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R K, Chandra A, Jain T, Singh N, Agrawal R. An enigmatic pathogenetic mechanism of hypoxia inducible factor - 1/2 alpha in the progression of fibrosis of oral submucous fibrosis and its malignant transformation: A systematic review and meta-analysis. Arch Oral Biol 2024; 162:105944. [PMID: 38492547 DOI: 10.1016/j.archoralbio.2024.105944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/12/2024] [Accepted: 03/03/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE Oral submucous fibrosis is a frequently reported potentially malignant disorder characterized by fibrosis and a malignant transformation rate of 7-30%. The role of hypoxia-inducible factor-1/2α in malignant transformation mechanisms of oral submucous fibrosis remains uncharted territory owing to a scarcity of studies. Thus the present systematic review and meta-analysis aimed to determine the role of hypoxia-inducible factor-1/2α in the progression of fibrosis of oral submucous fibrosis and its malignant transformation. MATERIAL AND METHODS Using PubMed, Google Scholar, and Cochrane Library databases, full-text articles that investigated hypoxia-inducible factor-1/2α in oral submucous fibrosis were entailed for review. A modified Newcastle-Ottawa scale was employed to evaluate risk of bias in all articles and Review Manager was utilized for meta-analysis. RESULTS Eighteen and eight qualified articles respectively were included for qualitative and quantitative data synthesis. Progressive upregulation of hypoxia-inducible factor-1/2α in oral submucous fibrosis is associated with fibrosis-induced carcinogenesis. A Random-effects model uncloaked that oral submucous fibrosis cases with significantly increased expression of hypoxia-inducible factor-1α had an increased associated risk of malignant transformation compared with controls (combined odds ratio 523.83, 95% confidence interval 125.74- 2182.28, p < 0.00001). CONCLUSION The existing evidence substantiates the notion that hypoxia-inducible factor-1/2α, a fundamental pathogenetic mechanism of progression and malignant transformation of oral submucous fibrosis in the background of fibrosis.
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Affiliation(s)
- Keerthika R
- MDS, Senior Resident, Unit of Oral Pathology and Microbiology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India
| | - Akhilesh Chandra
- MDS, Assistant Professor, Unit of Oral Pathology and Microbiology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Trupti Jain
- MDS, Junior Resident, Unit of Oral Pathology and Microbiology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Neha Singh
- MDS, Junior Resident, Unit of Oral Pathology and Microbiology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rahul Agrawal
- MDS, Professor, Unit of Oral Pathology and Microbiology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
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Girdhar A, Keerthika R, Narwal A, Kamboj M, Devi A, Sharma R. Comparative manual and digital analysis of gonial angle in lateral cephalograms for gender determination. Forensic Sci Med Pathol 2024; 20:73-78. [PMID: 37060537 DOI: 10.1007/s12024-023-00625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 04/16/2023]
Abstract
Human skull has always been used for victim identification in forensic odontology. The gender-dimorphic bone of the skull is the mandible. The gonial angle has frequently been investigated for gender estimation with variable results and requires further exploration. We aim to compare the efficacy of gonial angle estimation by ancient methods of lateral cephalometric tracing compared with more recent digital analysis methods for gender estimation in the Indian population. Lateral cephalograms of 191 (96 M and 95F) cases above the age of 17 years were retrieved. Cephalometric analysis of gonial angle on radiographs was done using both manual cephalometric tracing method and digitally using Adobe Photoshop software. The results were subjected to statistical analysis for evaluation. The mean gonial angle was higher in females (125.05; 123.77 and 125.28) than in males (122.583; 121.715 and 122.008) using both manual and digital methods. On applying the logistical regression analysis (LRA), the digital method showed the highest gender estimation accuracy of 60.7% followed by Burstone's analysis (57.1%) and manual conventional analysis (56.5%). Burstone's analysis (57.9%) correctly identified increased females, whereas digital analysis (62.5%) and manual conventional analysis (59.4%) accurately recognised increased males. The present study showed a higher gender estimation accuracy using digital methods as compared to manual methods, but it still lacks the credibility to be used as a sole factor for predicting the gender of an individual. Hence, a cumulative factor must be taken into consideration for gender identification which would provide more promising results.
