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Nikkilä R, Hirvonen E, Haapaniemi A, Tapiovaara L, Pitkäniemi J, Malila N, Mäkitie A. Significant risk of second primary cancer among laryngeal squamous cell carcinoma patients even after 20 years. Acta Oncol 2023; 62:1322-1330. [PMID: 37672344 DOI: 10.1080/0284186x.2023.2254482] [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: 06/08/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Evidence on the risk of second primary cancer (SPC) following primary laryngeal squamous cell carcinoma (LSCC) is limited, especially in Europe. METHODS Patients diagnosed with primary LSCC from 1953-2018 were retrieved from the Finnish Cancer Registry. A total of 6241 LSCC patients were identified adding to 49,393 person-years (PY) of follow-up until the end of 2019. Only one patient emigrated and was lost to follow-up. Both standardized incidence ratios (SIR) and excess absolute risk (EAR) per 1000 person-years at risk (PYR) of second primary cancer (SPC) were calculated relative to the general population. Only non-laryngeal SPCs diagnosed six months after diagnosis of primary LSCC were included. RESULTS A SPC was diagnosed in 1244 LSCC patients (20% of all LSCC patients) over the 65-year period, predominantly in men (92%, n = 1170). Out of all SPCs, 34% were diagnosed within 0.5 to 5 years and 66% after 5 years from primary LSCC. Among male patients, the overall SIR for SPC at any location was 1.61 (95% CI: 1.52-1.71), corresponding to 9.49 excess SPCs per 1000 PYR (95% CI: 8.19-11). The corresponding SIR for women was 1.47 (95% CI: 1.15-1.84), yielding 4.82 excess SPCs per 1000 PYR (95% CI: 2.36-9.84). The risk remained significant even after 20 years of follow-up (SIR for all 1.73, 95% CI: 1.49-2.01 and EAR 16.8 per 1000 PY, 11.88-23.75). The risk for SPC was also significantly elevated in all age groups, except <40. The highest SIRs were for SPCs arising in the mouth/pharynx (SIR for all 3.08, 95% CI: 2.36-3.95 and EAR 0.80 per 1000 PY, 0.55-1.15) and lungs (3.02, 2.75-3.30 and 5.90 per 1000, 5.13-6.78). CONCLUSION Patients with LSCC as primary cancer have a 60% excess risk for an SPC, especially for tobacco-associated cancers, remaining significantly elevated even decades after treatment.
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Affiliation(s)
- Rayan Nikkilä
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Elli Hirvonen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Aaro Haapaniemi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Laura Tapiovaara
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Nea Malila
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
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Peralta-Mamani M, Terrero-Pérez Á, Tucunduva RMA, Rubira CMF, Santos PSDS, Honório HM, Rubira-Bullen IRF. Occurrence of field cancerization in clinically normal oral mucosa: A systematic review and meta-analysis. Arch Oral Biol 2022; 143:105544. [PMID: 36126567 DOI: 10.1016/j.archoralbio.2022.105544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The purpose was to describe whether there are field cancerization (FC) indicators in clinically normal mucosa opposite to primary oral squamous cell carcinoma (OSCC). METHODS A search of the Cochrane Library, PubMed, Embase, Web of Science, Scopus, and Livivo databases was performed on June 12, 2022, which retrieved 152 records without duplicates. Studies that analyzed FC in biopsies in clinically normal tissue opposite to primary OSCC were included. The search was conducted under the PRISMA guideline and the protocol was registered in PROSPERO (CRD42017077125). RESULTS Eight articles with 302 patients were included, 192 men and 110 women, mean age 57.1 years. Most patients had deleterious habits. All studies performed histopathological confirmation of OSCC and biopsies were obtained the clinically normal mirror mucosa. The meta-analysis carried out with eight studies. The studies showed 57.3 % of cases with histopathological changes of clinically normal mucosa opposite to primary OSCC (Confidence interval 95 %, 0.443-0.703; heterogeneity: Q value 18.715; I2 73.284 %; n = 205). p53 and Ki-67 immunohistochemical analysis may be predictive for detecting changes. There was p53 immunoexpression in 41.3 % of cases (p = 0.872) (n = 55), ki-67 immunoexpression (< 20 %) in 68 % (p = 0.001) (n = 97) and ki-67 immunoexpression (> 20 %) in 28.4 % of cases (p = 0.000) (n = 110). CONCLUSIONS The findings suggest that FC can occur, and there are histopathological changes in clinically normal tissue opposite to primary OSCC. Nevertheless, the review showed that more longitudinal studies on FC are needed to draw a conclusive indication of the occurrence of FC in oral tissues opposite to OSCC.
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Affiliation(s)
- Mariela Peralta-Mamani
- Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
| | - Ángel Terrero-Pérez
- Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Rosana Mara Adami Tucunduva
- Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Cassia Maria Fischer Rubira
- Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health - Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Yang CC, Su YF, Cheng HC, Juan YC, Chiu YW, Wu CH, Chen PY, Lee YH, Chen YL, Chen YT, Peng CY, Lu MY, Yu CH, Huang YF, Kao SY, Fwu CW, Liu CJ. Improving the Diagnostic Performance by Adding Methylation Marker to Conventional Visual Examination in Identifying Oral Cancer. Diagnostics (Basel) 2022; 12:diagnostics12071544. [PMID: 35885450 PMCID: PMC9320763 DOI: 10.3390/diagnostics12071544] [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: 05/31/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Visual oral examination (VOE) is a conventional oral cancer screening method. This study aimed to evaluate the value of methylation marker to assist VOE in identifying oral epithelial dysplasia and oral squamous cell carcinoma (OED/OSCC) from non-cancerous lesions in a real-world situation. Methods: 201 patients with high-risk personal habits who self-perceived oral anomaly were VOE examined, ZNF582 methylation (ZNF582m) tested, and histologically diagnosed. Results: Among them, 132 patients (65.7%) were histologically diagnosed OED/OSCC. Using VOE, 56.1% OED/OSCC patients had possible oral cancer, whereas 37.7% non-OED/OSCC patients had leukoplakia. ZNF582m-positive was detected in 90.2% OED/OSCC patients and 44.9% non-OED/OSCC patients. Various logistic regression models were postulated to evaluate the diagnostic performance of conventional VOE and new strategies using ZNF582m. ROC analysis and its corresponding C-index demonstrated that either triage or co-testing models of VOE and ZNF582m could improve diagnostic performance and discriminative abilities compared with the VOE only approach. Conclusions: In conclusion, methylation marker test shows equivalent performance to an experienced judgment by oral maxillofacial surgeons and plays a significantly supplementary role in increasing the efficacy in identifying oral malignant lesions. ZNF582m may be an especially important tool for family physicians or general dentists to properly diagnose suspicious oral lesions.
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Affiliation(s)
- Cheng-Chieh Yang
- Department of Stomatology, Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (C.-C.Y.); (H.-C.C.); (C.-H.W.); (S.-Y.K.)
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
| | - Yee-Fun Su
- iStat Biomedical Co., Ltd., New Taipei City 22102, Taiwan; (Y.-F.S.); (Y.-C.J.)
| | - Han-Chieh Cheng
- Department of Stomatology, Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (C.-C.Y.); (H.-C.C.); (C.-H.W.); (S.-Y.K.)
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
| | - Yi-Chen Juan
- iStat Biomedical Co., Ltd., New Taipei City 22102, Taiwan; (Y.-F.S.); (Y.-C.J.)
| | - Yu-Wei Chiu
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (P.-Y.C.); (Y.-H.L.); (Y.-L.C.); (Y.-T.C.); (C.-Y.P.); (M.-Y.L.); (C.-H.Y.); (Y.-F.H.)
- College of Oral Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Cheng-Hsien Wu
- Department of Stomatology, Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (C.-C.Y.); (H.-C.C.); (C.-H.W.); (S.-Y.K.)
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
| | - Pei-Yin Chen
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (P.-Y.C.); (Y.-H.L.); (Y.-L.C.); (Y.-T.C.); (C.-Y.P.); (M.-Y.L.); (C.-H.Y.); (Y.-F.H.)
- College of Oral Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Yu-Hsien Lee
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (P.-Y.C.); (Y.-H.L.); (Y.-L.C.); (Y.-T.C.); (C.-Y.P.); (M.-Y.L.); (C.-H.Y.); (Y.-F.H.)
- College of Oral Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Yen-Lin Chen
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (P.-Y.C.); (Y.-H.L.); (Y.-L.C.); (Y.-T.C.); (C.-Y.P.); (M.-Y.L.); (C.-H.Y.); (Y.-F.H.)
- College of Oral Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Yi-Tzu Chen
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (P.-Y.C.); (Y.-H.L.); (Y.-L.C.); (Y.-T.C.); (C.-Y.P.); (M.-Y.L.); (C.-H.Y.); (Y.-F.H.)
- College of Oral Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Chih-Yu Peng
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (P.-Y.C.); (Y.-H.L.); (Y.-L.C.); (Y.-T.C.); (C.-Y.P.); (M.-Y.L.); (C.-H.Y.); (Y.-F.H.)
- College of Oral Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Ming-Yi Lu
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (P.-Y.C.); (Y.-H.L.); (Y.-L.C.); (Y.-T.C.); (C.-Y.P.); (M.-Y.L.); (C.-H.Y.); (Y.-F.H.)
- College of Oral Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Chuan-Hang Yu
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (P.-Y.C.); (Y.-H.L.); (Y.-L.C.); (Y.-T.C.); (C.-Y.P.); (M.-Y.L.); (C.-H.Y.); (Y.-F.H.)
- College of Oral Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Yu-Feng Huang
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (P.-Y.C.); (Y.-H.L.); (Y.-L.C.); (Y.-T.C.); (C.-Y.P.); (M.-Y.L.); (C.-H.Y.); (Y.-F.H.)
