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Chiewwit P, Khovidhunkit SOP, Tantipoj C, Worakhajit P, Klongnoi B. A study of risk factors associated with the presence of oral potentially malignant disorders: a community-based study from Northeastern Thailand. BMC Oral Health 2024; 24:932. [PMID: 39129030 PMCID: PMC11317011 DOI: 10.1186/s12903-024-04554-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/01/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND The principal objective of this study is to ascertain the connections between well-known risk factors of oral cancer, including smoking (cigarette and tobacco), alcohol consumption, betel quid chewing, irritations in the oral cavity, history of head and neck cancer, and history of working outdoor more than 4 days/week, and the presence of OPMDs within the Thai population. METHOD 349,318 subjects were recruited for initial screening, then 1,483 subjects who had at least 1 risk factor and a suspicious lesion underwent comprehensive oral examinations followed by a clinical diagnosis and then received initial treatment from either oral surgeons or oral medicine specialists. Among these subjects, individuals with at least 1 risk factor and with a clinical diagnosis of OPMDs were classified as cases, while those with at least 1 risk factor but without OPMDs were categorized as controls. The case group comprised a total of 487 subjects, whereas the control group consisted of 996 subjects. Exclusion criteria were known cases of currently having oral cancer or OPMDs. RESULTS The outcomes of the multivariate analysis revealed that among the variables assessed, betel quid (adjusted OR 5.12 [3.93-6.68], p < 0.001) and smoking (adjusted OR 1.46 [1.08-1.97], p = 0.013), there were an association with the presence of OPMDs. Conversely, alcohol drinking, having irritations in the oral cavity, a history of head and neck cancer, and a history of working outdoors more than 4 days/week were not associated with the presence of OPMDs. Furthermore, we also study the synergistic effect of alcohol drinking, irritations in the oral cavity, history of head and neck cancer, and history of working outdoors more than 4 days/week using subgroup analysis. The analysis showed that alcohol consumption combined with smoking or betel quid chewing expressed a significantly increased risk of OPMDs, from 1.46 to 2.03 (OR 2.03 [1.16-3.56], p = 0.014) and from 5.12 to 7.20 (OR 7.20 [3.96-13.09], p < 0.001). CONCLUSION Smoking and exposure to betel quid were a significant risk factors for the presence of OPMDs. The combination of alcohol with smoking or betel quid chewing was also found to increase the risk of OPMDs in this Thai northeastern population.
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Affiliation(s)
- Pim Chiewwit
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Chanita Tantipoj
- Department of Advance General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Prangtip Worakhajit
- Department of Advance General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Boworn Klongnoi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
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Chaowchuen S, Warin K, Somyanonthanakul R, Panichkitkosolkul W, Suebnukarn S. The Discovery of Oral Cancer Prognostic Factor Ranking Using Association Rule Mining. Eur J Dent 2024; 18:907-917. [PMID: 38744326 PMCID: PMC11290937 DOI: 10.1055/s-0043-1777050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE A 5-year survival rate is a predictor for the assessment of oral cancer prognosis. The purpose of this study is to analyze oral cancer data to discover and rank the prognostic factors associated with oral cancer 5-year survival using the association rule mining (ARM) technique. MATERIALS AND METHODS This study is a retrospective analysis of 897 oral cancer patients from a regional cancer center between 2011 and 2017. The 5-year survival rate was assessed. The multivariable Cox proportional hazards analysis was performed to determine prognostic factors. ARM was applied to clinicopathologic and treatment modalities data to identify and rank the prognostic factors associated with oral cancer 5-year survival. RESULTS The 5-year overall survival rate was 35.1%. Multivariable Cox proportional hazards analysis showed that tumor (T) stage, lymph node metastasis, surgical margin, extranodal extension, recurrence, and distant metastasis of tumor were significantly associated with overall survival rate (p < 0.05). The top associated death within 5 years rule was positive extranodal extension, followed by positive perineural and lymphovascular invasion, with confidence levels of 0.808, 0.808, and 0.804, respectively. CONCLUSION This study has shown that extranodal extension, and perineural and lymphovascular invasion were the top ranking and major deadly prognostic factors affecting the 5-year survival of oral cancer.
