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González-Moles MÁ, Keim-del Pino C, Ramos-García P. Hallmarks of Cancer Expression in Oral Lichen Planus: A Scoping Review of Systematic Reviews and Meta-Analyses. Int J Mol Sci 2022; 23:13099. [PMID: 36361889 PMCID: PMC9658487 DOI: 10.3390/ijms232113099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 09/05/2023] Open
Abstract
Oral lichen planus (OLP) is a common chronic inflammatory disease of unknown etiology and likely autoimmune nature that is currently considered an oral potentially malignant disorder, implying that patients suffering from this process are at risk of developing oral cancer in their lifetime. The molecular alterations that develop in OLP and that make the affected oral epithelium predisposed to malignancy are unknown, although, as in other autoimmune diseases (ulcerative colitis, primary biliary cirrhosis, etc.), they may be linked to oncogenesis-promoting effects mediated by the inflammatory infiltrate. So far there is no in-depth knowledge on how these hallmarks of cancer are established in the cells of the oral epithelium affected by OLP. In this scoping review of systematic reviews and meta-analyses the state of evidence based knowledge in this field is presented, to point out gaps of evidence and to indicate future lines of research. MEDLINE, Embase, Cochrane Library and Dare were searched for secondary-level studies published before October 2022. The results identified 20 systematic reviews and meta-analyses critically appraising the hallmarks tumor-promoting inflammation (n = 17, 85%), sustaining proliferative signaling (n = 2, 10%), and evading growth suppressors (n = 1, 5%). No evidence was found for the other hallmarks of cancer in OLP. In conclusion, OLP malignization hypothetically derives from the aggressions of the inflammatory infiltrate and a particular type of epithelial response based on increased epithelial proliferation, evasion of growth-suppressive signals and lack of apoptosis. Future evidence-based research is required to support this hypothesis.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Carmen Keim-del Pino
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Challenges in the Early Diagnosis of Oral Cancer, Evidence Gaps and Strategies for Improvement: A Scoping Review of Systematic Reviews. Cancers (Basel) 2022; 14:cancers14194967. [PMID: 36230890 PMCID: PMC9562013 DOI: 10.3390/cancers14194967] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/03/2022] [Accepted: 10/08/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Oral cancer presents a worldwide incidence of 377,713 new cases and 177,757 deaths per year (GLOBOCAN, IARC, WHO). Oral squamous cell carcinoma (OSCC) accounts for approximately 90% of oral malignancies and has a 5-year mortality rate close to 50%. We aim to better understand, based on the evidence, and to discuss in depth, the reasons for the diagnostic delay of oral cancer by reviewing systematic reviews and meta-analyses. We also aim to, identify gaps in evidence, recommend future lines of research that should be implemented, and formulate strategies for improvement. Abstract Oral cancer is a growing problem, accounting for 377,713 worldwide new cases per year, and 177,757 deaths annually and representing a 5-year mortality rate close to 50%, which is a considerable mortality that has not decreased substantially in the last 40 years. The main cause of this high mortality is related to the diagnosis of a high percentage of oral cancers in advanced stages (stages III and IV) in which treatment is complex, mutilating or disabling, and ineffective. The essential cause of a cancer diagnosis at a late stage is the delay in diagnosis, therefore, the achievement of the objective of improving the prognosis of oral cancer involves reducing the delay in its diagnosis. The reasons for the delay in the diagnosis of oral cancer are complex and involve several actors and circumstances—patients, health care providers, and health services. In this paper, we present the results of a scoping review of systematic reviews on the diagnostic delay in oral cancer with the aim to better understand, based on the evidence, and discuss in depth, the reasons for this fact, and to identify evidence gaps and formulate strategies for improvement.
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Ramos-García P, González-Moles MÁ, Warnakulasuriya S. Significance of p53 overexpression in the prediction of the malignant transformation risk of oral potentially malignant disorders: A systematic review and meta-analysis. Oral Oncol 2022; 126:105734. [DOI: 10.1016/j.oraloncology.2022.105734] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/10/2022] [Accepted: 01/19/2022] [Indexed: 12/24/2022]
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Prognosis Parameters of Oral Carcinomas Developed in Proliferative Verrucous Leukoplakia: A Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:cancers13194843. [PMID: 34638327 PMCID: PMC8507842 DOI: 10.3390/cancers13194843] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/29/2022] Open
Abstract
Simple Summary Proliferative verrucous leukoplakia is considered by the WHO as an oral potentially malignant disorder that presents the highest tendency to recurrence and malignant transformation rate. However, to date limited evidence-based prognostic data for oral carcinomas developed in patients with proliferative verrucous leukoplakia (PVL-OC) have been published, and these carcinomas probably perform better than conventional oral carcinomas. In this study we present a systematic review and meta-analysis to evaluate the current evidence in relation to the prognosis of oral carcinomas developed in patients PVL-OC. Abstract Proliferative verrucous leukoplakia (PVL) is contemplated by the World Health Organization (WHO) as an oral potentially malignant disorder (OPMD) with a high the highest malignant transformation ratio among all OPMD (approximately 50%). Our aim was to evaluate the current evidence in relation to the prognosis of oral carcinoma developed in patients with proliferative verrucous leukoplakia (PVL-OC). We searched PubMed, Embase, Web of Science and Scopus for published studies (upper date limit = June 2021). We evaluated the quality of studies (QUIPS tool). We carried out meta-analyses, examined inter-study heterogeneity through subgroup and meta-regression analyses, and performed sensitivity and small-study effects analyses to test the stability and reliability of results. 23 studies met inclusion criteria (505 patients with PVL, of which 288 developed a total of 504 carcinomas). The meta-analyzed overall mortality rate was 21.29% (pooled proportions [PP] = 95% confidence intervals [CI] = 8.77–36.36) for PVL-OC, clearly lower than the 34.7–50% mortality rate for conventional oral cancer reported in previous studies. In comparison with a single study reporting on conventional oral cancers, mortality was significantly lower for PVL-OC (hazard ratio = 0.29 [95%CI = 0.10–0.89], p = 0.03). Univariable meta-regression verified that case series that presented higher proportions of verrucous carcinomas showed a better survival of PVL-OC (p = 0.05), but not with higher proportion of oral squamous cell carcinomas (p = 0.74). Significant differences were not found for other relevant variables such as follow up period (p = 0.44) or multiple tumor development (p = 0.74). In conclusion, PVL-OC show favorable prognostic parameters, especially with regard to the mortality rate.