- College of Oral Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Shou-Yen Kao
- Department of Stomatology, Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (C.-C.Y.); (H.-C.C.); (C.-H.W.); (S.-Y.K.)
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
| | - Chyng-Wen Fwu
- iStat Biomedical Co., Ltd., New Taipei City 22102, Taiwan; (Y.-F.S.); (Y.-C.J.)
- Correspondence: (C.-W.F.); (C.-J.L.); Tel.: +886-(2)2696-3518 (C.-W.F.); +886-(2)5433535 (C.-J.L.)
| | - Chung-Ji Liu
- Department of Oral and Maxillofacial Surgery, MacKay Memorial Hospital, Taipei 10449, Taiwan
- Correspondence: (C.-W.F.); (C.-J.L.); Tel.: +886-(2)2696-3518 (C.-W.F.); +886-(2)5433535 (C.-J.L.)
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Tovaru S, Costache M, Perlea P, Caramida M, Totan C, Warnakulasuriya S, Parlatescu I. Oral leukoplakia: A clinicopathological study and malignant transformation. Oral Dis 2022; 29:1454-1463. [PMID: 34982498 DOI: 10.1111/odi.14123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/02/2021] [Accepted: 12/16/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To assess the clinicopathological characteristics of a cohort of patients with oral leukoplakia (OL) managed in a Romanian dental hospital and to evaluate the risk of malignant transformation (MT). MATERIALS AND METHODS We conducted a hospital-based retrospective study using the clinical charts of patients diagnosed with OL that had complete clinical and histopathological evaluation followed up for 1-16 years. RESULTS From 120 included patients, 68 (56.7%) were females, and 71 (59.2%) were current smokers. The homogeneous form was present in 60% of cases; the buccal mucosa was the most frequently involved site. MT was observed in 9 cases, which was more common in females and in those with dysplastic leukoplakia. A significant statistical association was found between MT and dysplasia grade (χ2 test: p = 0.007). MT occurred during a mean interval of time 75 months in both treated and non-treated patients. CONCLUSIONS In this leukoplakia cohort, most of the lesions encountered were in smokers, clinically homogeneous and 62.5% proved histologically benign. But despite the clinically benign appearance of leukoplakia, tissue diagnosis of some cases was carcinoma. The results of the current study advocate the necessity for biopsy even in apparently homogeneous, clinically benign lesions. The malignization rate was 7.5%; two-thirds were nonhomogeneous lesions.
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Affiliation(s)
- Serban Tovaru
- Department of Oral Medicine, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mariana Costache
- Department of Pathology, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Paula Perlea
- Department of Endodontics, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mariana Caramida
- Department of Oral Health and Community Dentistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Cosmin Totan
- Oral and Maxillofacial Department, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London and WHO Collaborating Center for Oral Cancer, London, UK
| | - Ioanina Parlatescu
- Department of Oral Medicine, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Vibhute NA, Jagtap SV, Patil SV. Velscope guided oral cancer screening: A ray of hope in early oral cancer diagnosis. J Oral Maxillofac Pathol 2021; 25:548-549. [PMID: 35281151 PMCID: PMC8859611 DOI: 10.4103/jomfp.jomfp_315_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 05/18/2021] [Accepted: 10/19/2021] [Indexed: 11/12/2022] Open
Abstract
Context: Early oral cancer diagnosis is an important factor in reducing cancer-associated mortality and morbidity. Traditional oral cancer screening by Conventional Oral Examination (COE) is limited. A new approach in this regard is the use of “optical biopsy systems” like VELscope. Aims: Hence, this study aimed to determine the diagnostic value of VELscope, an autofluorescence-based handheld device in detection of dysplasia and oral squamous cell carcinoma (OSCC) in general oral potentially malignant disorder. Settings and Design: A prospective, cross-sectional study was conducted at a tertiary hospital in western Maharashtra, India. Materials and Methods: Thirty patients with presence of clinically suspicious oral lesions were included, and for each lesion, both the COE and Autofluorescence Examination by VELscope were carried out at the same appointment by different experts. All lesions were biopsied and histopathological findings were documented and analyzed. Statistical Analysis Used: Sensitivity, specificity, positive predictive value and negative predictive value were estimated to determine the accuracy of VELscope examination analysis outcome. Results: The study included a total of 30 subjects including 19 (63.33%) males and 11 (26.66%) females. Autofluorescence examination by VELscope (AFV) revealed Autofluorescence Loss in 24 (80%) patients, while 6 (20%) patients showed Autofluorescence Retained. Comparison between the “high-risk lesions” (moderate/severe dysplasia and OSCC) and “low-risk lesions” (no/mild dysplasia) showed a 90.47% sensitivity but only 44.44% specificity. Conclusions: The findings of our study indicate that although AFV cannot be a substitute for COE, it can be used as a potential complementary diagnostic aid in surveillance of the high-risk patient population.
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Affiliation(s)
- Nupura Aniket Vibhute
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
| | - Sunil Vitthalrao Jagtap
- Department of Pathology, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
| | - Sujata Vijaysinh Patil
- Department of Community Medicine, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
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Adeoye J, Tan JY, Ip CM, Choi SW, Thomson P. "Fact or fiction?": Oral cavity cancer in nonsmoking, nonalcohol drinking patients as a distinct entity-Scoping review. Head Neck 2021; 43:3662-3680. [PMID: 34313348 DOI: 10.1002/hed.26824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/11/2021] [Accepted: 07/19/2021] [Indexed: 12/20/2022] Open
Abstract
Oral cavity cancer is often described as a lifestyle-related malignancy due to its strong associations with habitual factors, including tobacco use, heavy alcohol consumption, and betel nut chewing. However, patients with no genetically predisposing conditions who do not indulge in these risk habits are still being encountered, albeit less commonly. The aim of this review is to summarize contemporaneous reports on these nonsmoking, nonalcohol drinking (NSND) patients. We performed database searching to identify relevant studies from January 1, 2000 to March 31, 2021. Twenty-six articles from 20 studies were included in this study. We found that these individuals were mostly females in their eighth decade with tumors involving the tongue and gingivobuccal mucosa. This review also observed that these patients were likely diagnosed with early stage tumors with overexpression of programmed death-ligand 1 (PD-L1) and increased intensity of tumor infiltrating lymphocytes. Treatment response and disease-specific prognosis were largely comparable between NSND and smoking/drinking patients.
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Affiliation(s)
- John Adeoye
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Jia Yan Tan
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Cheuk Man Ip
- Department of Anesthesia, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Adeoye J, Hui L, Tan JY, Koohi-Moghadam M, Choi SW, Thomson P. Prognostic value of non-smoking, non-alcohol drinking status in oral cavity cancer. Clin Oral Investig 2021; 25:6909-6918. [PMID: 33991259 DOI: 10.1007/s00784-021-03981-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/10/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To compare the treatment response and prognosis of oral cavity cancer between non-smoking and non-alcohol-drinking (NSND) patients and smoking and alcohol-drinking (SD) patients. METHODS A total of 313 consecutively treated patients from 2000 to 2019 were included. Demographic, clinicopathologic, treatment, and prognosis information were obtained. Relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were compared between NSND and SD groups using Kaplan-Meier plots, log-rank test, and multivariate Cox regression analysis. RESULTS Sample prevalence of NSND patients was 54.6%. These patients were predominantly females in their eighth decade with lower prevalence of floor of the mouth cancers compared to SD patients (1.8% vs 14.8%). No difference in the RFS and DSS between both groups was found following multivariable analysis; however, NSND patients had better OS (HR (95% CI) - 0.47 (0.29-0.75); p = 0.002). Extracapsular extension was associated with significantly poorer OS, DSS, and RFS in this oral cavity cancer cohort. CONCLUSION Treatment response and disease-specific prognosis are comparable between NSND and SD patients with oral cavity cancer. However, NSND patients have better OS. CLINICAL RELEVANCE This study shows that oral cavity cancer in NSND is not less or more aggressive compared to SD patients. Although better survival is expected for NSND than SD patients, this is likely due to the reduced incidence of other chronic diseases in the NSND group.
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Affiliation(s)
- John Adeoye
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China. .,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.
| | - Liuling Hui
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Jia Yan Tan
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Mohamad Koohi-Moghadam
- Applied Oral Sciences and Community Dental Care, University of Hong Kong, Hong Kong SAR, China
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Oral Cancer Research Group, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
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Chaturvedi AK, Udaltsova N, Engels EA, Katzel JA, Yanik EL, Katki HA, Lingen MW, Silverberg MJ. Oral Leukoplakia and Risk of Progression to Oral Cancer: A Population-Based Cohort Study. J Natl Cancer Inst 2021; 112:1047-1054. [PMID: 31860085 DOI: 10.1093/jnci/djz238] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/18/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The optimal clinical management of oral precancer remains uncertain. We investigated the natural history of oral leukoplakia, the most common oral precancerous lesion, to estimate the relative and absolute risks of progression to cancer, the predictive accuracy of a clinician's decision to biopsy a leukoplakia vis-à-vis progression, and histopathologic predictors of progression. METHODS We conducted a retrospective cohort study (1996-2012) of patients with oral leukoplakia (n = 4886), identified using electronic medical records within Kaiser Permanente Northern California. Among patients with leukoplakia who received a biopsy (n = 1888), we conducted a case-cohort study to investigate histopathologic predictors of progression. Analyses included indirect standardization and unweighted or weighted Cox regression. RESULTS Compared with the overall Kaiser Permanente Northern California population, oral cancer incidence was substantially elevated in oral leukoplakia patients (standardized incidence ratio = 40.8, 95% confidence interval [CI] = 34.8 to 47.6; n = 161 cancers over 22 582 person-years). Biopsied leukoplakias had a higher oral cancer risk compared with those that were not biopsied (adjusted hazard ratio = 2.38, 95% CI = 1.73 to 3.28). However, to identify a prevalent or incident oral cancer, the biopsy decision had low sensitivity (59.6%), low specificity (62.1%), and moderate positive-predictive value (5.1%). Risk of progression to oral cancer statistically significantly increased with the grade of dysplasia; 5-year competing risk-adjusted absolute risks were: leukoplakia overall = 3.3%, 95% CI = 2.7% to 3.9%; no dysplasia = 2.2%, 95% CI = 1.5% to 3.1%; mild-dysplasia = 11.9%, 95% CI = 7.1% to 18.1%; moderate-dysplasia = 8.7%, 95% CI = 3.2% to 17.9%; and severe dysplasia = 32.2%, 95% CI = 8.1%-60.0%. Yet 39.6% of cancers arose from biopsied leukoplakias without dysplasia. CONCLUSIONS The modest accuracy of the decision to biopsy a leukoplakia vis-à-vis presence or eventual development of oral cancer highlights the need for routine biopsy of all leukoplakias regardless of visual or clinical impression. Leukoplakia patients, particularly those with dysplasia, need to be closely monitored for signs of early cancer.
