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Piemonte ED, Gilligan GM, Garola F, Lazos JP, Panico RL, Normando AGC, Santos-Silva AR, Warnakulasuriya S. Differences among oral carcinomas arising de novo from those associated with oral potentially malignant disorders: a systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:613-631. [PMID: 38609795 DOI: 10.1016/j.oooo.2024.03.006] [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: 12/18/2023] [Revised: 02/14/2024] [Accepted: 03/08/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To analyze the frequency of sequential oral squamous cell carcinomas (s-OSCC), preceded by oral potentially malignant disorders, and OSCC de novo (OSCC-dn) and explore differences in their clinicopathologic presentations. STUDY DESIGN A structured electronic search strategy identified studies that analyzed frequency, clinical, biological, demographic, biomarkers, and prognostic features of s-OSCC and OSCC-dn according to PRISMA guidelines in PubMed, Scopus, Cochrane Library, and Google Scholar, up to January 31, 2023. Inclusion criteria were original English, Spanish, Portuguese, French, Italian, and German cross-sectional, cohort, and case-control studies. The quality of studies was assessed using the Agency for Research and Health Quality tool and the Newcastle-Ottawa Scale tool. RESULTS The final selection included 40 studies. OSCC-dn and s-OSCC represent, respectively, 71% and 29% of cases of OSCC (P = .00), showing a higher percentage of T1 or of T1+T2 in s-OSCC (P < .0001). The association meta-analysis showed OSCC-dn with a significant association. The meta-analysis showed that s-OSCC was significantly associated with smaller tumor size, absence of distant metastases, relapses, male sex, and tumor sites different from tongue; and OSCC-dn was associated with more advanced tumor size, more regional and distant metastases, more advanced stages, and worse survival. CONCLUSIONS S-OSCC was less frequent than expected. OSCC-dn seems to have specific clinical, biological, and prognostic features. Future perspectives on oral cancer prevention should address novel approaches and alternatives to screening, such as urgent referral of OSCC-dn.
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Affiliation(s)
- Eduardo David Piemonte
- Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - Gerardo Marcelo Gilligan
- Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Federico Garola
- Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Jerónimo Pablo Lazos
- Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - René Luis Panico
- Oral Medicine Department, Dentistry College, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ana Gabriela Costa Normando
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
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Ahmed S, Khan S, Qureshi MA, Bukhari U, Anis M, Mughal MN. Expressional variations of Kaiso: an association with pathological characteristics and field cancerization of OSCC. BMC Cancer 2022; 22:990. [PMID: 36115941 PMCID: PMC9482199 DOI: 10.1186/s12885-022-10014-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
A group of genetically altered cells that have not transformed into a clinical or histologically identifiable state of malignancy but contains a higher risk of transforming into one is known as the field of cancerization. Numerous molecules are being investigated for their significance in the development of this phenomenon. One such protein of this family is Kaiso also known as ZBTB33 (Zinc Finger and BTB Domain containing 33). This protein belongs to the POZ-ZF family of transcription factors and may have functional tasks similar to its other siblings such as the growth and development of vertebrates and the pathogenesis of neoplastic diseases. Nevertheless, its role in the pathogenesis, progression, epithelial mesenchyal transition and field cancerization in case of oral cancer still needs exploration. Hence, this study was designed to explore the expressional differences between the mucosa of controls and those diagnosed with oral squamous cell carcinoma (OSCC).
Methods
Soft tissue samples were obtained from the main tumor, tumor periphery and opposite buccal mucosa of 50 oral cancer patients, whereas normal mucosa was taken from 50 volunteers undergoing elective tooth removal. The acquired samples were subjected to Immunohistochemical exploration for expression of Kaiso and E-Cadherin. The expression was measured using Image-J IHC profiler and summed as Optical density. The Optical density values were then subjected to statistical analysis.
Results
Results revealed a significant differential expression of Kaiso between the mucosal tissues taken from oral cancer patients and controls (p-value: < 0.0001), showing almost 50% down-regulation of Kaiso in all three tissue samples taken from oral cancer patients as compared to normal mucosa.
Conclusion
Kaiso has a significant difference of expression in the mucosa of oral cancer patients as compared to the mucosa of normal patients, making it a probable contributor to disease pathogenesis and field cancerization.