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Ramos-García P, González-Moles MÁ, Warnakulasuriya S. Oral cancer development in lichen planus and related conditions-3.0 evidence level: A systematic review of systematic reviews. Oral Dis 2021; 27:1919-1935. [PMID: 33616234 DOI: 10.1111/odi.13812] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 12/20/2022]
Abstract
A systematic review of systematic reviews-aka overview of reviews, a novel type of study design providing a tertiary level of evidence-is presented on systematic reviews (SR) and meta-analyses (MTA) evaluating the cancer development in oral lichen planus (OLP), oral lichenoid lesions (OLL), and oral lichenoid reactions (OLR). We searched for SR-MTA published before January 2021. We evaluated the methodological quality of SR-MTA using AMSTAR2 and checked the quality of evidence. Inclusion criteria were met by seven SR-MTA. Oral cancer ratios ranged between 0.44% and 2.28% for OLP, between 1.88% and 3.80% for OLL, and 1.71% for OLR. Significant factors on cancer development reported in SR-MTA were the presence of epithelial dysplasia, the consumption of tobacco and alcohol, the infection by the hepatitis C virus, the presence of atrophic and erosive lesions, and the location on the tongue. Only, one of the SRs assessed the quality of evidence, and most of them were judged to be of critically low methodological quality. In conclusion, based on the reported evidence on cancer incidence in OLP, our results reaffirm classifying OLP as an oral potentially malignant disorder. In relation to OLLs and OLRs, larger studies are necessary to provide further scientific evidence in this regard. Future follow-up studies on OLP and related lesions should be carried out under stricter criteria that improve their quality of evidence and methodological quality.
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Affiliation(s)
- Pablo Ramos-García
- School of Dentistry, University of Granada, Granada, Spain.,Biohealth Research Institute (IBS), Granada, Spain
| | - Miguel Ángel González-Moles
- School of Dentistry, University of Granada, Granada, Spain.,Biohealth Research Institute (IBS), Granada, Spain
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,WHO Collaborating Centre for Oral Cancer, London, UK
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Clinicopathological and prognostic characteristics of oral squamous cell carcinomas arising in patients with oral lichen planus: A systematic review and a comprehensive meta-analysis. Oral Oncol 2020; 106:104688. [PMID: 32305649 DOI: 10.1016/j.oraloncology.2020.104688] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 03/28/2020] [Accepted: 04/05/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate current evidence in relation to the prognostic and clinicopathological significance of oral squamous cell carcinomas arising in patients with oral lichen planus (OLP-OSCC). MATERIAL AND METHODS We searched PubMed, Embase, Web of Science and Scopus for studies published before May-2019. We evaluated the quality of studies (QUIPS tool). We carried out meta-analyses to fulfill our objective. We examined the between-study heterogeneity and small-study effects, and conducted sensitivity and subgroup analyses. RESULTS Inclusion criteria were met by 27 studies (10,505 patients with OLP, of whom 205 developed a total of 247 OSCCs). The combined 5-year mortality rate was 15.48% for OLP-OSCC (95%CI = 7.34-25.19), clearly lower than the 34.70-50.00% mortality rate for conventional oral cancer communicated in previous official reports. Also, 14.67% (95%CI = 6.34-24.81) of OLP-OSCC developed N+ status, compared to 47.00% of conventional oral carcinomas. Likewise, most of the OSCCs in the study were T1/T2 (93.57%, 95%CI = 82.20-99.88) and presented at stage I/II (81.51%, 95%CI = 68.32-92.38) at the time of diagnosis, which contrasts with 50.00% of conventional carcinomas diagnosed in stages I/II. Furthermore, most of the cases were grade I (well differentiated OSCC) (67.79%; 95%CI = 43.50-88.65), in comparison to conventional OSCCs, which present typically in grade II in 90.00% of cases. Our results also show an 11.21% of the OLP-OSCC patients in this study developed multiple tumors. CONCLUSIONS Oral squamous cell carcinomas that developed in oral lichen planus show favorable prognostic parameters, especially with regard to the mortality rate. Around 11% of OLP-OSCC patients develop multiple tumors, which confirms that OLP can lead to field cancerization.