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Affiliation(s)
- Anil K Chaturvedi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Eric A Engels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Jed A Katzel
- Department of Oncology, Kaiser Permanente, San Francisco, CA, USA
| | | | - Hormuzd A Katki
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Mark W Lingen
- Department of Pathology, University of Chicago, Chicago, IL, USA
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Minhas S, Sajjad A, Noor M, Qureshi F, Khokhar RA, Kashif M. A Cytological Study Enlightening the Unseen Effects of Concomitant Chemoradiotherapy in Contralateral Normal Buccal Mucosa of Oral Squamous Cell Carcinoma Patients. Cureus 2021; 13:e14483. [PMID: 34007739 PMCID: PMC8121010 DOI: 10.7759/cureus.14483] [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] [Indexed: 11/05/2022] Open
Abstract
Background/objectives In patients receiving concomitant chemoradiotherapy (CCRT) as a treatment for oral squamous cell carcinoma (OSCC), cytological changes were seen not only in neoplastic epithelial cells but the non-neoplastic epithelial cells are also affected, resulting in cytopathological atypical changes. The present study was designed to observe oral epithelial atypical cytopathologic changes induced in contralateral normal buccal mucosa in OSCC patients receiving CCRT. Methods The study included 150 patients with OSCC treated by CCRT whose details were collected from the Institute of Nuclear Medicine and Oncology Lahore (INMOL) Hospital Lahore. Cytological smears were obtained from the contralateral normal buccal mucosa of OSCC patients. The serial scrape smears were taken before, immediately after, on the 17th day (mid of treatment), and at the end of CCRT, whereas 20 patients were taken as normal healthy controls and were not exposed to CCRT. The smears were stained with hematoxylin and eosin and Papanicolaou stain. SPSS version 20 (Armonk, NY: IBM Corp.) was used for statistical analysis and p > 0.05 was considered to be significant. Results CCRT-induced oral epithelial atypical cytological changes were predominantly noted at end of therapy (19.7%) in the contralateral normal buccal mucosa. Nuclear atypia features were higher on the 17th day and end of treatment; whereas, epithelial atypia was mainly observed on the 17th day of CCRT (40%). A highly significant association was observed between epithelial atypia and radio-chemotherapy dose (p = 0.045), between CCRT-induced epithelial atypical cytological changes and days of treatment (p = 0.001), and between days of CCRT and nuclear atypia (0.000) accordingly. Atypia was not observed in any control group. Conclusion Varying degrees of oral epithelial atypical cytological changes may occur in otherwise normal contralateral mucosa of the patients receiving CCRT.
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Affiliation(s)
- Sadia Minhas
- Microbiology, The University of Lahore, Lahore, PAK.,Oral Pathology, Akhter Saeed Medical and Dental College, Lahore, PAK
| | - Aneequa Sajjad
- Oral Pathology, Akhter Saeed Medical and Dental College, Lahore, PAK
| | - Maria Noor
- Department of Oral Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, PAK
| | - Fariha Qureshi
- Anatomy, Akhtar Saeed Medical and Dental College, Lahore, PAK
| | - Romaisa A Khokhar
- Oral Pathology, Shifa College of Dentistry, Shifa Tameer e Millat University, Islamabad, PAK
| | - Muhammad Kashif
- Oral Pathology, Bakhtawar Amin Medical and Dental College, Multan, PAK
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Wang W, Adeoye J, Thomson P, Choi SW. Multiple tumour recurrence in oral, head and neck cancer: Characterising the patient journey. J Oral Pathol Med 2021; 50:979-984. [PMID: 33811374 DOI: 10.1111/jop.13182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) is the 15th most common cause of cancer-related mortality worldwide and approximately one oral cancer-related death occurs for every two new diagnoses. Death-due-to-disease is usually ascribed to inoperable primary tumours, treatment complications, second primary tumours arising due to field cancerization, or locoregional recurrence and distant metastases. METHODS A retrospective review of OSCC patients treated over a 19-year period, betweenOctober 1st , 2000 and October 1st , 2019. Patient demographic records were collected from consecutively treated adult patients with clinical subtypes corresponding to ICD-10 C00-C06, C09 and C10 were retrieved from the database. Patients who had suffered three or more recurrences after diagnosis of the primary tumour are defined as multiple-recurrent patients. RESULTS A total of 467 OSCC patients were treated during the study period. One hundred and fifty-five patients developed recurrent OSCC, amongst which 22 were designated as multiple cases. The time between initial OSCC diagnosis and first tumour recurrence varied from 3 to 276 months. Nine of the 22 multiple patients (41%) were diagnosed with buccal mucosal SCC as the primary tumour, which is significantly higher than the average prevalence (or 4.4, 95% CI (1.8, 10.8), p < 0.001) for buccal tumours within the cohort. All patients were treated initially by surgical tumour excision. There were no demonstrable differences in adjuvant chemo-radiotherapy regimes in any of the study groups. CONCLUSION Multiple OSCC development may occur either synchronously or metachronously during the course of oral cancer disease and poses an important management problem in contemporary oncology practice.
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Efficacy of non-invasive diagnostic methods in the diagnosis and screening of oral cancer and precancer. Braz J Otorhinolaryngol 2021; 88:937-947. [PMID: 33642212 PMCID: PMC9615541 DOI: 10.1016/j.bjorl.2020.12.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/13/2020] [Accepted: 12/19/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Traditional meta-analyses on the diagnostic accuracy of oral lesions have been conducted, but they were inherently limited to direct pairwise comparisons between a single method and a single alternative, while multiple diagnostic options and the ranking thereof were methodologically not possible. OBJECTIVE To evaluate the diagnostic values of various methods in patients with oral potential malignant disease by performing a network meta-analysis. METHODS Two authors independently searched the databases (MEDLINE, SCOPUS, the Cochrane Register of Controlled Trials, and Google scholar) up to June 2020 for studies comparing the diagnostic accuracy of various tools (autofluorescence, chemiluminescence, cytology, narrow band imaging, and toluidine blue) with visual examination or other tools. The outcomes of interest for this analysis were sensitivity, specificity, negative predictive value, positive predictive value and accuracy. Both a standard pairwise meta-analysis and network meta-analysis were conducted. RESULTS Treatment networks consisting of six interventions were defined for the network meta-analysis. The results of traditional meta-analysis showed that, among six methods, narrow band imaging showed higher sensitivity, specificity, negative predictive value, positive predictive value, and accuracy compared to visual examination. The results of network meta-analysis showed that autofluorescence, chemiluminescence, and narrow band imaging had higher sensitivity compared with visual examination, and that chemiluminescence and narrow band imaging had higher negative predictive value compared with visual examination. However, autofluorescence and chemiluminescence had lower specificity compared with visual examination. There were no significant differences in positive predictive value and accuracy among the six interventions. CONCLUSION This study demonstrated that narrow banding imaging has superiority in terms of sensitivity and negative predictive value compared with the other five tested agents.
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Gissi DB, Morandi L, Colella G, De Luca R, Campisi G, Mauceri R, Romeo U, Tenore G, Mignogna MD, Adamo D, Oteri G, Marcianò A, Vescovi P, Meleti M, Serpico R, Di Stasio D, Pentenero M, Santarelli A, Bianchi A, Crimi S, Marchetti C, Tarsitano A, Foschini MP, Montebugnoli L. Clinical validation of 13-gene DNA methylation analysis in oral brushing samples for detection of oral carcinoma: Italian multicenter study. Head Neck 2021; 43:1563-1573. [PMID: 33511711 DOI: 10.1002/hed.26624] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/27/2020] [Accepted: 01/15/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The aim of this Italian multicenter study was to evaluate the diagnostic performance of a minimally invasive method for the detection of oral squamous cell carcinoma (OSCC) based on 13-gene DNA methylation analysis in oral brushing samples. METHODS Oral brushing specimens were collected in 11 oral medicine centers across Italy. Twenty brushing specimens were collected by each center, 10 from patients with OSCC, and 10 from healthy volunteers. DNA methylation analysis was performed in blindness, and each sample was determined as positive or negative based on a predefined cutoff value. RESULTS DNA amplification failed in 4 of 220 (1.8%) samples. Of the specimens derived from patients with OSCC, 93.6% (103/110) were detected as positive, and 84.9% (90/106) of the samples from healthy volunteers were negative. CONCLUSION These data confirmed the diagnostic performance of our novel procedure in a large cohort of brushing specimens collected from 11 different centers and analyzed in blindness.