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Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, González-Moles MÁ, Kerr AR, Lodi G, Mello FW, Monteiro L, Ogden GR, Sloan P, Johnson NW. Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis 2020; 27:1862-1880. [PMID: 33128420 DOI: 10.1111/odi.13704] [Citation(s) in RCA: 387] [Impact Index Per Article: 96.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/21/2020] [Accepted: 10/25/2020] [Indexed: 12/12/2022]
Abstract
Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term "potentially malignant disorders of the oral mucosa" (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Any new evidence published in the intervening period was considered to make essential changes to the 2007 classification. In the current update, most entities were retained with minor changes to their definition. There is sufficient evidence for an increased risk of oral cancer among patients diagnosed with "oral lichenoid lesions" and among those diagnosed with oral manifestations of 'chronic graft-versus-host disease'. These have now been added to the list of OPMDs. There is, to date, insufficient evidence concerning the malignant potential of chronic hyperplastic candidosis and of oral exophytic verrucous hyperplasia to consider these conditions as OPMDs. Furthermore, due to lack of clear evidence of an OPMD in epidermolysis bullosa this was moved to the category with limited evidence. We recommend the establishment of a global research consortium to further study the natural history of OPMDs based on the classification and nomenclature proposed here. This will require multi-center longitudinal studies with uniform diagnostic criteria to improve the identification and cancer risk stratification of patients with OPMDs, link them to evidence-based interventions, with a goal to facilitate the prevention and management of lip and oral cavity cancer.
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Affiliation(s)
- Saman Warnakulasuriya
- The WHO Collaborating Centre for Oral Cancer and Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Perth, WA, Australia
| | - José M Aguirre-Urizar
- Oral and Maxillofacial Medicine & Pathology Unit, Department of Stomatology II, Faculty of Medicine and Nursery, University of the Basque Country/EHU, Bilbao, Spain
| | - José V Bagan
- Oral Medicine, Valencia University, Valencia, Spain.,Department of Oral and Maxillofacial Surgery, University General Hospital, Valencia, Spain
| | - Miguel Ángel González-Moles
- School of Dentistry, University of Granada, Granada, Spain.,Biohealth Research Institute (IBS), Granada, Spain
| | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, New York University College of Dentistry, New York, NY, USA
| | - Giovanni Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milano, Italy
| | | | - Luis Monteiro
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), IUCS - Instituto Universitário de Ciências da Saúde, Gandra, Portugal
| | - Graham R Ogden
- Department of Oral Surgery, Dundee Dental School, Dundee, Scotland, UK
| | - Philip Sloan
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Qld, Australia.,Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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Vinuth DP, Agarwal P, Kale AD, Hallikeramath S, Shukla D. Acetic acid as an adjunct vital stain in diagnosis of tobacco-associated oral lesions: A pilot study. J Oral Maxillofac Pathol 2015; 19:134-8. [PMID: 26604486 PMCID: PMC4611918 DOI: 10.4103/0973-029x.164521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: One of the most important risk factors for oral precancer and cancer in India is the use of tobacco. In chronic tobacco users, the mucosa may appear clinically healthy, however, changes are observed histologically. Screening of such tobacco users for an early diagnosis is, therefore, of paramount importance. Several adjunctive diagnostic modalities have been used in the past, but none has been conclusively validated as confirmative and cost-effective screening methodology. The aim of this study was to evaluate the use of 5% acetic acid as a vital staining agent in tobacco-associated oral lesions. Materials and Methods: The study subjects were divided into two groups. Group I (n = 40) subjects with a history of chronic tobacco use and clinically apparent normal mucosa. Group II (n = 40) subjects suspected of having oral cancer, 5% acetic acid was applied to the mucosa/lesions, followed by incisional biopsy for confirmatory diagnosis. Results: The sensitivity and specificity for Groups I and II were 97%, 50% and 95%, 60%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) of Group I were 0.95 and 0.66. Group II showed PPV and NPV of 0.95 and 0.60. Conclusion: The results of this study suggest that acetic acid holds promise for future. Hence, further studies are needed to be undertaken on a large scale to assess its potential as a screening tool for high-risk individuals and oral cancer.