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González-Ruiz L, González-Moles MÁ, González-Ruiz I, Ruiz-Ávila I, Ayén Á, Ramos-García P. An update on the implications of cyclin D1 in melanomas. Pigment Cell Melanoma Res 2020; 33:788-805. [PMID: 32147907 DOI: 10.1111/pcmr.12874] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 02/03/2020] [Accepted: 03/02/2020] [Indexed: 12/13/2022]
Abstract
Cyclin D1 is a protein encoded by the CCND1 gene, located on 11q13 chromosome, which is a key component of the physiological regulation of the cell cycle. CCND1/cyclin D1 is upregulated in several types of human tumors including melanoma and is currently classified as an oncogene that promotes uncontrolled cell proliferation. Despite the demonstrated importance of CCND1/cyclin D1 as a central oncogene in several types of human tumors, its knowledge in melanoma is still limited. This review examines data published on upregulation of the CCND1 gene and cyclin D1 protein in the melanoma setting, focusing on the pathways and molecular mechanisms involved in the activation of the gene and on the clinical and therapeutic implications.
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Affiliation(s)
- Lucia González-Ruiz
- Dermatology Service, Ciudad Real General University Hospital, Ciudad Real, Spain
| | | | | | - Isabel Ruiz-Ávila
- Biohealth Research Institute, Granada, Spain.,Pathology Service, San Cecilio Hospital Complex, Granada, Spain
| | - Ángela Ayén
- Dermatology Service, San Cecilio Hospital Complex, Granada, Spain
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Lou J, Liu L, Zhang W, Zhou Z, Fan Y. Differential expression of ghrelin and GHSR via the mTOR pathway during the dynamic carcinogenic process involving oral, potentially malignant disorders. Biosci Rep 2019; 39:BSR20192102. [PMID: 31750884 PMCID: PMC6923334 DOI: 10.1042/bsr20192102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/12/2019] [Accepted: 11/18/2019] [Indexed: 02/08/2023] Open
Abstract
The purpose was to explore the sequence changes in ghrelin and GHSR in the mTOR signaling pathway during carcinogenesis involving oral, potentially malignant disorders (OPMD). The samples were confirmed through in vivo pathologic tissue screening and diagnosis. The immunohistochemical method was used to detect the expression of the ghrelin/growth hormone secretagogue receptor (GHSR) protein. The expression of ghrelin, GHSR 1α, GHSR 1β, and mammalian target of rapamycin (mTOR) RNA were detected by real-time PCR. The expression of ghrelin, GHSR, mTOR, and phosphorylated mTOR (phosphor-mTOR) protein were detected by Western blot. The expression of ghrelin/GHSR increased gradually in the dynamic process of OPMD carcinogenesis. There was a correlation between the increase in ghrelin, GHSR, mTOR, and phospho-mTOR. The in vivo expression of ghrelin/GHSR protein was the most apparent pathologic change from normal-to-mild, moderate, and severe dysplasia, and finally to the dynamic process from normal-to-mild-to-moderate dysplasia. The in vitro cell experiments based on QPCR results also proved that GHSR 1a functional receptor of ghrelin had a peak expression in LEUK-1 cells. In conclusioin, the close relationship between ghrelin and OPMD carcinogenesis can be used as a new biological target to assess the carcinogenesis of OPMD.
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Affiliation(s)
- Jianing Lou
- Department of Stomatology, Shanghai General Hospital of Nanjing Medical University, Shanghai 201620, China
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Lin Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Weizhen Zhang
- Department of Surgery, Medical School, University of Michigan, Ann Arbor, MI 48109, U.S.A
| | - Zengtong Zhou
- Department of Oral Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Yuan Fan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
- Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
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Feng J, Zhou Z, Shi L, Yang X, Liu W. Cancer stem cell markers ALDH1 and Bmi1 expression in oral erythroplakia revisited: Implication for driving the process of field cancerization. J Oral Pathol Med 2019; 49:96-99. [PMID: 31444928 DOI: 10.1111/jop.12955] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/22/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
The correlation of ALDH1 and Bmi1 expression in potentially malignant oral erythroplakia (OE) with oral carcinoma development was reported in our earlier study. Interestingly, a model of field cancerization orchestrated by the cancer stem cells (CSC) was proposed and suggested the identification of CSC-specific markers is useful for prognosis and providing novel targets for prevention and treatment of field cancerization. We revisited the correlation of ALDH1 and Bmi1 expression in OE with the second and multiple carcinomas development. Strikingly, we observed that the expression of ALDH1 and Bmi1 within a single potentially malignant OE lesion significantly correlate with subsequently developing multiple and multifocal carcinomas, which parallels the process of oral field cancerization. Significantly, ALDH1 and Bmi1 are well-defined markers of CSC for head and neck cancer. Consequently, we provided a preliminary evidence for CSC driving the process of field cancerization.
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Affiliation(s)
- Jinqiu Feng
- Department of Pediatric Dentistry, Shanghai Stomatological Hospital, Fudan University, Shanghai, China.,Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Zengtong Zhou
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linjun Shi
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Yang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yang X, Shi L, Zhou Z, Liu W. Podoplanin and ABCG2 expression in oral erythroplakia revisited: Potential evidence for cancer stem cells driving the process of field cancerization. Oral Oncol 2019; 101:104368. [PMID: 31300272 DOI: 10.1016/j.oraloncology.2019.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/03/2019] [Accepted: 07/06/2019] [Indexed: 11/30/2022]
Abstract
A model of field cancerization orchestrated by the cancer stem cells (CSC) was proposed. Podoplanin and ABCG2 are promising marker of CSCs for head and neck cancer. We revisited the correlation of the two markers with the follow-up data of the patients with oral erythroplakia (OE). Strikingly, we observed that the expression of podoplanin and ABCG2 within a single pre-neoplastic OE lesion significantly correlate with subsequently developing multiple and multifocal carcinomas, thus to some extent demonstrating the concept of field cancerization. Collectively, a point to highlight was that a preliminary evidence that provided by this revisited study supported the perspective on cancer stem cells driving the process of field cancerization.