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Affiliation(s)
- Davide B Gissi
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Luca Morandi
- Functional MR Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania "L. Vanvitelli", Naples, Italy
| | - Roberto De Luca
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological, and oral Sciences, Sector of Oral Medicine "Valerio Margiotta", University of Palermo, Palermo, Italy
| | - Rodolfo Mauceri
- Department of Surgical, Oncological, and oral Sciences, Sector of Oral Medicine "Valerio Margiotta", University of Palermo, Palermo, Italy
| | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Gianluca Tenore
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Michele D Mignogna
- Oral Medicine Complex Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences - Head & Neck Clinical Section, "Federico II" University of Naples, Naples, Italy
| | - Daniela Adamo
- Oral Medicine Complex Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences - Head & Neck Clinical Section, "Federico II" University of Naples, Naples, Italy
| | - Giacomo Oteri
- Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Antonia Marcianò
- Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Paolo Vescovi
- Oral Medicine and Laser Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marco Meleti
- Oral Medicine and Laser Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania "L. Vanvitelli", Naples, Italy
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania "L. Vanvitelli", Naples, Italy
| | - Monica Pentenero
- Oral Medicine and Oral Oncology Unit, Department of Oncology, University of Turin, Turin, Italy
| | - Andrea Santarelli
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy
| | - Alberto Bianchi
- Section of Maxillo-Facial Surgery, Department of General Surgery, Policlinico - San Marco, University of Catania, Catania, Italy
| | - Salvatore Crimi
- Section of Maxillo-Facial Surgery, Department of General Surgery, Policlinico - San Marco, University of Catania, Catania, Italy
| | - Claudio Marchetti
- Section of Maxillo-Facial Surgery at Policlinico S. Orsola-Malpighi, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Achille Tarsitano
- Section of Maxillo-Facial Surgery at Policlinico S. Orsola-Malpighi, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maria Pia Foschini
- Section of Anatomic Pathology at Bellaria Hospital, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Lucio Montebugnoli
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
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Sarode GS, Sarode SC, Maniyar N, Sam Regi R, Aruna A, Patil S. Malignant transformation rate based stratification model for oral potentially malignant disorders: A potential idea. J Oral Biol Craniofac Res 2020; 10:490-491. [PMID: 32904274 DOI: 10.1016/j.jobcr.2020.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 11/29/2022] Open
Abstract
By the virtue of heterogeneous biological aggressiveness, oral potentially malignant disorders (OPMDs) comprise the ideal group of disorders for biological behavior-based classification system. Concerning the exponentially increasing incidence and mortality of oral squamous cell carcinoma (OSCC), it has now become a need of the hour to formulate a classification system for OPMDs that even a general dental surgeon could apply in everyday clinical practice. With this view in mind, efforts have been made to stratify various OPMDs based on their malignant transformation rate (MTR). Databases like PubMed, SCOPUS, Web of Science and CINHAL were used for searching the appropriate papers. Preferences were given to meta-analyses and cohort studies for determining the value of MTRs. In other cases, cross-sectional studies, case series and case reports were consulted for obtaining the values. Based on the MTRs obtained, we stratified all the OPMDs into 3 groups: Low risk group (MTR: 0-3%), Moderate risk group (MTR: 4-15%) and High risk group (MTR: above 15%), based on their MTRs available from the literature so far. The idea proposed in the paper can aid researchers and clinicians in identifying and planning treatment strategies that can be generalized to different OPMDs included in the same group. Since the paper is not based on a cohort study or a meta-analysis, the authors recommend a systematic review and meta-analysis to be carried out for a clinically applicable classification based on the proposed idea.
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Affiliation(s)
- Gargi S Sarode
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, 411018, MH, India
| | - Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, 411018, MH, India
| | - Nikunj Maniyar
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, 411018, MH, India
| | - Roney Sam Regi
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, 411018, MH, India
| | - Aakriti Aruna
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, 411018, MH, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Hwang SH, Kim SW, Song EA, Lee J, Kim DH. Methylene Blue as a Diagnosis and Screening Tool for Oral Cancer and Precancer. Otolaryngol Head Neck Surg 2020; 164:271-276. [DOI: 10.1177/0194599820947686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives To evaluate the accuracy of methylene blue (MB) for diagnosing oral cancer and precancer. Data Sources PubMed, Cochrane Database, Embase, Web of Science, SCOPUS, and Google Scholar. Review Methods Two authors working independently reviewed 6 databases from their dates of inception until April 2020. Studies exploring oral mucosal disorders as detected by MB were assessed. True-positive, true-negative, false-positive, and false-negative data were extracted for each study. Methodological quality was evaluated with the Quality Assessment of Diagnostic Accuracy Studies tool (v 2). Results Seven prospective and retrospective studies (N = 493) were included. The diagnostic odds ratio of MB was 20.017 (95% CI, 10.65-37.63, I2 = 23%). The area under the summary receiver operating characteristic curve was 0.699. Sensitivity was 0.903 (95% CI, 0.84-0.94, I2 = 54%), and specificity was 0.68 (95% CI, 0.60-0.75, I2 = 0%). The correlation between the sensitivity and the false-positive rate was –0.17, indicating an absence of heterogeneity. Conclusions Regarding diagnostic accuracy, MB had high sensitivity but low specificity, suggesting that it cannot be recommended as a replacement for the currently used standard of a scalpel biopsy with histologic assessment. Instead, it should be used as an adjunct to conventional assessment because of its low toxicity and price.
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Affiliation(s)
- Se Hwan Hwang
- Department of Otolaryngology–Head and Neck Surgery, Bucheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Won Kim
- Department of Otolaryngology–Head and Neck Surgery, Bucheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Otolaryngology–Head and Neck Surgery, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun A. Song
- Department of Otolaryngology–Head and Neck Surgery, Bucheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Junuk Lee
- Department of Otolaryngology–Head and Neck Surgery, Bucheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Do Hyun Kim
- Department of Otolaryngology–Head and Neck Surgery, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Shah S, Waknis P, Saha A, Setiya S, Ratra T, Vaswani V. The use of Velscope to assess cellular changes occuring in oral premalignancy. J Oral Biol Craniofac Res 2020; 10:99-103. [PMID: 32211285 DOI: 10.1016/j.jobcr.2020.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/10/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives To improve visualization of suspicious lesions of the oral mucosa and to assess the accuracy of Velscope in assessing cellular changes occurring in oral premalignancy for early diagnosis. Materials and methods In this prospective, randomized in-vivo clinical study a total of 250 patients who gave history of chewing tobacco were screened. The selection of the site of biopsy was taken based on the area of loss of fluorescence identified by the Velscope within the lesion. Routine blood investigations were done. A biopsy was performed to confirm the findings of clinical examination. The data was collected and analysed. Results Among 200 patients only 110 underwent incisional biopsy. Of these only 89 patients showed neoplastic changes. Of the control biopsies, none of them showed any dysplastic changes. Out of 106 who exhibited speckling under autofluorescence, only 89 showed dysplastic changes whereas only 17 showed no dysplastic changes. Out of these 17 specimens, the histopathological diagnosis of 5 was coated tongue, 3 were pigmented lesions, 3 were geographic tongue and 2 were mucositis. Of the remaining 4, the histopathological diagnosis of 1 was oral submucous fibrosis, 1 was lichen planus and 2 were frictional keratosis. Conclusion False positive findings are possible in presence of highly inflamed tissues, and it is possible that use of Velscope alone may result in failure to detect regions of dysplasia, but it has its use definitely to improve clinical decision making about the nature of oral lesions and aids in decisions to biopsy regions of concern. Use of the scope has allowed practitioners to identify the best region for biopsy. It is much better to occasionally sample tissue that turns out to be benign than to fail to diagnose dysplastic or malignant lesions. However, poor specificity is a major limitation for using it as a screening tool.
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Affiliation(s)
- Sonal Shah
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Pushkar Waknis
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Aditi Saha
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Sneha Setiya
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Tusha Ratra
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Vibha Vaswani
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
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Thomson P. The "Peter Principle" revisited-Reflections on science, surgery and research. J Oral Pathol Med 2020; 49:596-600. [PMID: 32162731 DOI: 10.1111/jop.13011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Revisiting the eponymous "Peter Principle," in this article the author reflects upon a professional lifetime as a clinician, surgeon and researcher, and summarises his efforts to improve contemporary understanding of oral cancer development, refine diagnostic procedure and facilitate efficacious, early treatment intervention to halt the process of carcinogenesis. The author reviews the principles underpinning effective translational research. Utilising his own work in oral epithelial cell science, interventional surgery and potentially malignant disorder patient management and surveillance, a number of significant advances in our knowledge base and their specific clinical application and potential impact are discussed. Research remains an active and ongoing process, however, and the author believes it essential for future relevance that hypotheses should always be initiated, led and mentored by experienced clinical practitioners.
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Affiliation(s)
- Peter Thomson
- Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Adeoye J, Brennan PA, Thomson P. “Search less, verify more”—Reviewing salivary biomarkers in oral cancer detection. J Oral Pathol Med 2020; 49:711-719. [DOI: 10.1111/jop.13003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/03/2020] [Indexed: 12/19/2022]
Affiliation(s)
- John Adeoye
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| | | | - Peter Thomson
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
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Assessment of Clinical Examination Validity in Oral Cancer Risk Patients. BALKAN JOURNAL OF DENTAL MEDICINE 2020. [DOI: 10.2478/bjdm-2020-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Summary
Background/Aim: Oral cancer is one of the ten most common cancers in the world, recently positioned as a sixth one, unfortunately with poor prognosis after treatment because of the late diagnostics in advanced stages of the disease. Aim of this study was to present the basic criteria in assessment the accuracy/efficacy, specificity and sensitivity, the positive and negative predicted values of the conventional oral examination (COE) as the easiest and most acceptable procedure in detection of the early changes of the suspicious oral tissue changes compared to the diagnostic gold standard – tissue biopsy in two different groups of examinees.
Material and Methods: Sixty patients divided into two study groups (one with potentially malignant oral lesions and a second consisted of clinically suspicious oral cancer lesions) were examined with COE and subjected to histopathological confirmation - tissue biopsy. All examined patients underwent the diagnostic protocol by the American Joint Commission on Cancer, selected under certain inclusion and exclusion criteria.