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Affiliation(s)
| | - Kritsasith Warin
- Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
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Khan AS, Khan ZA, Nisar M, Saeed S, Maryam H, Haq M, Naushin T, Issrani R. Description of clinicopathological characteristics of oral potentially malignant disorders with special focus on two histopathologic grading systems and subepithelial inflammatory infiltrate. J Cancer Res Ther 2023; 19:S724-S730. [PMID: 38384046 DOI: 10.4103/jcrt.jcrt_969_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/06/2022] [Indexed: 02/23/2024]
Abstract
OBJECTIVE This study was conducted to evaluate the clinicopathological features of oral potentially malignant disorders (OPMDs) with a focus on two histologic grading systems and subepithelial inflammatory infiltrates. MATERIALS AND METHODS This cross-sectional and multicenter study was conducted from April 2016 to September 2021 and comprised patients diagnosed with OPMDs. Hematoxylin and eosin-stained slides of 127 cases were assessed based on the World Health Organization (WHO) 2005 classification system, namely, epithelial precursor lesions and binary system of oral epithelial dysplasia (OED). Chi-square test and Fisher's exact test were used to compare different categorical variables related to OPMDs. RESULTS The mean age of OPMD cases at presentation was 54.72 13.30 (P < 0.01) with a male to female ratio of 1.6:1. Oral leukoplakia (52.8%) was the most commonly diagnosed form of OPMD. Most OPMDs were classified as oral epithelial hyperplasia (59.1%) and the remaining (40.9%) as OED (P < 0.01). Of the 52 OPMDs with OED, all cases of mild dysplasia (36.5%) and carcinoma in situ (9.6%) were categorized as low-risk and high-risk lesions, respectively. Chronic inflammatory infiltrate (79.5%) was the most common subepithelial inflammatory alteration observed among OPMDs. CONCLUSIONS Early detection of OPMDs is vital due to increased risk of developing into oral cancer. Timely clinicopathological risk assessment of OPMD is desirable for improving the prognosis and preventing the malignant transformation in oral premalignancy. Besides the epithelial precursor lesions' classification by the WHO, binary system of grading OED use can be encouraged. Also, subepithelial inflammatory infiltrate can be of importance in future research regarding OPMDs.
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Affiliation(s)
- Abbas Saleem Khan
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Zafar Ali Khan
- Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Kingdom of Saudi Arabia
| | - Muhammad Nisar
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Saleha Saeed
- Department of Oral Pathology, Faryal Dental College, Lahore, Pakistan
| | - Hoor Maryam
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Mohsina Haq
- Department of Microbiology, Peshawar Medical College, Riphah International University, Islamabad, Pakistan
| | - Tehmina Naushin
- Department of Oral Pathology, Peshawar Dental College, Riphah International University, Islamabad, Pakistan
| | - Rakhi Issrani
- Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
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4
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Khalesi S, Abbasi A, Razavi SM. Evaluating the Clinicopathologic Parameters of Tongue Squamous Cell Carcinoma based on its Local Distribution. Adv Biomed Res 2023; 12:71. [PMID: 37200763 PMCID: PMC10186057 DOI: 10.4103/abr.abr_197_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 05/20/2023] Open
Abstract
Background Oral squamous cell carcinoma (OSCC) is one of the most common oral lesions and the tongue is one of the most common areas involved. The aim of this study was to evaluate the clinicopathologic feature of tongue SCCs based on its local distribution. Materials and Methods In this cross-sectional study, clinical data such as age, gender, location, and clinical appearance were extracted from the archives of the Oral Pathology Department, Isfahan Dental School, registered with a definitive diagnosis of tongue SCC during 2005-2019. Then, 34 specimens were selected for histopathological evaluation in a simple random way. The histopathologic slides were examined to determine the grade of tumor malignancy. The data were entered into SPSS23 software and analyzed by Chi-square, Fisher exact, One-way ANOVA, and Non-parametric tests. P value <0.05 was considered significant. Results Of the 275 OSCCs, 68 samples were tongue SCC. The mean age of patients was 61.7 ± 15 and 61.8% were women. The most common clinical manifestations were exophytic lesions (42.6%) and the most common site was the lateral border of the tongue (36.8%). The results did not show a significant relationship between the clinicopathologic feature including mean age (p = 0.766), gender (p = 0.338), clinical presentation (p = 0.434), grade of malignancy (p = 0.763) and location. But, among the histopathological parameters, the pattern of invasion (p = 0.047) was significantly associated with the local distribution. Conclusion Given that most OSCCs had moderate differentiation of malignancy, identification of clinical features is needed. Attention to the pattern of invasion and location on the tongue can be effective in determining the therapeutic approach.