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Affiliation(s)
- Xi Yang
- Department of Oral and Maxillofacial-Head and Neck Oncology, 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
| | - Linjun Shi
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zengtong Zhou
- Department of Oral Mucosal Diseases, 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, 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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Ramos-García P, González-Moles MÁ, González-Ruiz L, Ayén Á, Ruiz-Ávila I, Bravo M, Gil-Montoya JA. Clinicopathological significance of tumor cyclin D1 expression in oral cancer. Arch Oral Biol 2019; 99:177-182. [DOI: 10.1016/j.archoralbio.2019.01.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 12/11/2022]
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Ramos-García P, González-Moles MÁ, Ayén Á, González-Ruiz L, Ruiz-Ávila I, Lenouvel D, Gil-Montoya JA, Bravo M. Asymmetrical proliferative pattern loss linked to cyclin D1 overexpression in adjacent non-tumour epithelium in oral squamous cell carcinoma. Arch Oral Biol 2019; 97:12-17. [DOI: 10.1016/j.archoralbio.2018.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/20/2018] [Accepted: 10/06/2018] [Indexed: 12/12/2022]
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Ge W, Jiao Y, Chang L. The association between MTHFR gene polymorphisms (C677T, A1298C) and oral squamous cell carcinoma: A systematic review and meta-analysis. PLoS One 2018; 13:e0202959. [PMID: 30142181 PMCID: PMC6108503 DOI: 10.1371/journal.pone.0202959] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 08/13/2018] [Indexed: 01/10/2023] Open
Abstract
A consensus has not been reached regarding the association of MTHFR gene polymorphism and susceptibility to oral squamous cell carcinoma (OSCC). We performed a meta-analysis to better evaluate the association between MTHFR C677T, A1298C polymorphism and OSCC risk. The studies regarding the association of MTHFR C677T, A1298C polymorphisms and OSCC were identified in PubMed and EMBASE and Google Scholar. The pooled odd rates (ORs) with 95%CIs were estimated using a fixed-effect or random-effect model. The associations between MTHFR polymorphisms and OSCC risk were assessed under the dominant, recessive and additive models. A collective total of 1539 OSCC patients and 2131 normal controls were included across 13 studies. The minor T allele of MTHFR C677T was significantly associated with the increased risk of OSCC development(OR = 1.35, 95%CI 1.04-1.76). Individuals carrying the ''T" allele (TT+CT) had a nearly 43% increased risk for OSCC development when compared with CC (OR = 1.43, 95%CI 1.02-1.99). Under additive model, the results also showed that individuals with CT or TT genotype were more susceptible to OSCC than CC (OR = 1.45, 95%CI 1.02-2.08; OR = 1.79, 95%CI 1.28-2.50; respectively). The subgroup analysis by ethnicity revealed that significant difference in C677T allele distribution could be observed in European (OR = 1.33, 95%CI 1.02-1.75) rather than Asian (OR = 1.59, 95%CI 0.91-2.78). No significant association of MTHFR A1298C polymorphism and OSCC risk could be observed. The present study revealed that T allele and TT genotype of MTHFR C677T polymorphism were significantly associated with the increased risk of OSCC development.
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Affiliation(s)
- Wenzhang Ge
- Department of Special Clinic, Jinan Stomatological Hospital, Jinan, Shandong, P.R. China
| | - Yang Jiao
- Department of Medicine and Education, Jinan Stomatological Hospital, Jinan, Shandong, P.R. China
| | - Lianzhen Chang
- Department of Periodontics and Oral Medicine, Jinan Stomatological Hospital, Jinan, Shandong, P.R. China
- * E-mail:
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Kumar M, Prasad UC, Chandolia B, Manjunath SM, Basu S, Verma S. Can Feulgen Stain be a Reliable Biomarker over PAP Stain for Estimation of Micronuclei Score? J Clin Diagn Res 2016; 10:ZC07-ZC11. [PMID: 27891448 DOI: 10.7860/jcdr/2016/18859.8630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 07/20/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Malignant transformation of the Potentially Malignant Lesions (PML) in the oral cavity is associated with elevated mortality rate because of its aggressive and exceedingly invasive nature. Meticulous diagnosis and prompt therapy of PML may help prevent malignant conversion in oral lesions. Carcinogenic insult to oral cells results in chromosomal damage and formation of Micronuclei (Mn), before the development of clinical symptoms. AIM To determine the genotoxic effect of smoking and chewing tobacco on target tissue using Mn assay and to evaluate the prevalence of other nuclear anomalies associated with it and to determine the reliability of feulgen stain for Mn assay over Papaincolau (PAP) stain. MATERIALS AND METHODS PAP and feulgen staining was done to study Mn in individuals who were having tobacco habits (smoking and chewing) without lesion (n=30), individuals who were having tobacco habit (smoking and chewing) with PML (n=30) and apparently healthy subjects (n=30). Data was analysed for statistical significance using SPSS 17.0 by Kruskal - Wallis Test and Bonferronii test. RESULTS Tobacco habits in the form of smoking and chewing have mutagenic effects on human chromosomes which is indicated by increased frequency of Mn in oral exfoliative cells. The mean Mn frequency using feulgen stain was found to be 12.27 with lesion, 10.23 with without lesion and 3.87 in controls. Whereas, metanucleated analysis revealed no significant correlation with the formation of Mn. Non-specific DNA stain (PAP) showed high numbers of Mn cells in all the groups compared to feulgen. Statistically significant difference (p<0.0001) was observed when both the stains were compared for Mn numbers. CONCLUSION These findings indicate that the individuals having tobacco habits (smoking and chewing) with lesion have high number of Mn cells, thus supporting the assay to be used as a reliable biomarker to assess the genotoxic effect of tobacco in the oral mucosa. The reason for almost twice as high Mn in PAP stained smears is suggestive of cell injury which is collimated by formation of keratin bodies, resulting in its misinterpretation as Mn, leading to false positive results. Hence, it was concluded that PAP stain can be used to identify abnormal cytological changes resulting from mutagenic agent but not to interpret Mn.