Results: Sensitivity of COE in the group of examinees with oral potentially malignant lesions is 83.33%, its specificity is 20.83%, the positive predictive value is 20.83% and the negative predictive value is 83.33%. The accuracy of the COE method is 33.33%. The sensitivity, in the group of patients with oral cancer is 96.43%, specificity is 0%, the positive predictive value is 93.10% and the negative predictive value is 0%. The accuracy of this method is 90%.
Conclusions: The accuracy reaches a value over 90% for the group with lesions with highly suspected malignant potential – oral cancer, and sets the thesis that COE as screening method for oral cancer or premalignant tissue changes is more valuable for the patients with advanced oral epithelial changes, but is recommended to be combined with some other type of screening procedure in order to gain relevant results applicable in the everyday clinical practice.
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Fricain JC, Fenelon M, Baschet L, Catros S, Glock N, Lerici S, Gaston R, Perez P, Doussau A. Reproducibility of tissue autofluorescence for screening potentially malignant disorders. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Direct tissue autofluorescence (AF) visualization devices such as VELscope® are gaining interest to improve early detection of oral potentially malignant disorders (OPMD) and cancers. The main objective of this study was to assess inter-observer reproducibility of incandescent light (IL) and AF observations for OPMD and cancer. Materials and methods: High risk patients (exposed to alcohol or tobacco) were screened by two independent operators with a conventional oral examination (IL) followed by AF examination. The primary endpoint was the inter-observer agreement on the decision to biopsy assessed by kappa coefficients.Accuracy of IL and AF were estimated by the relative true positive rate (RTPR, increase of sensitivity), relative false positive rate (RFPR, loss of specificity) and their ratio. Results: 179 patients were included. 833 lesions were identified after IL and AF. Indication for biopsy was retrieved for 41 patients (61 lesions). Inter-observer agreement on the indications for biopsy was 93.3% after IL (Kappa coefficient 0.88 [0.80, 0.97]) and 96.1% after IL and AF (Kappa coefficient 0.78 [0.66, 0.90]). RTPR was 1.2, RFPR was 1 and their ratio was 1.2. Conclusion: IL and AF examination has shown good inter-observer reproducibility. Adjunction of AF allowed diagnosing more leukoplakia without dysplasia.
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Emran S, Hurskainen M, Tomppo L, Lappalainen R, Kullaa AM, Myllymaa S. Bioimpedance spectroscopy and spectral camera techniques in detection of oral mucosal diseases: a narrative review of the state-of-the-art. J Med Eng Technol 2019; 43:474-491. [DOI: 10.1080/03091902.2019.1692940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Shekh Emran
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Miia Hurskainen
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Laura Tomppo
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Reijo Lappalainen
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Arja M. Kullaa
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Educational Dental Clinic, Kuopio University Hospital, Kuopio, Finland
| | - Sami Myllymaa
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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Choi S, Thomson P. Multiple oral cancer development—Clinico‐pathological features in the Hong Kong population. J Oral Pathol Med 2019; 49:145-149. [DOI: 10.1111/jop.12962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Siu‐Wai Choi
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| | - Peter Thomson
- Oral & Maxillofacial Surgery Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
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Atarbashi-Moghadam S, Lotfi A, Poornaghi S, Mokhtari S. Bilateral squamous cell carcinoma of buccal mucosa in a young adult man: A case presentation with review of literature. J Oral Maxillofac Pathol 2019; 23:90-93. [PMID: 30967734 PMCID: PMC6421909 DOI: 10.4103/jomfp.jomfp_21_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The control of oral squamous cell carcinoma (SCC) is difficult even after treatment because it has a tendency to multiple primary carcinomas. The incidence of second primary neoplasm in the head and neck region cannot be forecasted reliably. The purpose of this report is to describe the clinicopathological characteristics of a unique case of bilateral buccal mucosal SCC in a 35-year-old male and to determine whether any associated risk factors are present.
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Affiliation(s)
- Saede Atarbashi-Moghadam
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Lotfi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samane Poornaghi
- Dentist, Private Practice, Research Center, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Mokhtari
- Education Development Office, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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23
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Farah CS, Pollaers K, Frydrych A. Management of Premalignant Disease of the Oral Mucosa. HEAD AND NECK CANCER CLINICS 2019. [DOI: 10.1007/978-981-13-2931-9_11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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24
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Strome A, Kossatz S, Zanoni DK, Rajadhyaksha M, Patel S, Reiner T. Current Practice and Emerging Molecular Imaging Technologies in Oral Cancer Screening. Mol Imaging 2018; 17:1536012118808644. [PMID: 32852263 PMCID: PMC6287312 DOI: 10.1177/1536012118808644] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Oral cancer is one of the most common cancers globally. Survival rates for patients are directly correlated with stage of diagnosis; despite this knowledge, 60% of individuals are presenting with late-stage disease. Currently, the initial evaluation of a questionable lesion is performed by a conventional visual examination with white light. If a lesion is deemed suspicious, a biopsy is taken for diagnosis. However, not all lesions present suspicious under visual white light examination, and there is limited specificity in differentiating between benign and malignant transformations. Several vital dyes, light-based detection systems, and cytology evaluation methods have been formulated to aid in the visualization process, but their lack of specific biomarkers resulted in high false-positive rates and thus limits their reliability as screening and guidance tools. In this review, we will analyze the current methodologies and demonstrate the need for specific intraoral imaging agents to aid in screening and diagnosis to identify patients earlier. Several novel molecular imaging agents will be presented as, by result of their molecular targeting, they aim to have high specificity for tumor pathways and can support in identifying dysplastic/cancerous lesions and guiding visualization of biopsy sites. Imaging agents that are easy to use, inexpensive, noninvasive, and specific can be utilized to increase the number of patients who are screened and monitored in a variety of different environments, with the ultimate goal of increasing early detection.
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Affiliation(s)
- Arianna Strome
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Susanne Kossatz
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Snehal Patel
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thomas Reiner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Radiology, Weill-Cornell Medical College, New York, NY, USA
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25
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Gandara-Vila P, Perez-Sayans M, Suarez-Penaranda JM, Gallas-Torreira M, Somoza-Martin J, Reboiras-Lopez MD, Blanco-Carrion A, Garcia-Garcia A. Survival study of leukoplakia malignant transformation in a region of northern Spain. Med Oral Patol Oral Cir Bucal 2018; 23:e413-e420. [PMID: 29924757 PMCID: PMC6051679 DOI: 10.4317/medoral.22326] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/22/2018] [Indexed: 11/26/2022] Open
Abstract
Background Oral leukoplakia is the most common potentially malignant disorder (PMD) of the oral cavity. The objectives of this study are to determine the clinicopathologic features in a group of patients with oral leukoplakia of Northern Spain (Galicia), determining the factors associated to clinical risk and analyzing the malignant transformation of these patients. Material and Methods We included 85 patients. We recorded sex and age, habits like alcohol and tobacco, size, clinical appearance, site, number of lesions, and presence or absence of dysplasia. We assess the association between risk factors and transformation and developed a logistic regression analysis. Finally we used the Kaplan-Meier and log-rank test for the survival analysis. Results 7 patients (8.2%) had malignant transformation. The mean follow-up of the patients was 4.13 years versus 5.58 years of those who developed carcinoma. Only location and initial dysplasia have a statistically significant relationship with malignant transformation, but when applied the long rank test only the presence of dysplasia remains statistically significant(P<0,026). Oral Cancer Free Survival was 81.9% (0.150) at 11 years for the group without dysplasia. Conclusions We found that the presence of dysplasia is the only risk factor that is statistically related to the development of a carcinoma. Key words:Leukoplakia, oral cancer and oral precancer, follow-up, malignant transformation.
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Affiliation(s)
- P Gandara-Vila
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Entrerrios s/n, Santiago de Compostela C.P. 15705,
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26
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Thomson PJ. Perspectives on oral squamous cell carcinoma prevention-proliferation, position, progression and prediction. J Oral Pathol Med 2018; 47:803-807. [PMID: 29752860 DOI: 10.1111/jop.12733] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2018] [Indexed: 11/27/2022]
Abstract
Squamous cell carcinoma arising from oral mucosal epithelium remains a lethal and deforming disease due to tumour invasion, oro-facial destruction, cervical lymph node metastasis and ultimate blood-borne dissemination. Worldwide, 300 000 new cases are seen each year, with a recent and significant rise in incidence affecting particularly the young. To rationalize perspectives on preventive strategies in oral cancer management, this study addresses a number of fundamental questions regarding carcinogenesis: proliferation-what epithelial cell changes precede tumour development? Position-why are certain oral sites so predisposed to cancer? Progression-why do some precursor lesions progress to invasive carcinoma and others do not? Prediction-how can we predict individual patient and/or lesion behaviour to prevent disease progression? By improving our understanding of oral carcinogenesis, can we thereby facilitate more effective primary, secondary and tertiary preventive strategies and ultimately reduce the global burden of oral squamous cell carcinoma (OSCC)?