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Affiliation(s)
- Saeedeh Khalesi
- Dental Materials Research Center, Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Abbasi
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Mohammad Razavi
- Dental Materials Research Center, Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
- Address for correspondence: Prof. Sayed Mohammad Razavi, Professor, Dental Implant Research Center, Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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Klongnoi B, Sresumatchai V, Clypuing H, Wisutthajaree A, Pankam J, Srimaneekarn N, Shrestha B, Khovidhunkit SOP. Histopathological and risk factor analyses of oral potentially malignant disorders and oral cancer in a proactive screening in northeastern Thailand. BMC Oral Health 2022; 22:613. [PMID: 36527041 PMCID: PMC9756922 DOI: 10.1186/s12903-022-02646-9] [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: 06/17/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Lip and oral cavity cancer has been reported as the 10th most common cancer in Thailand. Recently, a screening program for oral potentially malignant disorders (OPMDs) and oral cancer was conducted in the northeastern Thailand which took into consideration a total of 371,911 people who resided in the provinces of Buriram, Chaiyaphum, Nakhon Ratchasima, and Surin. METHODS A total of 330,914 subjects were consecutively screened for risk factors of oral cancer by village health volunteers (VHVs) using a questionnaire (S1). Then, 186,710 subjects with one or more risk factors for oral cancer were referred for oral screening by dental auxiliaries or dentists at sub-district level hospitals (S2) where 86,941 subjects were subsequently screened. Afterwards, 1576 subjects with suspicious oral lesions for OPMDs or oral cancer attended local hospitals for further investigation and treatment. Oral medicine specialists, oral surgeons, and local dentists at the district level hospitals performed biopsies and the samples were sent for histopathological analysis. The objectives of the study were to report the histopathology findings from the biopsies obtained from these subjects and the associated risk factors. RESULTS Out of 427 subjects who received biopsies, complete diagnostic results were obtained from 409 patients (462 specimens). The 5 most common histopathological results from these specimens were mild epithelial dysplasia (27.3%), fibroepithelial hyperplasia (14.5%), oral lichen planus/oral lichenoid reactions (11.5%), moderate epithelial dysplasia (8%), and acanthosis with or without hyperkeratosis (5%). Oral squamous cell carcinoma was detected in 14 subjects and 11 other forms of oral cancer were revealed. Among the analyzed risk factors, habitual betel quid chewing was established as a statistically significant risk factor associated with OPMDs and oral cancer. CONCLUSION The most frequently observed histopathological results of clinically suspected oral cancer and OPMDs included mild epithelial dysplasia, fibroepithelial hyperplasia, oral lichen planus/oral lichenoid reactions, moderate epithelial dysplasia, and acanthosis with or without hyperkeratosis. Betel quid chewing habit was found to be associated with OPMDs and oral cancer.
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Affiliation(s)
- Boworn Klongnoi
- grid.10223.320000 0004 1937 0490Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Vanvisa Sresumatchai
- grid.10223.320000 0004 1937 0490Department of Family Health, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Harin Clypuing
- Dental Department, Maharat Nakorn Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | | | - Jintana Pankam
- grid.10223.320000 0004 1937 0490Employee of the Development of Disease Management Model for Oral Cancer with an Integration Network of Screening, Surveillance, and Treatment in North East Health District Grant, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Natchalee Srimaneekarn
- grid.10223.320000 0004 1937 0490Department of Anatomy, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Binit Shrestha
- grid.10223.320000 0004 1937 0490Maxillofacial Prosthetic Unit, Department of Prosthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Siribang-on Piboonniyom Khovidhunkit
- grid.10223.320000 0004 1937 0490Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Rd., Rajthewee, Bangkok, 10400 Thailand