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Affiliation(s)
- Akhil Girdhar
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
| | - R Keerthika
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India.
| | - Anjali Narwal
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
| | - Mala Kamboj
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
| | - Anju Devi
- Department of Oral Pathology and Microbiology, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
| | - Rekha Sharma
- Department of Orthodontics, Pt. Bhagwat Dayal Sharma, University of Health Sciences, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, 124001, India
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Sharma G, Kamboj M, Narwal A, Keerthika R, Devi A, Vijayakumar G. Diagnostic Utility of Expression Pattern of S100/Mammaglobin/SOX10/DOG 1 Immunohistochemistry in Differentiation of Secretory and Acinic Cell Carcinoma: A Systematic Review and Meta-Analysis. Indian J Otolaryngol Head Neck Surg 2024; 76:208-218. [PMID: 38440438 PMCID: PMC10908910 DOI: 10.1007/s12070-023-04127-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 07/28/2023] [Indexed: 03/06/2024] Open
Abstract
Secretory carcinoma (SC) is a relatively new disease entity, separate from acinic cell carcinoma (AciCC), which frequently displays ETV6-NTRK3 gene fusion. However, the differences between SC and AciCC remain ambiguous. Genetic diversity makes its diagnosis complicated. In this regard combined expression of immunohistochemistry markers S100/Mammaglobin/SOX10 and DOG1 is need of the hour as alternative methodology. The current systematic review was to investigate the diagnostic utility of combined immunohistochemical expression of S100/Mammaglobin/SOX10/DOG1 in distinction of SC from AciCC histologically. An electronic search of databases was carried out using MEDLINE by PubMed, Google scholar, Scopus and Web of science. Articles inclusive of SC and AciCC were assessed with S100/Mammaglobin/SOX10/DOG1 immunohistochemistry and their predominant expression pattern, predictive values, sensitivity and specificity were gathered. Fourteen eligible articles were analysed, which revealed predominant immunostaining pattern of S100 + /Mammaglobin + /SOX10 + /DOG1- by nearly all ETV6::NTRK3 fusion prevalent SCs alongside with other gene fusions like RET, MET and MAML3 with 98.4% sensitivity as well as 86.1% specificity. The evidence supports that S100/Mammaglobin/SOX10/DOG1 combined immunostaining can serve as a reliable diagnostic method to differentiate secretory from acinic cell carcinoma.
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Affiliation(s)
- Gitika Sharma
- Pandit Bhagwat Dayal Sharma, University of Health Sciences, Oral Pathology and Microbiology, Rohtak, Haryana 124001 India
| | - Mala Kamboj
- Pandit Bhagwat Dayal Sharma, University of Health Sciences, Oral Pathology and Microbiology, Rohtak, Haryana 124001 India
| | - Anjali Narwal
- Pandit Bhagwat Dayal Sharma, University of Health Sciences, Oral Pathology and Microbiology, Rohtak, Haryana 124001 India
| | - R. Keerthika
- Pandit Bhagwat Dayal Sharma, University of Health Sciences, Oral Pathology and Microbiology, Rohtak, Haryana 124001 India
| | - Anju Devi
- Pandit Bhagwat Dayal Sharma, University of Health Sciences, Oral Pathology and Microbiology, Rohtak, Haryana 124001 India
| | - Gopikrishnan Vijayakumar
- Pandit Bhagwat Dayal Sharma, University of Health Sciences, Oral Pathology and Microbiology, Rohtak, Haryana 124001 India
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Keerthika R, Kamboj M, Girdhar A, Narwal A, Devi A, Anand R, Juneja M. An exotic pathogenetic mechanism of angiogenesis in oral lichen planus-A systematic review. J Oral Pathol Med 2023; 52:803-810. [PMID: 37553286 DOI: 10.1111/jop.13472] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 05/09/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE Angiogenesis plays a vital role at the molecular level in various inflammatory lesions, that lead to their chronicity. Oral lichen planus is an immune-mediated chronic inflammatory disorder. The angiogenetic role and exact mechanisms in oral lichen planus are still unclear due to a dearth of studies. Its clinical significance with angiogenesis also requires further elucidation necessitating a thorough review of the studies that have been conducted so far. The present review was designed to identify the dependence of oral lichen planus progression on angiogenesis which could aid in devising metronomic treatments required to halt the progression of this disease. MATERIALS AND METHODS A thorough search was made using MEDLINE by PubMed, Scopus, Google scholar, Cochrane library, and EMBASE databases. Original research articles, that immunohistochemically evaluated angiogenesis in oral lichen planus were included for review. Risk of bias was analysed for each study using Modified Newcastle-Ottawa scale and Review Manager 5.4 was used to output its result. RESULTS Twenty-nine published articles were included for data synthesis. The most commonly employed antibody was CD34, however, upregulated VEGF expression was the principal while ICAM-1, VCAM-1, and PECAM-1 were critical angiogenic factors to mediate angiogenesis in oral lichen planus. CONCLUSION The current evidence supports that angiogenesis, a fundamental pathogenetic mechanism of oral lichen planus, leads to its persistence and chronicity. However, studies with a larger sample size, standard evaluation criteria, different subtypes, and adequate follow-up are warranted.