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Affiliation(s)
- P J Thomson
- Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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27
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Farah CS, Kordbacheh F, John K, Bennett N, Fox SA. Molecular classification of autofluorescence excision margins in oral potentially malignant disorders. Oral Dis 2018; 24:732-740. [DOI: 10.1111/odi.12818] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 12/23/2022]
Affiliation(s)
- C S Farah
- Australian Centre for Oral Oncology Research & Education; UWA Dental School; University of Western Australia; Nedlands WA Australia
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - F Kordbacheh
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - K John
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - N Bennett
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - S A Fox
- Australian Centre for Oral Oncology Research & Education; UWA Dental School; University of Western Australia; Nedlands WA Australia
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28
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Tissue Fluorescence Imaging (VELscope) for Quick Non-Invasive Diagnosis in Oral Pathology. J Craniofac Surg 2018; 28:e112-e115. [PMID: 27984435 DOI: 10.1097/scs.0000000000003210] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Oral squamous cell carcinoma is the most common form of malignancy of the oral cavity; its incidence is increasing and late-stage presentation is common. It is usually predated by oral premalignant disorders. For this reason, early diagnosis is fundamental to reduce the malignant transformation of oral premalignant disorders and for increase the survival rate for oral cancer. Scraping the surface of the lesion is useful for having cytological features of the investigated tissue. The features of smears of oral premalignant lesions are the keratinization growth (red, orange, brown), the increased nuclear area and so the nuclear hyperchromatism, the nuclear pleomorphism, and the chromatin clumping. All those features are essential for doing the right diagnosis. However, the oral disease should be recognized at the first view by the clinical investigation without touching the lesions avoiding possible alteration in the cells of the tissue. The current standard of incisional biopsy with histology is painful for patients and involves a delay, although histology is completed. The aim of this article is to evaluate the effectiveness of other available tests that are unobtrusive and provide immediate results like the tissue fluorescence imaging.
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29
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Wu MH, Luo JD, Wang WC, Chang TH, Hwang WL, Lee KH, Liu SY, Yang JW, Chiou CT, Chang CH, Chiang WF. Risk analysis of malignant potential of oral verrucous hyperplasia: A follow-up study of 269 patients and copy number variation analysis. Head Neck 2018; 40:1046-1056. [DOI: 10.1002/hed.25076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/26/2017] [Accepted: 12/06/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Ming-Heng Wu
- Graduate Institute of Translational Medicine, College of Medical Science and Technology; Taipei Medical University; Taipei Taiwan
| | - Ji-Dung Luo
- Bioinformatics Core Laboratory, Molecular Medicine Research Center; Chang Gung University; Taoyuan Taiwan
| | - Wen-Chang Wang
- Graduate Institute of Translational Medicine, College of Medical Science and Technology; Taipei Medical University; Taipei Taiwan
| | - Tzu-Hao Chang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology; Taipei Medical University; Taipei Taiwan
| | - Wei-Lun Hwang
- Graduate Institute of Translational Medicine, College of Medical Science and Technology; Taipei Medical University; Taipei Taiwan
| | - Kuen-Haur Lee
- Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology; Taipei Medical University; Taipei Taiwan
| | - Shyun-Yeu Liu
- Department of Oral and Maxillofacial Surgery, Chi-Mei Medical Center; Liouying Taiwan
| | - Jung-Wu Yang
- Department of Oral and Maxillofacial Surgery; Sin-Lau Hospital; Tainan Taiwan
| | - Chang-Ta Chiou
- Department of Oral and Maxillofacial Surgery; An-Nan Hospital; Tainan Taiwan
| | - Chi-Hua Chang
- Department of Oral and Maxillofacial Surgery; Chang-Chung Memorial Hospital; Kaohsiung Taiwan
| | - Wei-Fan Chiang
- Graduate Institute of Translational Medicine, College of Medical Science and Technology; Taipei Medical University; Taipei Taiwan
- Department of Oral and Maxillofacial Surgery, Chi-Mei Medical Center; Liouying Taiwan
- School of Dentistry; National Yang-Ming University; Taipei Taiwan
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30
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Nag R, Kumar Das R. Analysis of images for detection of oral epithelial dysplasia: A review. Oral Oncol 2018; 78:8-15. [PMID: 29496062 DOI: 10.1016/j.oraloncology.2018.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/02/2018] [Accepted: 01/07/2018] [Indexed: 10/18/2022]
Abstract
This paper provides a review of various image analysis approaches that have been previously used for recognition of dysplasia in images of the epithelium of the oral cavity. This domain has become especially admissible with the uncovering of the importance of image analysis which can probably be an aid to subjective diagnosis by histopathologists. Oral malignancy is a rampant form of cancer found among people of the Indian subcontinent due to various deleterious habits like consumption of tobacco, areca nut, betel leaf etc. Oral Submucous Fibrosis, a precancer, whose pathological category falls between normal epithelium and epithelial dysplasia, is caused because of these habits and can ultimately lead to oral cancer. Hence early detection of this condition is necessary. Image analysis methods for this purpose have an enormous potential which can also reduce the heavy workload of pathologists and to refine the criterion of interpretation. This paper starts with a critique of statistics of oral carcinoma in India and distribution of cancer in intra-oral sites and moves on to its causes and diagnostic approaches including causative agents, problems in curative approach and importance of image analysis in cancer detection. The various image analysis methods to appraise the cytological and architectural changes accompanied by Oral Epithelial Dysplasia in the images of the oral epithelial region have been described in relation to 2005 WHO Classification System and it was found that in future, analysis of images based on the mentioned methods has the potential in better interpretation and diagnosis of oral carcinoma.
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Affiliation(s)
- Reetoja Nag
- Centre for Biomaterials, Cellular, and Molecular Theranostics, VIT University, Vellore 632014, India.
| | - Raunak Kumar Das
- Centre for Biomaterials, Cellular, and Molecular Theranostics, VIT University, Vellore 632014, India; School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia.
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31
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Sarode SC, Sarode GS, Patil S. Decoding oral cancer conundrums from 'bad luck' point of view. Future Oncol 2018; 14:409-411. [PMID: 29318903 DOI: 10.2217/fon-2017-0517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Sachin C Sarode
- Department of Oral Pathology & Microbiology, Dr DY Patil Dental College & Hospital, Dr DY Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune 411018, Maharashtra, India
| | - Gargi S Sarode
- Department of Oral Pathology & Microbiology, Dr DY Patil Dental College & Hospital, Dr DY Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune 411018, Maharashtra, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery & Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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32
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Evidence-based clinical practice guideline for the evaluation of potentially malignant disorders in the oral cavity. J Am Dent Assoc 2017; 148:712-727.e10. [DOI: 10.1016/j.adaj.2017.07.032] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 12/20/2022]
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33
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34
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Liu SY, Feng IJ, Wu YW, Chen CY, Hsiung CN, Chang HW, Lin CY, Chang MT, Yu HC, Lee SY, Yen CY. Implication for second primary cancer from visible oral and oropharyngeal premalignant lesions in betel-nut chewing related oral cancer. Head Neck 2017; 39:1428-1435. [PMID: 28383824 DOI: 10.1002/hed.24777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/22/2016] [Accepted: 02/10/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Visible oral and oropharyngeal premalignant lesions may be used to monitor for a second primary oral cancer. To control for bias, we focused on the visible oral and oropharyngeal premalignant lesions of patients with oral cancer with a positive betel-nut chewing habit. Visible oral and oropharyngeal premalignant lesions that can predict second primary oral cancers were studied. METHODS Nine hundred ninety-seven patients with positive betel-nut chewing habits and oral cancer were enrolled in this retrospective cohort study. We analyzed the relevance of their visible oral and oropharyngeal premalignant lesion incidence and relative clinicopathological variables to the development of a second primary oral cancer. RESULTS Second primary oral cancer risk was significantly higher in patients with positive visible oral and oropharyngeal premalignant lesions (P < .0001), especially in younger patients (P = .0023; ≤40 years: adjusted odds ratio [OR] 2.66; 40-60 years: adjusted OR 2.61). The heterogeneous leukoplakia was (adjusted OR 2.17) higher than homogeneous leukoplakia. CONCLUSION The predictive value and practicality of visible oral and oropharyngeal premalignant lesions make it a potentially valuable marker in follow-ups of patients with a positive betel-nut chewing habit with oral cancer, especially young patients with heterogeneous leukoplakia.
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Affiliation(s)
- Shyun-Yu Liu
- Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Tainan, Taiwan
| | - I-Jung Feng
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Wei Wu
- Center for Teeth Bank and Dental Stem Cell Technology, Taipei Medical University, Taipei, Taiwan.,College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ching-Yuan Chen
- Department of Electrical Engineering, Southern Taiwan University, Tainan, Taiwan
| | - Chao-Nan Hsiung
- Center for Teeth Bank and Dental Stem Cell Technology, Taipei Medical University, Taipei, Taiwan.,College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,College of Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Hsueh-Wei Chang
- Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan.,Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Che-Yi Lin
- Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Lioying, Tainan, Taiwan
| | - Min-Te Chang
- Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Tainan, Taiwan
| | - Hsi-Chien Yu
- Department of Dentistry, Chiali Chi Mei Hospital, Tainan, Taiwan
| | - Sheng-Yang Lee
- School of Dentistry, Taipei Medical University, Taipei, Taiwan.,Division of Orthodontics, Wan-Fang Medical Center, Taipei Medical University, Taipei, Taiwan
| | - Ching-Yu Yen
- Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Tainan, Taiwan.,School of Dentistry, Taipei Medical University, Taipei, Taiwan
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35
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Kao HK, Abdelrahman M, Huang Y, Tsai CH, Barrera MJ, Tsang NM, Couves AJ, Cheng MH, Chang KP. Multiple concomitant oral cavity cancers: Incidence, management, and outcomes. J Surg Oncol 2017; 115:835-841. [PMID: 28320044 DOI: 10.1002/jso.24600] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 02/08/2017] [Accepted: 02/13/2017] [Indexed: 11/05/2022]
Abstract
BACKGROUND Little is known about the appropriate treatment and long-term survival of patients with multiple concomitant oral cavity cancers (MOC). The aim of this study was to clarify the clinicopathological features of MOC, to compare the prognosis of MOC patients with that of patients with single oral cavity cancers (SOC), and to describe reconstructive options based on the concept of economy in autologous tissue transfer. METHODS Data from 603 patients diagnosed with at least one squamous cell carcinoma of the oral cavity who underwent surgery for primary oral cavity cancers between 2006 and 2014 were reviewed retrospectively to identify MOC patients. RESULTS Among 603 cases of surgically resected primary oral cancers, 20 cases (3.3%) with MOC were identified. Patients with MOC did not differ from patients with SOC in age, and their index lesions did not differ in pT value, pN value, pathological stage, extracapsule spread, or perineural or bone invasion. The 5-year overall and disease-free survival rates for MOC and SOC cases were 72.6% versus 68.7%, and 65.3% versus 64.8%, respectively (P = 0.785 and 0.770, respectively). The anterolateral thigh flap was widely applied. According to its origin of blood supply, the reconstructive options of MOC patients with separated defects were classified and proposed. CONCLUSIONS MOC and SOC were similar in clinicopathological characteristics. The prognosis of patients with MOC was similar to that of patients with SOC. Resections were performed with curative intent. A multidisciplinary team management approach is essential for customized treatment in MOC patients.