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Affiliation(s)
- D P Vinuth
- Department of Oral Pathology and Microbiology, Buraydah Private Dental College, Qassim, Kingdom of Saudi Arabia
| | - Poonam Agarwal
- Department of Oral Medicine and Radio Diagnosis, Buraydah Private Dental College, Qassim, Kingdom of Saudi Arabia
| | - Alka D Kale
- Department of Oral Pathology and Microbiology, KLE VK Dental College, Belgaum, Karnataka, India
| | - Seema Hallikeramath
- Department of Oral Pathology and Microbiology, KLE VK Dental College, Belgaum, Karnataka, India
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Simple M, Suresh A, Das D, Kuriakose MA. Cancer stem cells and field cancerization of Oral squamous cell carcinoma. Oral Oncol 2015; 51:643-51. [DOI: 10.1016/j.oraloncology.2015.04.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/02/2015] [Accepted: 04/04/2015] [Indexed: 12/20/2022]
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Angadi PV, Patil PV, Kale AD, Hallikerimath S, Babji D. Myofibroblast presence in apparently normal mucosa adjacent to oral squamous cell carcinoma associated with chronic tobacco/areca nut use: evidence for field cancerization. Acta Odontol Scand 2014; 72:502-8. [PMID: 24359586 DOI: 10.3109/00016357.2013.871648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Myofibroblasts are primary cellular components of activated tumor stroma, associated with poor prognosis in oral squamous cell carcinoma (OSCC). However, their role in field cancerization has not been addressed. This study aims to evaluate the presence of myofibroblasts in patient-matched histologically normal mucosa adjacent to oral squamous cell carcinoma (HNMAOSCC) and OSCC tissues. MATERIALS AND METHODS Fifty patient-matched tissues of OSCC and HNMAOSCC associated with chronic areca nut/tobacco use were subjected to immunohistochemistry using α-SMA for detection of myofibroblasts. Normal oral mucosa (n = 15) were stained as controls. RESULTS The number of α-SMA stained myofibroblasts in OSCC and HNMAOSCC were significantly increased as compared to that of the normal controls (p < 0.001). Further, a significant correlation was established for the presence of myofibroblasts in the stroma of OSCC and HNMAOSCC. CONCLUSIONS Myofibroblasts are an early stromal change in the HNMAOSCC, highlighting the possible role of myofibroblasts as likely mediators for field cancerization and their potential use as a field effect marker.
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Affiliation(s)
- Punnya V Angadi
- Department of Oral Pathology and Microbiology, KLE University's VK Institute of Dental Sciences , Belgaum, Karnataka , India
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Mohan M, Jagannathan N. Oral field cancerization: an update on current concepts. Oncol Rev 2014; 8:244. [PMID: 25992232 PMCID: PMC4419611 DOI: 10.4081/oncol.2014.244] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 04/04/2014] [Accepted: 04/27/2014] [Indexed: 12/17/2022] Open
Abstract
There always exists a field with genetically altered cells with a high risk of developing premalignant and malignant lesions. It may often happen that an individual stem cell is genetically altered and can cause the formation of a clone or a patch which is likely to turn into a tumor. This explains the higher recurrence rates following tumor resections. It is essential to identify and to treat this field in order to have greater chances to prevent cancer and achieve a better outcome. This article reports concepts, theories and markers for the assessment of field cancerization.
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Affiliation(s)
- Meenakshi Mohan
- Department of Oral Pathology, Saveetha Dental College, Saveetha University , Chennai, India
| | - Nithya Jagannathan
- Department of Oral Pathology, Saveetha Dental College, Saveetha University , Chennai, India
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Curry JM, Sprandio J, Cognetti D, Luginbuhl A, Bar-ad V, Pribitkin E, Tuluc M. Tumor microenvironment in head and neck squamous cell carcinoma. Semin Oncol 2014; 41:217-34. [PMID: 24787294 DOI: 10.1053/j.seminoncol.2014.03.003] [Citation(s) in RCA: 193] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The tumor microenvironment (TME) of head and neck squamous cell carcinoma (HNSCC) is comprised of cancer-associated fibroblasts (CAFs), immune cells, and other supporting cells. Genetic changes in the carcinoma cells, such as alterations to TP53, NOTCH1, and specific gene expression profiles, contribute to derangements in cancer and microenvironment cells such as increased ROS, overproduction of cytokines, and epithelial to mesenchymal transition (EMT). CAFs are among the most critical elements of the TME contributing to proliferation, invasion, and metastasis. The adaptive immune response is suppressed in HNSCC through overexpression of cytokines, triggered apoptosis of T cells, and alterations in antigen processing machinery. Overexpression of critical cytokines, such as transforming growth factor-β (TGF-β), contributes to EMT, immune suppression, and evolution of CAFs. Inflammation and hypoxia are driving forces in angiogenesis and altered metabolism. HNSCC utilizes glycolytic and oxidative metabolism to fuel tumorigenesis via coupled mechanisms between cancer cell regions and cells of the TME. Increased understanding of the TME in HNSCC illustrates that the long-held notion of "condemned mucosa" reflects a process that extends beyond the epithelial cells to the entire tissue comprised of each of these elements.