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Udompatanakorn C, Taebunpakul P. The Expression of Methyltransferase-Like 3 in Oral Precancerous Lesions and Oral Squamous Cell Carcinoma. Eur J Dent 2022. [PMID: 35785826 DOI: 10.1055/s-0042-1747950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE N6-methyladenosine is the most frequent mRNA modification in eukaryotic cells. It is catalyzed by the methyltransferase complex, methyltransferase-like 3 (METTL3). Previous studies have revealed that METTL3 plays a role in various cancers. However, there is limited information about the roles of METTL3 in oral epithelial dysplasia (OED). This study determined METTL3 expression in normal oral mucosa (NOM), OED, and oral squamous cell carcinoma (OSCC) by immunohistochemistry. MATERIALS AND METHODS Twenty formalin-fixed paraffin embedded specimens each of NOM, OED, and OSCC were included. The expression pattern, the number of positive cells, the staining intensity, and the histochemical score (H-score) of METTL3 were investigated. STATISTICAL ANALYSIS The data were analyzed by using one-way analysis of variance, chi-squared test, and a Kruskal-Wallis test. A p-value < 0.05 indicated statistically significant. RESULTS The METTL3 expression in NOM was observed in the basal, parabasal, and lower layers of epithelium. In low-grade OED, METTL3 was expressed in the lower epithelial layers and partially presented in the spinous layer. However, in high-grade OED, METTL3 expression was observed in the lower layers, spinous layers, and upper layers of dysplastic epithelium. For OSCC, METTL3 immunostaining was presented in both the peripheral and central cells of the tumor islands. All NOM samples showed weak-to-moderate METTL3 staining intensity, while the moderate-to-strong METTL3 staining intensity was observed in 95% of both OED and OSCC specimens (p < 0.05). The percentage of METTL3 positive cells and H-score was highest in OSCC, followed by OED and NOM, respectively (p < 0.05). Interestingly, H-score was greater in high-grade OED (209.8 ± 18.61) when compared with low-grade OED (162.1 ± 38.93) (p < 0.05). CONCLUSION METTL3 expression in OED and OSCC was more outstanding than in NOM, suggesting possible roles for OED and OSCC pathogenesis. Additionally, METTL3 expression may be an indicator for OED progression to OSCC.
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Affiliation(s)
- Chatchaphan Udompatanakorn
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Patrayu Taebunpakul
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
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Ramírez-Martínez CM, Trejo-Remigio DA, Jurado-Castañeda E, Alonso-Moctezuma A, Rivera-Reza DI, Leyva-Huerta ER, Portilla-Robertson J, Jacinto-Alemán LF. Multiple approaches to oral epithelial dysplasia degree analyses: a pilot study. Minerva Dent Oral Sci 2022; 71:59-65. [PMID: 34609112 DOI: 10.23736/s2724-6329.21.04538-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Oral epithelial dysplasia (OED) is the presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer. Our aim was to determine the interrelation between the expression of multiple molecular markers and the histological features of oral dysplasia. METHODS Fifteen samples of OED (five for each severity degree) were analyzed through software assisted image cytometry nuclear morphology. p53 (wild-type and mutated form), Bax and Bcl2 expression was immunohistochemically determined, and the gene expression of MMP1, MMP2, MMP9 and hTERT was determined by RT-PCR. The mean, standard deviation, ANOVA and Fisher's Exact Test (P<0.05) were performed. RESULTS Our analysis indicated congruence between the software-assisted measurement of nuclear morphology and severity degree. Only five samples were positive to p53-mutated form; and Bax was more expressed than Bcl-2. hTERT expression was significantly expressed in relation to severity, and MMP1 was predominantly expressed, followed by MMP9 and MMP2. CONCLUSIONS Our results reinforce that software-assisted measurement is an alternative to severity degree determination. MMP1 is an important marker for severity dysplasia degree; however, the predominant expression of Bax over Bcl-2 suggests that this pro-apoptotic state could be used to minorize the progression, perhaps, as a future therapeutic target.