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Affiliation(s)
- Manish Kumar
- Senior Lecturer, Department of Oral Pathology, Tatyasaheb Kore Dental College and Research Centre , Kolhapur, Maharashtra, India
| | - Umesh Chandra Prasad
- Professor and Head of Department, Department of Oral Pathology, Kanti Devi Dental College , Mathura, Uttar Pradesh, India
| | - Betina Chandolia
- Senior Lecturer, Department of Oral Pathology, NIMS , Jaipur, Rajasthan, India
| | - S M Manjunath
- Professor, Department of Oral Pathology, Surendra Dental College , Sriganganagar, Rajasthan, India
| | - Shiva Basu
- Professor, Department of Oral Pathology, Gurunanak Dental College and Research Institute , Sunam, Punjab, India
| | - Silvie Verma
- Demonstrator, Department of Oral Pathology, Tatyasaheb Kore Dental College and Research Centre , Kolhapur, Maharashtra, India
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Garcia N, González-Moles M, Ruiz-Ávila I, Bravo M, Ramos-García P, Minicucci E, Domingues M, Oliveira D. Asymmetrical proliferative pattern loss linked to cyclin D1 overexpression during malignant transformation of the lip epithelium. J Eur Acad Dermatol Venereol 2016; 30:1315-20. [DOI: 10.1111/jdv.13671] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 03/03/2016] [Indexed: 12/24/2022]
Affiliation(s)
- N.G. Garcia
- Stomatology Department; Area of Pathology; Bauru School of Dentistry; University of São Paulo; Bauru São Paulo Brazil
- Oral Medicine Department; School of Dentistry; Instituto de Biomedicina; University of Granada; Granada Spain
| | - M.A. González-Moles
- Oral Medicine Department; School of Dentistry; Instituto de Biomedicina; University of Granada; Granada Spain
| | - I. Ruiz-Ávila
- Unidad de Gestión Clínica de Anatomía Patológica; Instituto de Biomedicina de Granada Complejo Hospitalario san Cecilio; Granada Spain
| | - M. Bravo
- Oral Medicine Department; School of Dentistry; Instituto de Biomedicina; University of Granada; Granada Spain
| | - P. Ramos-García
- Oral Medicine Department; School of Dentistry; Instituto de Biomedicina; University of Granada; Granada Spain
| | - E.M. Minicucci
- Pathology Department; Botucatu School of Medicine; State University of São Paulo; Botucatu São Paulo Brazil
| | - M.A.C. Domingues
- Pathology Department; Botucatu School of Medicine; State University of São Paulo; Botucatu São Paulo Brazil
| | - D.T. Oliveira
- Stomatology Department; Area of Pathology; Bauru School of Dentistry; University of São Paulo; Bauru São Paulo Brazil
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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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Smetsers SE, Velleuer E, Dietrich R, Wu T, Brink A, Buijze M, Deeg DJH, Soulier J, Leemans CR, Braakhuis BJM, Brakenhoff RH. Noninvasive molecular screening for oral precancer in Fanconi anemia patients. Cancer Prev Res (Phila) 2015; 8:1102-11. [PMID: 26276748 DOI: 10.1158/1940-6207.capr-15-0220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 08/05/2015] [Indexed: 11/16/2022]
Abstract
LOH at chromosome arms 3p, 9p, 11q, and 17p are well-established oncogenetic aberrations in oral precancerous lesions and promising biomarkers to monitor the development of oral cancer. Noninvasive LOH screening of brushed oral cells is a preferable method for precancer detection in patients at increased risk for head and neck squamous cell carcinoma (HNSCC), such as patients with Fanconi anemia. We determined the prevalence of LOH in brushed samples of the oral epithelium of 141 patients with Fanconi anemia and 144 aged subjects, and studied the association between LOH and HNSCC. LOH was present in 14 (9.9%) nontransplanted patients with Fanconi anemia, whereas LOH was not detected in a low-risk group (n = 50, >58 years, nonsmoking/nonalcohol history) and a group with somewhat increased HNSCC risk (n = 94, >58 years, heavy smoking/excessive alcohol use); Fisher exact test, P = 0.023 and P = 0.001, respectively. Most frequent genetic alteration was LOH at 9p. Age was a significant predictor of LOH (OR, 1.13, P = 0.001). Five patients with Fanconi anemia developed HNSCC during the study at a median age of 39.6 years (range, 24.8-53.7). LOH was significantly associated with HNSCC (Fisher exact test, P = 0.000). Unexpectedly, the LOH assay could not be used for transplanted patients with Fanconi anemia because donor DNA in brushed oral epithelium, most likely from donor leukocytes present in the oral cavity, disturbed the analysis. Noninvasive screening using a LOH assay on brushed samples of the oral epithelium has a promising outlook in patients with Fanconi anemia. However, assays need to be adapted in case of stem cell transplantation, because of contaminating donor DNA.