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Affiliation(s)
- Joseph M Curry
- Department of Otolaryngology Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA.
| | - John Sprandio
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - David Cognetti
- Department of Otolaryngology Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Adam Luginbuhl
- Department of Otolaryngology Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Voichita Bar-ad
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Edmund Pribitkin
- Department of Otolaryngology Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Madalina Tuluc
- Department of Pathology, Thomas Jefferson University, Philadelphia, PA
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Koontongkaew S. The tumor microenvironment contribution to development, growth, invasion and metastasis of head and neck squamous cell carcinomas. J Cancer 2013; 4:66-83. [PMID: 23386906 PMCID: PMC3564248 DOI: 10.7150/jca.5112] [Citation(s) in RCA: 216] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 12/20/2012] [Indexed: 12/13/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a complex tissue that contains tumor cells and the surrounding stroma, which is populated by different types of mesenchymal cells and the extracellular matrix (ECM). Collectively, they are referred to as the tumor microenvironment (TME). Recent studies have shown that TME has a more profound influence on the growth and metastasis of HNSCC than was previously appreciated. Because carcinoma-associated fibroblasts (CAFs) are frequently observed in the stroma of the tumor, this review focuses on the potential role of tumor-CAFs interactions in progression of HNSCC. Tumor-CAFs crosstalk enhances the production of growth factors, cytokines, chemokines, matrix metalloproteinases (MMPs), and inflammatory mediators, which eventually facilitates tumor growth. In fact, factors and cells that do not support tumor growth are usually down regulated or mitigated in TME. Therefore TME may determine the fate of the tumors at the site of invasion and metastasis. For tumor cells that survive at these sites, stromal activation may serve to establish a supportive tumor stroma, fostering the outgrowth of the metastatic cells. The concept of tumor-stromal interactions and microenvironmental niche has profound consequences in tumor growth and metastasis and therefore, it's understanding will open up new strategies for the diagnosis, prognosis and therapy of HNSCC.
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Affiliation(s)
- Sittichai Koontongkaew
- 1. Oral Biology Unit, Faculty of Dentistry, Thammasat University, Klong Luang, Prathumtani 12121, Thailand ; 2. Medicinal Herb Research Unit, Thammasat University, Thailand
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Oral field cancerization: current evidence and future perspectives. Oral Maxillofac Surg 2012; 16:171-80. [PMID: 22354325 DOI: 10.1007/s10006-012-0317-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 01/31/2012] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Oral field cancerization implies that oral cancer does not arise as an isolated cellular phenomenon but rather as an anaplastic tendency involving many cells at once and results in the multifocal development of cancer at various rates within the entire field in response to a carcinogen especially tobacco. This concept has been frequently used to explain the occurrence of multiple primary cancers and recurrences following complete excision of oral cancer. DISCUSSION This review deals in detail with the origin, principle, various theories used to explain this effect and molecular, genetic, as well as cytogenetic findings related to oral field cancerization. Further, the clinical implications and future research directives are also discussed.
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Fruhwirth GO, Ameer-Beg S, Cook R, Watson T, Ng T, Festy F. Fluorescence lifetime endoscopy using TCSPC for the measurement of FRET in live cells. OPTICS EXPRESS 2010; 18:11148-58. [PMID: 20588974 PMCID: PMC3408954 DOI: 10.1364/oe.18.011148] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Revised: 03/31/2010] [Accepted: 04/13/2010] [Indexed: 05/03/2023]
Abstract
Development of remote imaging for diagnostic purposes has progressed dramatically since endoscopy began in the 1960's. The recent advent of a clinically licensed intensity-based fluorescence micro-endoscopic instrument has offered the prospect of real-time cellular resolution imaging. However, interrogating protein-protein interactions deep inside living tissue requires precise fluorescence lifetime measurements to derive the Förster resonance energy transfer between two tagged fluorescent markers. We developed a new instrument combining remote fiber endoscopic cellular-resolution imaging with TCSPC-FLIM technology to interrogate and discriminate mixed fluorochrome labeled beads and expressible GFP/TagRFP tags within live cells. Endoscopic-FLIM (e-FLIM) data was validated by comparison with data acquired via conventional FLIM and e-FLIM was found to be accurate for both bright bead and dim live cell samples. The fiber based micro-endoscope allowed remote imaging of 4 microm and 10 microm beads within a thick Matrigel matrix with confident fluorophore discrimination using lifetime information. More importantly, this new technique enabled us to reliably measure protein-protein interactions in live cells embedded in a 3D matrix, as demonstrated by the dimerization of the fluorescent protein-tagged membrane receptor CXCR4. This cell-based application successfully demonstrated the suitability and great potential of this new technique for in vivo pre-clinical biomedical and possibly human clinical applications.