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Affiliation(s)
- Carla M Ramírez-Martínez
- School of Dentistry, Postgraduate and Research Division, Department of Oral Medicine and Pathology, National Autonomous University of Mexico, Mexico City, Mexico
| | - David A Trejo-Remigio
- School of Dentistry, Postgraduate and Research Division, Department of Oral Medicine and Pathology, Laboratory of Cell Culture and Immunohistochemistry, National Autonomous University of Mexico, Mexico City, Mexico
| | - Emiliano Jurado-Castañeda
- School of Dentistry, Postgraduate and Research Division, Department of Oral Medicine and Pathology, Clinic of Oral Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Alejandro Alonso-Moctezuma
- School of Dentistry, Postgraduate and Research Division, Department of Oral and Maxillofacial Surgery Specialty, National Autonomous University of Mexico, Mexico City, Mexico
| | - Diana I Rivera-Reza
- School of Dentistry, Postgraduate and Research Division, Department of Oral Medicine and Pathology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Elba R Leyva-Huerta
- School of Dentistry, Postgraduate and Research Division, Department of Oral Medicine and Pathology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Javier Portilla-Robertson
- School of Dentistry, Postgraduate and Research Division, Department of Oral Medicine and Pathology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Luis F Jacinto-Alemán
- School of Dentistry, Postgraduate and Research Division, Department of Oral Medicine and Pathology, National Autonomous University of Mexico, Mexico City, Mexico -
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Worakhajit P, Fuangtharnthip P, Khovidhunkit SOP, Chiewwit P, Klongnoi B. The Relationship of Tobacco, Alcohol, and Betel Quid with the Formation of Oral Potentially Malignant Disorders: A Community-Based Study from Northeastern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8738. [PMID: 34444487 PMCID: PMC8392647 DOI: 10.3390/ijerph18168738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 01/05/2023]
Abstract
This study's objective was to describe the relationship between the main risk factors for oral cancer, including tobacco (in the form of cigarettes, smokeless tobacco (SLT), secondhand smoking (SS)), alcohol, and betel quid (BQ), and the occurrence of oral potentially malignant disorders (OPMDs). A community-based case-control study was conducted with a population of 1448 adults aged 40 years or above in northeastern Thailand. Patients aged 60 years or above (OR 1.79, p < 0.001) and female patients (OR 2.17, p < 0.001) had a significant chance of having OPMDs. Our multivariate analysis showed that the most potent risk factor for OPMDs occurrence was betel quid (BQ) (adjusted OR 4.65, p < 0.001), followed by alcohol (OR 3.40, p < 0.001). Even former users were at risk of developing OPMDs. The synergistic effect between these main risk factors was significantly shown in the group exposed to SLT, SS, BQ, and alcohol. The most potent synergistic effect was found in the group exposed to SLT, BQ and alcohol with the OR = 20.96.
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Affiliation(s)
- Prangtip Worakhajit
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; (P.W.); (P.C.)
| | - Pornpoj Fuangtharnthip
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; (P.F.); (S.-o.P.K.)
| | | | - Pim Chiewwit
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; (P.W.); (P.C.)
| | - Boworn Klongnoi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand; (P.W.); (P.C.)
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9
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Yang X, Chen F, Shen X, Zhang C, Liu W. Profiling risk factors of micro-invasive carcinoma within oral potentially malignant disorders: a cross-sectional study. Clin Oral Investig 2020; 24:3715-3720. [PMID: 32902677 DOI: 10.1007/s00784-020-03568-y] [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: 07/26/2020] [Accepted: 09/02/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To investigate the clinicopathological profile and risk factors of micro-invasive carcinoma within oral potentially malignant disorders (OPMD). METHODS Micro-invasive carcinomas were identified in a large prospective series of OPMD patients (n = 810) from eastern China. Logistic regression was applied to evaluate odds ratios (OR) with 95% confidence interval (CI) for indicative of malignant risk in general OPMD. RESULTS Leukoplakia (41.4%), lichen planus (28.0%), and lichenoid lesion (23.7%) were the most 3 clinical subtypes of OPMD. A total of 62 (7.7%) micro-invasive carcinomas within OPMD were identified, and 96.8% of micro-invasive carcinoma was found within leukoplakia and erythroplakia. Multivariate regression analysis revealed that the risk of malignant change within OPMD located on lateral/ventral tongue (OR, 15.1; 95% CI, 1.85-122.8; P = 0.011) was higher than other sites. The risk of malignant change within non-homogenous type (OR, 103.3; 95% CI, 13.39-796.7; P < 0.001) was strikingly higher than other subtypes of OPMD, respectively. Intriguingly, the risk of micro-invasive carcinoma diagnosed in current smoker (OR, 3.96; 95% CI, 1.31-12.02; P = 0.015) was higher than non-smoker. CONCLUSION This large-scale cross-sectional study elucidated the clinical factors and risk assessment of micro-invasive carcinoma within OPMD. CLINICAL RELEVANCE Non-homogenous lesions located on lateral/ventral tongue might be monitored at closer intervals, and the need for rigorous management to detect malignant changes.