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Affiliation(s)
- Huang-Kai Kao
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | | | - Yenlin Huang
- Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Chia-Hsuan Tsai
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Keelung and Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Megias J Barrera
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Ngan-Ming Tsang
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Adam J Couves
- Department of Surgery, Royal Alexandra Hospital, Glasgow, United Kingdom
| | - Ming-Huei Cheng
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Kai-Ping Chang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan
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36
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Gupta V, Ramani P. Histologic and immunohistochemical evaluation of mirror image biopsies in oral squamous cell carcinoma. J Oral Biol Craniofac Res 2016; 6:194-197. [PMID: 27761383 DOI: 10.1016/j.jobcr.2016.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 06/07/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The concept of field cancerization has frequently been quoted to explain the occurrence of multiple primary cancers in the head and neck region and recurrence following complete excision of the original tumor. The main objective is to study the occurrence of field changes in mirror image biopsy in relation to histopathological changes in the oral mucosa among oral cancer patients using hematoxylin and eosin and to study the expression pattern of cytokeratin, Ki-67 and p53 in oral squamous cell carcinoma and mirror image biopsy. MATERIALS AND METHODS A pilot study of 15 patients clinically diagnosed with carcinoma lesion and their corresponding mirror image sites were taken and stained using immunohistochemistry method for the expression of cytokeratin, Ki-67 and p53. RESULTS Primary tumors showed strong positive staining for cytokeratin throughout both the epithelium and malignant epithelial islands but absence of staining for Ki-67 and p53. CONCLUSION CK may be useful in predicting epithelial differentiation and Ki-67 and p53 act as weak indicators of malignant disease progression in oral tissues.
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Affiliation(s)
- Vineet Gupta
- Department Oral Pathology and Microbiology, Shree Bankey Bihari Dental College, NH 24, GZB, U.P., India
| | - Pratibha Ramani
- Department Oral Pathology and Microbiology, Saveetha Dental College, Chennai, Tamil Nadu, India
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37
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Accuracy of autofluorescence in diagnosing oral squamous cell carcinoma and oral potentially malignant disorders: a comparative study with aero-digestive lesions. Sci Rep 2016; 6:29943. [PMID: 27416981 PMCID: PMC4945954 DOI: 10.1038/srep29943] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 06/24/2016] [Indexed: 02/05/2023] Open
Abstract
Presently, various studies had investigated the accuracy of autofluorescence in diagnosing oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) with diverse conclusions. This study aimed to assess its accuracy for OSCC and OPMD and to investigate its applicability in general dental practice. After a comprehensive literature search, a meta-analysis was conducted to calculate the pooled diagnostic indexes of autofluorescence for premalignant lesions (PML) and malignant lesions (ML) of the oral cavity, lung, esophagus, stomach and colorectum and to compute indexes regarding the detection of OSCC aided by algorithms. Besides, a u test was performed. Twenty-four studies detecting OSCC and OPMD in 2761 lesions were included. This demonstrated that the overall accuracy of autofluorescence for OSCC and OPMD was superior to PML and ML of the lung, esophagus and stomach, slightly inferior to the colorectum. Additionally, the sensitivity and specificity for OSCC and OPMD were 0.89 and 0.8, respectively. Furthermore, the specificity could be remarkably improved by additional algorithms. With relatively high accuracy, autofluorescence could be potentially applied as an adjunct for early diagnosis of OSCC and OPMD. Moreover, approaches such as algorithms could enhance its specificity to ensure its efficacy in primary care.
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38
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Holmstrup P, Dabelsteen E. Oral leukoplakia-to treat or not to treat. Oral Dis 2016; 22:494-7. [DOI: 10.1111/odi.12443] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 01/14/2016] [Indexed: 02/06/2023]
Affiliation(s)
- P Holmstrup
- Section of Periodontology, Microbiology and Community Dentistry, School of Dentistry, Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen N Denmark
| | - E Dabelsteen
- Section of Periodontology, Microbiology and Community Dentistry, School of Dentistry, Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen N Denmark
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39
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Kordbacheh F, Bhatia N, Farah CS. Patterns of differentially expressed genes in oral mucosal lesions visualised under autofluorescence (VELscope™). Oral Dis 2016; 22:285-96. [DOI: 10.1111/odi.12438] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 01/03/2016] [Accepted: 01/04/2016] [Indexed: 12/13/2022]
Affiliation(s)
- F Kordbacheh
- Oral Oncology Research Program; UQ Centre for Clinical Research; University of Queensland; Herston Qld Australia
| | - N Bhatia
- Oral Oncology Research Program; UQ Centre for Clinical Research; University of Queensland; Herston Qld Australia
| | - CS Farah
- Oral Oncology Research Program; UQ Centre for Clinical Research; University of Queensland; Herston Qld Australia
- Australian Centre for Oral Oncology Research & Education; School of Dentistry; University of Western Australia; Nedlands WA Australia
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40
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Kalavrezos N, Scully C. Mouth Cancer for Clinicians Part 6: Potentially Malignant Disorders. ACTA ACUST UNITED AC 2016; 42:866-8, 871-4, 877. [PMID: 26749794 DOI: 10.12968/denu.2015.42.9.866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team, in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. CLINICAL RELEVANCE This article offers the dental team an overview of oral potentially malignant disorders.
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Narayan TV, Shilpashree S. Meta-analysis on clinicopathologic risk factors of leukoplakias undergoing malignant transformation. J Oral Maxillofac Pathol 2016; 20:354-361. [PMID: 27721597 PMCID: PMC5051280 DOI: 10.4103/0973-029x.190900] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Context: Leukoplakia is classified under the term potentially malignant disorder. This term does not suggest the clinician or the patient about the severity of the disease to undergo a malignant transformation. Thus, there arises a need to identify the risk factors associated with malignant transformation (MT) to predict it at the earliest. Aims: To generate evidence regarding the clinicopathologic factors affecting MT in oral leukoplakias. Materials and Methods: Meta-analysis was done by extracting data from all the previous studies published. Articles were searched in PubMed databases. Statistical Analysis: Mixed model by using the PROC MIXED (SAS 9.3) was performed to estimate the effect of different factors such as gender, type of habit (smoking tobacco, gutka, paan (with tobacco) and no habit association), clinical type and histopathology on MT. The lower specific mean for MT was also calculated with respect to the above-mentioned factors. Results: Speckled leukoplakias also known as erythroleukoplakia confirmed to be at the highest risk. Lateral border of the tongue followed by gingiva, buccal mucosa, floor of the mouth, lesions involving tongue and floor of mouth showed increased risk. Smoking tobacco (cigarette and bidi) and idiopathic leukoplakia (without habit) carried almost equal risk. Gender had minimal influence on MT. Histopathologic correlation of grades showed an insignificant bearing on MT. Conclusion: The carcinogenic transformation of a preexisting lesion (leukoplakia) is multifactorial and patient specific. The protocol to delineate a high-risk lesion should include the clinical type and site.
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Affiliation(s)
- T V Narayan
- Private Dental Practitioner, Coles Road, Frazer Town, Bengaluru, Karnataka, India
| | - S Shilpashree
- Department of Oral and Maxillofacial Pathology, The Oxford Dental College, Bengaluru, Karnataka, India
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Liu D, Zhao X, Zeng X, Dan H, Chen Q. Non-Invasive Techniques for Detection and Diagnosis of Oral Potentially Malignant Disorders. TOHOKU J EXP MED 2016; 238:165-77. [PMID: 26888696 DOI: 10.1620/tjem.238.165] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Dongjuan Liu
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Xin Zhao
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
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Ye X, Zhang J, Tan Y, Chen G, Zhou G. Meta-analysis of two computer-assisted screening methods for diagnosing oral precancer and cancer. Oral Oncol 2015; 51:966-975. [PMID: 26384539 DOI: 10.1016/j.oraloncology.2015.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 11/27/2022]
Abstract
The early diagnosis of oral precancer and cancer is crucial and could have the highest impact on improving survival rates. A meta-analysis was conducted to compare the accuracy between the OralCDx brush biopsy and DNA-image cytometry in diagnosing both conditions. Bibliographic databases were systematically searched for original relevant studies on the early diagnosis of oral precancer and oral cancer. Study characteristics were evaluated to determine the accuracy of the two screening strategies. Thirteen studies (eight of OralCDx brush biopsy and five of DNA-image cytometry) were identified as having reported on 1981 oral mucosa lesions. The meta-analysis found that the area under the summary receiver operating characteristic curves of the OralCDx brush biopsy and DNA-image cytometry were 0.8879 and 0.9885, respectively. The pooled sensitivity, specificity, and diagnostic odds ratio of the OralCDx brush biopsy were 86% (95% CI 81-90), 81% (95% CI 78-85), and 20.36 (95% CI 2.72-152.67), respectively, while these modalities of DNA-image cytometry were 89% (95% CI 83-94), 99% (95% CI 97-100), and 446.08 (95% CI 73.36-2712.43), respectively. Results of a pairwise comparison between each modality demonstrated that specificity, area under the curve (AUC), and Q(∗) index of DNA-image cytometry was significantly higher than that of the OralCDx brush biopsy (Z=2.821, p<0.05; Z=1.711, p<0.05; Z=1.727, p<0.05), but no significant difference in sensitivity was found (Z=1.520, p>0.05). In conclusion, the meta-analysis of the published studies indicated that DNA-image cytometry is more accurate than the OralCDx brush biopsy in diagnosing oral precancer and oral cancer.