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Affiliation(s)
- Stephanie E Smetsers
- Section Tumor Biology, Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Eunike Velleuer
- Clinic of Pediatric Oncology, Hematology and Clinical Immunology, Center for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Ralf Dietrich
- Fanconi-Anämie Hilfe e.V., Unna-Siddinghausen, Germany
| | - Thijs Wu
- Section Tumor Biology, Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Arjen Brink
- Section Tumor Biology, Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Marijke Buijze
- Section Tumor Biology, Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Jean Soulier
- Department of Hematology, Saint Louis Hospital, Paris, France
| | - C René Leemans
- Section Tumor Biology, Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Boudewijn J M Braakhuis
- Section Tumor Biology, Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Ruud H Brakenhoff
- Section Tumor Biology, Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
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Abstract
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 a simplified overview of carcinogenesis, and a review of cancers that affect the oral region.
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19
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Simple M, Suresh A, Das D, Kuriakose MA. Cancer stem cells and field cancerization of Oral squamous cell carcinoma. Oral Oncol 2015; 51:643-51. [DOI: 10.1016/j.oraloncology.2015.04.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/02/2015] [Accepted: 04/04/2015] [Indexed: 12/20/2022]
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Abstract
Oral and oropharyngeal cancer (OPC) is a complex and often relentless malignancy prone to local invasion and dissemination. Despite advances in understanding of the disease and improved therapeutic interventions, it continues to be diagnosed at an advanced stage and the survival rate remains poor. The financial cost of treating OPC may be the highest of all cancers in the United States and survivors often experience major detriments to quality of life. Major risk factors for OPC are tobacco, alcohol, areca nut, and human papillomavirus infection. This article updates medical practitioners on the causes, presentation, diagnosis, and management of OPC.
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Affiliation(s)
- Michaell A Huber
- Department of Comprehensive Dentistry, University of Texas Health Science Center, School of Dentistry, 7703 Floyd Curl Drive, Mail Code 7919, San Antonio, TX 78229, USA.
| | - Bundhit Tantiwongkosi
- Department of Radiology, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, Mail Code 7800, San Antonio, TX 78229, USA; Department of Otolaryngology, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, Mail Code 7800, San Antonio, TX 78229, USA
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van der Waal I. Oral potentially malignant disorders: is malignant transformation predictable and preventable? Med Oral Patol Oral Cir Bucal 2014; 19:e386-90. [PMID: 24905952 PMCID: PMC4119315 DOI: 10.4317/medoral.20205] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 05/28/2014] [Indexed: 01/14/2023] Open
Abstract
Leukoplakia is the most common potentially malignant disorder of the oral mucosa. The prevalence is approximately 1% while the annual malignant transformation ranges from 2% to 3%. At present, there are no reliable clinicopathological or molecular predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented. Furthermore, follow-up programs are of questionable value in this respect. Cessation of smoking habits may result in regression or even disappearance of the leukoplakia and will diminish the risk of cancer development either at the site of the leukoplakia or elsewhere in the mouth or the upper aerodigestive tract.
The debate on the allegedly potentially malignant character of oral lichen planus is going on already for several decades. At present, there is a tendency to accept its potentially malignant behaviour, the annual malignant transformation rate amounting less than 0.5%. As in leukoplakia, there are no reliable predicting factors of malignant transformation that can be used in an individual patient and such event can not truly be prevented either. Follow-up visits, e.g twice a year, may be of some value.
It is probably beyond the scope of most dentists to manage patients with these lesions in their own office. Timely referral to a specialist seems most appropriate, indeed.
Key words:Oral potentially malignant disorders, oral leukoplakia, oral lichen planus.
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Affiliation(s)
- Isaäc van der Waal
- VU Medical Center, Department of Oral and Maxillofacial, Surgery/Pathology and Academic Centre for Dentistry, (ACTA), Amsterdam, P.O. Box 7057, 1007MB, Amsterdam, The Netherlands, i.vander
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22
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Dotto GP. Multifocal epithelial tumors and field cancerization: stroma as a primary determinant. J Clin Invest 2014; 124:1446-53. [PMID: 24691479 DOI: 10.1172/jci72589] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
It is increasingly evident that cancer results from altered organ homeostasis rather than from deregulated control of single cells or groups of cells. This applies especially to epithelial cancer, the most common form of human solid tumors and a major cause of cancer lethality. In the vast majority of cases, in situ epithelial cancer lesions do not progress into malignancy, even if they harbor many of the genetic changes found in invasive and metastatic tumors. While changes in tumor stroma are frequently viewed as secondary to changes in the epithelium, recent evidence indicates that they can play a primary role in both cancer progression and initiation. These processes may explain the phenomenon of field cancerization, i.e., the occurrence of multifocal and recurrent epithelial tumors that are preceded by and associated with widespread changes of surrounding tissue or organ "fields."
