can be due to induction of a senescent phenotype or an inherent radiosensitivity due to the ability of p16 to inhibit homologous recombination repair.
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Pianka A, Knösel T, Probst FA, Troeltzsch M, Woodlock T, Otto S, Ehrenfeld M, Troeltzsch M. Vascular endothelial growth factor receptor isoforms: are they present in oral squamous cell carcinoma? J Oral Maxillofac Surg 2015; 73:897-904. [PMID: 25883000 DOI: 10.1016/j.joms.2014.12.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 12/21/2014] [Accepted: 12/22/2014] [Indexed: 12/11/2022]
Abstract
PURPOSE Although the clinical importance of vascular endothelial growth factor (VEGF) overexpression in oral squamous cell carcinoma (OSCC) has been investigated, there are limited data about the overexpression of VEGF receptors (VEGF-Rs) and their clinical importance. VEGF-R isoforms have proven influence on proliferation rates, metastasis, and survival in different neoplasms. This study was conducted to investigate VEGF-R expression levels in OSCC samples and to identify any clinical relevance. MATERIALS AND METHODS A retrospective cohort study design (n = 50) was used. Clinical data were gathered from patient charts. Validated immunohistochemical methods were applied to determine VEGF-R isoform expression by tumor cells. Descriptive and inferential statistics with respect to the variable scale were computed. The significance level was set at a P value less than or equal to .05. RESULTS This study found overexpression of different VEGF-R isoforms in 88% of examined specimens. Statistically important associations were detected between overexpression of specific VEGF-Rs and tumor size, neck node metastasis, and tumor-associated death. Furthermore, a history of common OSCC risk factors (smoking and alcohol consumption) were found considerably more often in patients whose OSCC specimens displayed VEGF-R overexpression. CONCLUSION These findings show that VEGF-R overexpression occurs frequently in OSCC and could have clinical implications.
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Affiliation(s)
- Alix Pianka
- Graduate Student, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany
| | - Thomas Knösel
- Associate Professor, Department of Pathology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Florian Andreas Probst
- Resident, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany
| | - Markus Troeltzsch
- Resident, Department of Oral and Maxillofacial Surgery, Georg - August University of Göttingen, Germany
| | - Timothy Woodlock
- Medical Oncologist, Division of Medical Oncology and Hematology, Department of Medicine, School of Medicine and Dentistry, University of Rochester; and Unity Health System, Rochester, NY
| | - Sven Otto
- Associate Professor, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany
| | - Michael Ehrenfeld
- Professor and Department Chair, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany
| | - Matthias Troeltzsch
- Resident, Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany.
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