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Affiliation(s)
- Xiaojing Ye
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Jing Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Yaqin Tan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Guanying Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Gang Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China.
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Abstract
The concept of an oral disease process that presents as a ‘potentially malignant state’ that is neither entirely benign nor frankly malignant is a difficult concept both for clinicians and their affected patients. While it is recognised that a range of oral mucosal conditions, now collectively termed ‘potentially malignant disorders’, harbour an increased risk of squamous carcinoma, we remain frustratingly unable in contemporary clinical practice to predict individual lesion behaviour, quantify the risk of malignant transformation or objectively plan interventions.
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Affiliation(s)
- Peter Thomson
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW
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Scully C. Challenges in predicting which oral mucosal potentially malignant disease will progress to neoplasia. Oral Dis 2015; 20:1-5. [PMID: 24320967 DOI: 10.1111/odi.12208] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 11/11/2013] [Accepted: 11/11/2013] [Indexed: 01/18/2023]
Abstract
Probably the greatest challenge to those managing patients with oral diseases is the dilemma of attempting to predict which oral erythroplakias, leukoplakias, lichenoid and other potentially malignant mucosal disease (PMD) such as oral submucous fibrosis will progress to neoplasia--notably oral squamous cell carcinoma (OSCC). The paper reviews progress over the past decade and the application to the clinical situation.
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Affiliation(s)
- C Scully
- University College of London, London, UK
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46
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Moore C, Mehta V, Ma X, Chaudhery S, Shi R, Moore-Medlin T, Lian T, Nathan CAO. Interobserver agreement of confocal laser endomicroscopy for detection of head and neck neoplasia. Laryngoscope 2015; 126:632-7. [DOI: 10.1002/lary.25646] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2015] [Indexed: 01/17/2023]
Affiliation(s)
- Charles Moore
- Louisiana State University Health Shreveport School of Medicine; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
| | - Vikas Mehta
- Department of Otolaryngology-Head and Neck Surgery; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
- Feist-Weiller Cancer Center; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
| | - Xiaohui Ma
- Department of Otolaryngology-Head and Neck Surgery; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
| | - Shabnum Chaudhery
- Louisiana State University Health Shreveport School of Medicine; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
- Department of Pathology; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
| | - Runhua Shi
- Feist-Weiller Cancer Center; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
| | - Tara Moore-Medlin
- Department of Otolaryngology-Head and Neck Surgery; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
| | - Timothy Lian
- Department of Otolaryngology-Head and Neck Surgery; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
- Feist-Weiller Cancer Center; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
| | - Cherie-Ann O. Nathan
- Department of Otolaryngology-Head and Neck Surgery; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
- Feist-Weiller Cancer Center; Louisiana State University Health Shreveport; Shreveport Louisiana U.S.A
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Mandlik D, Gupta K, Patel D, Patel P, Toprani R, Patel K. Use of 90° Hopkin's Telescopic Examination as an OPD Tool to Clinically Evaluate and Record Oral Cavity Lesions: Our Experience in Early Detection, Especially in Patients with Limited Mouth Opening. J Clin Diagn Res 2015; 9:XC01-XC04. [PMID: 26266199 DOI: 10.7860/jcdr/2015/12493.6018] [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: 12/10/2014] [Accepted: 04/17/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Restricted mouth opening due to premalignant lesions like oral sub-mucous fibrosis, malignancies of oral cavity and postoperative status is very common in Indian patients. It is very difficult to evaluate, document and biopsy the lesions due to inability to access, vast area and diversity of premalignant lesions and subject variations. 90° Hopkin's slender out-patient examination telescope was found useful tool in this. AIM The aim of the study was to evaluate the use of magnified view and reach of a slender telescope to document and examine the oral cavity for any premalignant and malignant lesions, especially for patients with restricted mouth opening and to study its impact on management. MATERIALS AND METHODS A 90(0) Hopkin's telescope was used to evaluate and document oral cavity examination in the Out Patients Department (OPD). The data of first 2000 patients was analysed. RESULTS Difficult to reach areas, where mouth opening was severely restricted was the significant subset. A total of 1394 patients approached OPD for primary diagnosis at our tertiary cancer care centre. Six hundred and six patients were the ones in follow up after treatment in form of Surgery, Chemotherapy or Radiotherapy, or combination. Five twenty three patients (of 1394) with mouth opening ≤ 20mm formed the study group. Telescope guided biopsies were also taken in 50 patients from 56 sites. Serial recordings were compared objectively in premalignant, treatment evaluation and close watch groups. An increase of 5.6% in rate of diagnosis of malignancy was made possible with the help of telescopic examination in patients with mouth opening ≤ 20mm. CONCLUSION A 90(0) Hopkin's telescopic examination is a useful tool to evaluate and record oral cavity lesions, especially in patients with restricted mouth openings. It is a useful tool for screening high risk group, giving definite advantage of objective evaluation and recording of the lesion. It can also be used to objectively evaluate response of neo-adjuvant chemotherapy and as a teaching tool for the fellows.
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Affiliation(s)
- Dushyant Mandlik
- Consultant, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India
| | - Karan Gupta
- Fellow, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India
| | - Daxesh Patel
- Consultant, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India
| | - Purvi Patel
- Consultant, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India
| | - Rajendra Toprani
- Senior Consultant, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India
| | - Kaustubh Patel
- Senior Consultant and Director, Department of Head & Neck Surgical Oncology, Aastha Oncology Associates, HCG Cancer Center , Ahmedabad, Gujarat, India
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The treatment of oral leukoplakia with the CO2 laser: A retrospective study of 65 patients. J Craniomaxillofac Surg 2015; 43:677-81. [PMID: 25913630 DOI: 10.1016/j.jcms.2015.03.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 01/21/2015] [Accepted: 03/18/2015] [Indexed: 02/04/2023] Open
Abstract
The use of CO2 laser has become a routine procedure for the treatment of oral leukoplakia. In this retrospective study, we evaluated 65 patients with oral leukoplakia treated with CO2 laser vaporization. The main location was the tongue (n = 21/65, 32.3%). The initial biopsy showed mild/moderate dysplasia in almost half the patients (n = 29, 44.6%) and hyperplasia without dysplasia in around a third of the patients (n = 21, 32.3%). The recurrence and malignant transformation rates were 33.8% (n = 22) and 15.4% (n = 10), respectively. The follow-up mean (standard deviation) was 15.0 (10.6) months. The procedure-related complications rate was 7.7% (n = 5). The Kaplan-Meier curves for time to recurrence showed differences only for gingiva lesions compared to tongue lesions (log rank, p = 0.032). Malignant leukoplakia transformation is independent of treatment, although it seems advisable to treat leukoplakia with or without dysplasia.
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Mochizuki Y, Harada H, Ikuta M, Shimamoto H, Tomioka H, Tanaka K, Hirai H, Omura K. Clinical characteristics of multiple primary carcinomas of the oral cavity. Oral Oncol 2015; 51:182-9. [DOI: 10.1016/j.oraloncology.2014.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/17/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
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50
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Babji DV, Kale AD, Hallikerimath SR, Kotrashetti VS. Histomorphometric study to compare histological changes between oral squamous cell carcinoma and apparently normal adjacent oral mucosa. Indian J Otolaryngol Head Neck Surg 2015; 67:21-8. [PMID: 25621249 DOI: 10.1007/s12070-014-0730-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 05/02/2014] [Indexed: 11/30/2022] Open
Abstract
Despite the advances in surgery, radiotherapy and chemotherapy the annual death for oral squamous cell carcinoma (OSCC) is rising rapidly. The carcinoma has propensity to develop in a field of cancerization. Clinically may it be apparently normal mucosa (ANM) adjacent to squamous cell carcinoma which harbours certain discrete molecular alteration which ultimately reflects in cellular morphology. Hence the aim of the study is to assess histomorphometric changes in ANM adjacent to OSCC. A prospective study was done on 30 each of histologically diagnosed cases OSCC, ANM at least 1 cm away from OSCC, and normal oral mucosa (NOM). Cellular and nuclear morphometric measurements were assessed on hematoxylin and eosin sections using image analysis software. Statistical analysis was done using analysis of variance test and Tukey's post hoc test. The present study showed significant changes in cellular and nuclear area in superficial and invasive island of OSCC compared to ANM. The basal cells of ANM showed significant decrease in cellular and nuclear areas and nuclear cytoplasmic ratio when compared to NOM. Histomorphometry definitely can differentiate OSCC form ANM and NOM. The basal cells of ANM showed significant alterations in cellular area, nuclear area and nuclear cytoplasmic area when compared to NOM suggesting change in the field and have high risk of malignant transformation. These parameters can be used as indicator of field cancerization.
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Affiliation(s)
- Deepa V Babji
- Department of Oral Pathology and Microbiology, Maratha Mandal's NGH Institute of Dental Sciences, Belgaum, 590010 Karnataka India
| | - Alka D Kale
- Department of Oral Pathology and Microbiology, KLE VK Institute of Dental Sciences, Belgaum, 590010 Karnataka India
| | - Seema R Hallikerimath
- Department of Oral Pathology and Microbiology, KLE VK Institute of Dental Sciences, Belgaum, 590010 Karnataka India
| | - Vijayalakshmi S Kotrashetti
- Department of Oral Pathology and Microbiology, Maratha Mandal's NGH Institute of Dental Sciences, Belgaum, 590010 Karnataka India
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