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González-Moles MA, Plaza-Campillo J, Ruiz-Ávila I, Herrera P, Bravo M, Gil-Montoya JA. Asymmetrical proliferative pattern loss during malignant transformation of the oral mucosa. J Oral Pathol Med 2014; 43:507-13. [DOI: 10.1111/jop.12164] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- M. A. González-Moles
- School of Dentistry; Instituto de Biomedicina de Granada; University of Granada; Granada Spain
| | - J. Plaza-Campillo
- School of Dentistry; Instituto de Biomedicina de Granada; University of Granada; Granada Spain
| | - I. Ruiz-Ávila
- Unidad de Gestión Clínica de Anatomía Patológica; Instituto de biomedicina de Granada Complejo Hospitalario san Cecilio; Granada Spain
| | - P. Herrera
- School of Dentistry; Instituto de Biomedicina de Granada; University of Granada; Granada Spain
| | - M. Bravo
- School of Dentistry; Instituto de Biomedicina de Granada; University of Granada; Granada Spain
| | - J. A. Gil-Montoya
- School of Dentistry; Instituto de Biomedicina de Granada; University of Granada; Granada Spain
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Rettori MM, de Carvalho AC, Longo ALB, de Oliveira CZ, Kowalski LP, Carvalho AL, Vettore AL. TIMP3 and CCNA1 hypermethylation in HNSCC is associated with an increased incidence of second primary tumors. J Transl Med 2013; 11:316. [PMID: 24359512 PMCID: PMC3884019 DOI: 10.1186/1479-5876-11-316] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 12/17/2013] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Hypermethylation in the promoter regions is associated with the suppression of gene expression and has been considered a potential molecular marker for several tumor types, including head and neck squamous cell carcinomas (HNSCC). METHODS To evaluate the gene hypermethylation profile as a prognostic marker, this retrospective study used a QMSP approach to determine the methylation status of 19 genes in 70 HNSCC patients. RESULTS The methylation profile analysis of primary HNSCC revealed that genes CCNA1, DAPK, MGMT, TIMP3 and SFRP1 were frequently hypermethylated, with high specificity and sensitivity. TIMP3 and CCNA1 hypermethylation was significantly associated with lower rates of second primary tumor-free survival (p = 0.007 and p = 0.001; log-rank test, respectively). CONCLUSION This study, for the first time, presents CCNA1 and TIMP3 hypermethylation as a helpful tool to identify HNSCC subjects at risk of developing second primary carcinomas.
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Affiliation(s)
| | | | | | | | | | | | - André Luiz Vettore
- Cancer Molecular Biology Laboratory, Department of Biological Sciences, Federal University of São Paulo, 04039-020, São Paulo, Brazil.
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26
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Aldehyde dehydrogenase 1 expression correlated with malignant potential of oral lichen planus. Ann Diagn Pathol 2013; 17:408-11. [DOI: 10.1016/j.anndiagpath.2013.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 04/18/2013] [Indexed: 01/10/2023]
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27
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Sun L, Feng J, Ma L, Liu W, Zhou Z. CD133 expression in oral lichen planus correlated with the risk for progression to oral squamous cell carcinoma. Ann Diagn Pathol 2013; 17:486-9. [PMID: 23911820 DOI: 10.1016/j.anndiagpath.2013.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 06/27/2013] [Indexed: 11/19/2022]
Abstract
Oral lichen planus (OLP) is a potentially malignant disorder associated with an increased risk for progression to oral squamous cell carcinoma (OSCC). The objective of this study to determine protein expression of cancer stem cell marker CD133 in tissue samples of patients with OLP and evaluate the correlation between CD133 expression and the risk of progression to OSCC. In this longitudinal case-control study, a total of 110 patients with OLP who received a mean follow-up of 56 months were enrolled, including 100 patients who did not progress to OSCC and 10 patients who had progressed to OSCC. CD133 expression was determined using immunohistochemistry in samples from these patients. Analysis of 10 cases of normal oral mucosa and 6 cases of postmalignant OSCC form previously diagnosed OLP was also performed. The results showed that CD133 expression was observed in 29% cases of nonprogressing OLP and in 80% cases of progressing OLP (P = .002). CD133 was not expressed in normal oral mucosa, but it positively expressed in the 100% cases of OSCC. Logistic regression analysis revealed that the risk of malignant progression in the patients with CD133-positive expression was significantly higher than those with CD133 negativity (odds ratio, 9.79; 95% confidence interval, 1.96-48.92; P = .005). Collectively, CD133 expression was significantly associated with malignant progression in a longitudinal series of patients with OLP. Our findings suggested that CD133 may serve as a novel candidate biomarker for risk assessment of malignant potential of OLP.
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Affiliation(s)
- Lili Sun
- Department of Stomatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Artificial Cell, Tianjin, China.
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28
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The cancer stem cell hypothesis applied to oral carcinoma. Oral Oncol 2013; 49:738-46. [PMID: 23642758 DOI: 10.1016/j.oraloncology.2013.04.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 04/09/2013] [Accepted: 04/09/2013] [Indexed: 12/14/2022]
Abstract
It has been proposed that the development of tumors is based exclusively on the activity of cancer stem cells (CSCs) leading to a new model of carcinogenesis, the CSC hypothesis, in opposition to the conventional model of clonal evolution. The new model may help to explain the high mortality of oral cancer, unchanged over the past decades, the low response to treatment and the tendency of oral squamous cell carcinoma (OSCC) patients to develop multiple tumors. However, a more profound understanding of the molecular pathways involved in maintaining the stem cell (SC) state and of their alterations is required to elucidate the mechanisms underlying the development of tumors and metastatic spread, but research into SC biopathology is hampered by the lack of specific markers for identifying SCs and CSCs in tissues and for establishing topographic relationships with their lineage. We review current knowledge on stem cells in relation to oral cancer, including their possible origins, focusing on the CSC hypothesis of oral tumorigenesis and attempts being made to identify oral stem cells.