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Affiliation(s)
- Xi Yang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Fengcheng Hospital, Fengxian District, Shanghai, China.,Department of Oral and Maxillofacial-Head and Neck Oncology, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fubo Chen
- Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xuemin Shen
- Department of Oral Mucosal Diseases, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenping Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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10
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Li C, Wu L, Deng Y, Shen X, Liu W, Shi L. DNA aneuploidy with image cytometry for detecting dysplasia and carcinoma in oral potentially malignant disorders: A prospective diagnostic study. Cancer Med 2020; 9:6411-6420. [PMID: 32638539 PMCID: PMC7476813 DOI: 10.1002/cam4.3293] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/15/2020] [Accepted: 06/21/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Current evidence on diagnostic value of aneuploidy with DNA image cytometry (ICM) using brushings for oral potentially malignant disorders (OPMD) is limited by sample size and inconsistent classification criteria of aneuploidy. This study aimed to explore the optimal cut-off values of DNA content and evaluate the diagnostic accuracy of DNA-ICM for detecting dysplasia and/or carcinoma in OPMD. MATERIALS AND METHODS A total of 401 consecutive patients with OPMD were enrolled in this prospective diagnostic study. Brushing and biopsy sample form each patient was processed by DNA-ICM and histological examination respectively. RESULTS When the optimal cut-off of at least one aneuploid cell with DNA index (DI) ≥2.3, the area under the curves (AUC) was 0.735 and positive predictive value was 92.7% for detecting dysplasia within OPMD. When the optimal cut-off of at least one aneuploid cell with DI ≥ 3.5, the AUC was 0.851 and negative predictive values was 96.8% for detecting carcinoma within OPMD. Importantly, multivariate analysis revealed that aneuploidy with DI ≥ 2.3 in OPMD was significantly associated with dysplasia risk (adjusted OR, 5.52; 95%CI, 2.90-10.51; P < .001), and aneuploidy with DI ≥ 3.5 in OPMD was strongly associated with malignant risk (adjusted OR, 21.05; 95%CI, 9.34-47.41; P < .001). CONCLUSIONS This largest-scale diagnostic study optimized the criteria of aneuploidy cytology for noninvasive detection of oral dysplasia and carcinoma within OPMD. DNA aneuploidy in OPMD was an independent marker that strongly associated with oral dysplasia/carcinoma. Our findings suggest that DNA-ICM may serve as a useful noninvasive adjunctive tool for oral cancer and OPMD screening.
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Affiliation(s)
- Chenxi Li
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lan Wu
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yiwen Deng
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xuemin Shen
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linjun Shi
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Dhanuthai K, Kintarak S, Subarnbhesaj A, Chamusri N. A Multicenter Study of Tongue Lesions from Thailand. Eur J Dent 2020; 14:435-439. [PMID: 32542633 PMCID: PMC7440959 DOI: 10.1055/s-0040-1713296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Tongue lesions constitute a considerable proportion of the oral lesions. Previous studies on tongue lesions were based on clinical studies. There has been a scarcity of the studies which are based on histopathological examination. This study aimed to determine the prevalence, demographic, and pathologic features of tongue lesions from Thailand. MATERIALS AND METHODS Biopsy records of the participating institutions were reviewed for lesions on the tongue diagnosed during 1998 to 2017. Demographic data were collected from the biopsy records. Locations were arbitrarily classified as dorsal, lateral, and ventral surfaces, tip of the tongue, and the combination of sites. Lesions of the tongue were classified as reactive/inflammatory, developmental, immune-mediated, cystic, benign, premalignant, malignant, infectious, and miscellaneous categories. STATISTICAL ANALYSIS Data were analyzed by descriptive statistics using SPSS version 20.0. RESULTS Of the 44,188 accessioned cases, 2,153 cases (4.87%) were diagnosed from the tongue. The age of the patients ranged from 3 to 93 years with the mean ± standard deviation = 45.26 ± 20.48 years. The female-to-male ratio was 1.49:1. The majority of the tongue lesions were encountered at the lateral border of the tongue (47.66%). Most of the tongue lesions in the present study (53.74%) fell into the reactive/inflammatory category. Irritation fibroma was the most prevalent lesion (18.99%) followed by squamous cell carcinoma (16.91%), and mucus extravasation phenomenon (14.26%), respectively. CONCLUSIONS This study offers new perspective into the study of tongue lesions apart from the clinically based studies. It also demonstrates the difference between the pediatric and the elderly patients. This study provides invaluable database for clinicians when formulating the clinical diagnosis of tongue lesions.
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Affiliation(s)
- Kittipong Dhanuthai
- Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sompid Kintarak
- Department of Stomatology, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Ajiravudh Subarnbhesaj
- Department of Oral Diagnosis, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Nutchapon Chamusri
- Department of Oral Biology and Oral Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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