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Affiliation(s)
- Gilbert O. Fruhwirth
- King’s College London, The Richard Dimbleby Department of Cancer Studies, Division of Cancer, Guy’s Medical School Campus, SE1 1UL, London,
United Kingdom
- King’s College London, Randall Division of Cellular and Molecular Biophysics, Guy’s Medical School Campus, SE1 1UL, London,
United Kingdom
| | - Simon Ameer-Beg
- King’s College London, The Richard Dimbleby Department of Cancer Studies, Division of Cancer, Guy’s Medical School Campus, SE1 1UL, London,
United Kingdom
- King’s College London, Randall Division of Cellular and Molecular Biophysics, Guy’s Medical School Campus, SE1 1UL, London,
United Kingdom
| | - Richard Cook
- King’s College London, Dental Institute, Biomaterials Biomimetics and Biophotonics Research Group, SE1 9RT, London,
United Kingdom
| | - Timothy Watson
- King’s College London, Dental Institute, Biomaterials Biomimetics and Biophotonics Research Group, SE1 9RT, London,
United Kingdom
| | - Tony Ng
- King’s College London, The Richard Dimbleby Department of Cancer Studies, Division of Cancer, Guy’s Medical School Campus, SE1 1UL, London,
United Kingdom
- King’s College London, Randall Division of Cellular and Molecular Biophysics, Guy’s Medical School Campus, SE1 1UL, London,
United Kingdom
| | - Frederic Festy
- King’s College London, Dental Institute, Biomaterials Biomimetics and Biophotonics Research Group, SE1 9RT, London,
United Kingdom
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López-Blanc SA, Collet AM, Gandolfo MS, Femopase F, Hernández SL, Tomasi VH, Paparella ML, Itoiz ME. Nucleolar organizer regions (AgNOR) and subepithelial vascularization as field cancerization markers in oral mucosa biopsies of alcoholic and smoking patients. ACTA ACUST UNITED AC 2009; 108:747-53. [PMID: 19748291 DOI: 10.1016/j.tripleo.2009.06.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 05/14/2009] [Accepted: 06/26/2009] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this study was to show that variations in nucleolar organizer regions (AgNOR) and the increase in subepithelial vascularization could reveal changes related to markers of field cancerization in alcoholic and smoking patients who have not yet expressed clinical or histological malignant lesions. STUDY DESIGN Quantitative variations in epithelial AgNOR and in the vascularization of the underlying connective tissue were assessed by image analysis in histologically normal biopsy specimens from alcohol drinkers and smoking patients (DS). AgNORs were evidenced by silver staining and vessel walls were labeled by immunohistochemical demonstration of the CD34 antigen. Samples of oral mucosa of nonalcoholic, nonsmoking patients (NDS) obtained during surgical procedures served as controls. Eight parameters related to number, volume, and shape of nuclei and AgNORs, and 4 parameters related to number and diameter of vascular sections were evaluated. Differences between DS and NDS groups were statistically evaluated by means of ANOVA test and posterior Bonferroni comparisons. RESULTS The morphometric analysis revealed more irregular-shaped AgNORs in the superficial and suprabasal layers of the oral mucosa of DS patients. The suprabasal layers also exhibited a significantly larger number of AgNORs. The normal oral mucosa of DS patients exhibited a greater vascular density, with predominance of small-caliber blood vessels underlying the basement membrane. CONCLUSION The variations in AgNOR and epithelial vascularization would be practical biomarkers to evaluate changes underlying the augmented risk of cancerization in oral mucosa.
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Affiliation(s)
- Silvia A López-Blanc
- Department of Oral Pathology, Clinical Stomatology, Faculty of Dentistry, National University of Córdoba, Córdoba, Argentina
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Macluskey M, El-Gazzar R, Ogden G. Comment on Letter to the editor by P.A. Kyzas Re: “Vascularity and expression of vascular endothelial growth factor in oral squamous cell carcinoma, resection margins, and nodal metastases.” Br J Oral Maxillofac Surg 2006;44:193–7 [Epub 2005 August]. Br J Oral Maxillofac Surg 2007. [DOI: 10.1016/j.bjoms.2006.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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