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29
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Ma L, Wang H, Yao H, Zhu L, Liu W, Zhou Z. Bmi1 expression in oral lichen planus and the risk of progression to oral squamous cell carcinoma. Ann Diagn Pathol 2013; 17:327-30. [PMID: 23639414 DOI: 10.1016/j.anndiagpath.2013.03.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 03/20/2013] [Indexed: 11/18/2022]
Abstract
Oral lichen planus (OLP) is a potentially malignant disorder associated with an increased risk of progression to oral squamous cell carcinoma (OSCC). The objective of this study was to determine protein expression of cancer stem cell factor Bmi1 in a longitudinal series of patients with OLP and evaluate the correlation between Bmi1 expression and the risk of progression to OSCC. In a retrospective study, Bmi1 expression was determined using immunohistochemistry in samples from 96 patients with OLP who received a mean follow-up of 54 months, including patients who did not progress to OSCC (n=87) and patients who had progressed to OSCC (n=9). Analysis of 10 cases of normal oral mucosa and 6 cases of postmalignant OSCC form previously diagnosed OLP was also performed. The results showed that Bmi1 expression was observed in 32 (36.8%) of 87 cases of nonprogressing OLP and in 8 (88.9%) of 9 cases of progressing OLP. Bmi1 was not expressed in normal oral mucosa, but it was positively expressed in the 6 (100%) cases of OSCC. Multivariate analysis revealed that the risk of malignant progression in the patients with Bmi1-positive expression was significantly higher than those with Bmi1 negativity (odds ratio, 20.75; 95% confidence interval, 2.21-194.57; P=.008). Collectively, Bmi1 expression was significantly associated with malignant transformation in a large series of patients with OLP who received a longitudinal observation. Our findings suggested that Bmi1 may serve as a useful marker for the identification of a high risk of malignant progression of OLP.
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Affiliation(s)
- Lihua Ma
- School of Stomatology, Zhengzhou University, Zhengzhou, Henan, China.
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30
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Braakhuis BJM, Brakenhoff RH, Leemans CR. Treatment choice for locally advanced head and neck cancers on the basis of risk factors: biological risk factors. Ann Oncol 2013; 23 Suppl 10:x173-7. [PMID: 22987957 DOI: 10.1093/annonc/mds299] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Patients with locally advanced head and neck squamous cell carcinoma often experience relapse, the cause of poor survival statistics. Relapse occurs following the three main types of treatment, surgery with or without post-operative (chemo)radiotherapy, or chemoradiation (containing cisplatin). Cancer relapse can result from (i) outgrowth of residual tumour cells, sometimes with a number too small to be detected by routine histopathology or (ii) development of another carcinoma in a field of pre-neoplastic cells that has remained after treatment of the primary carcinoma. At this moment, clinical staging is not enough to identify patients who will develop relapse and who need tailored treatment. This review describes the latest knowledge of mechanisms of cancer relapse, addresses the biomarkers of potential interest detectable in the tissue of the tumour or its surgical margins and discusses three biomarkers, human papillomavirus, TP53 and epidermal growth receptor in more detail. Once a marker panel has been established, treatment should be focussed on the patients at risk of relapse by improved tailoring of existing treatment modalities. Also, the implementation of more targeting therapies based on the characteristics of the discovered markers should lead to better survival rates.
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Affiliation(s)
- B J M Braakhuis
- Department of Otolaryngology/Head-Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
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31
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Hughes AM, Pozzi ECC, Thorp S, Garabalino MA, Farías RO, González SJ, Heber EM, Itoiz ME, Aromando RF, Molinari AJ, Miller M, Nigg DW, Curotto P, Trivillin VA, Schwint AE. Boron neutron capture therapy for oral precancer: proof of principle in an experimental animal model. Oral Dis 2013; 19:789-95. [DOI: 10.1111/odi.12077] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 12/26/2012] [Accepted: 12/28/2012] [Indexed: 11/26/2022]
Affiliation(s)
- A Monti Hughes
- Department of Radiobiology; National Atomic Energy Commission (CNEA); San Martin; Argentina
| | | | - S Thorp
- Department of Technology and Applications of Accelerators; CNEA; Ezeiza; Argentina
| | - MA Garabalino
- Department of Radiobiology; National Atomic Energy Commission (CNEA); San Martin; Argentina
| | - RO Farías
- Department of Technology and Applications of Accelerators; CNEA; Ezeiza; Argentina
| | | | - EM Heber
- Department of Radiobiology; National Atomic Energy Commission (CNEA); San Martin; Argentina
| | | | | | - AJ Molinari
- Department of Radiobiology; National Atomic Energy Commission (CNEA); San Martin; Argentina
| | - M Miller
- Department of Technology and Applications of Accelerators; CNEA; Ezeiza; Argentina
| | - DW Nigg
- Idaho National Laboratory; Idaho Falls; ID; USA
| | - P Curotto
- Department of Research and Production Reactors; CNEA; Ezeiza; Argentina
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