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Affiliation(s)
- R Keerthika
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Mala Kamboj
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Akhil Girdhar
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Anjali Narwal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Anju Devi
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Rahul Anand
- Department of Oral and Maxillofacial Pathology, Dr D Y Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth, Pimpri, Pune, India
| | - Manish Juneja
- Oral and Maxillofacial Pathologist, Franklin, Massachusetts, USA
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Keerthika R, Narwal A, Kamboj M, Devi A, Anand R, N S, Singh V, Agarwal V, Gupta A. Mucormycosis infection associated with global COVID-19 pandemic - an institutional histopathological study. Med Oral Patol Oral Cir Bucal 2023; 28:e99-e107. [PMID: 36806020 PMCID: PMC9985935 DOI: 10.4317/medoral.25130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/10/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) in the recent times have instilled signs of immunosuppression globally which has further precipitated increasing range of opportunistic infections. Mucormycosis is a distressing opportunistic fungal infection with a high incidence and is the third commonest acute invasive infection following candidiasis and aspergillosis. The aim of the present observational study is to delineate the enigmatic histopathological profile between mucormycosis cases seen prior to pandemic (PPM) and pandemic associated mucormycosis (PAM). MATERIAL AND METHODS Tissue archives of 105 histopathologically diagnosed cases of mucormycosis were included and analysed for demographical details and histopathological parameters like fungal load and localization, granuloma formation, necrosis, inflammatory infiltrate and tissue invasion. RESULTS 0ut of 105 included cases, 11/105 (10.48%) were reported PPM and 94/105 (89.52%) PAM. Among 94 cases of PAM, 51/94 (54%) cases also showed COVID-19 positivity, while 43/94 (46%) did not. Of all the histological variables, increased fungal load and necrosis were observed in PAM relative to PPM cases. CONCLUSIONS The histopathological variables like fungal load, necrosis, granuloma formation and tissue invasion, could help the clinician in assessing the clinical status at the time of tissue diagnosis and improve the treatment accordingly.
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Affiliation(s)
- R Keerthika
- Department of Oral and Maxillofacial Pathology and Microbiology Pt. Bhagwat Dayal Sharma University of Health Sciences Post Graduate Institute of Dental Sciences (PGIDS) Rohtak, Haryana-124001, India
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Keerthika R, Devi A, Kamboj M, Sivakumar N, Vijayakumar G, Narwal A, Girdhar A. Diagnostic Reliability of CRTC1/3::MAML2 Gene Fusion Transcripts in Discriminating Histologically Similar Intraosseous Mucoepidermoid Carcinoma from Glandular Odontogenic Cyst: A Systematic Review and Meta-analysis. Head Neck Pathol 2023; 17:233-245. [PMID: 36357765 PMCID: PMC10063707 DOI: 10.1007/s12105-022-01494-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/09/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Intraosseous mucoepidermoid carcinoma (IMEC) and Glandular odontogenic cyst (GOC) are those two pathological entities causing diagnostic dilemma due to the histopathological similarity. An accurate distinction between the two entities is difficult as both presents with a common radiological and histological similarities. The aim of our systematic review was to establish the diagnostic reliability of CRTC1/3::MAML2 gene fusion for the distinction between IMEC and GOC. METHODS A complete electronic literature search was made in MEDLINE by PubMed, Google Scholar, and EMBASE databases. Articles with keywords using molecular genetic findings of CRTC1/3::MAML2 gene fusion transcripts, IMEC and GOC were assessed and included for the systematic review. RESULTS Twelve subgroups having both qualitative and quantitative analysis revealed CRTC1/3::MAML2 sensitivity of 100% and specificity of 70.59% in differentiating GOC and IMEC. Fixed-effects model confirmed translocation-negative cases to have a decreased risk of association with IMEC (combined odds ratio 8.770, 95% confidence interval - 2.45 to 31.45, p < 0.002). CONCLUSIONS The current evidence supports that in all cases with positive gene fusion transcript of the CRTC1/3::MAML2 was specific for IMEC and was significantly differentiating it from GOC. Whereas cases of IMEC with negative gene fusion transcript pose diagnostic difficulty in differentiating from a GOC which is negative for CRTC1/3::MAML2 expression.
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Affiliation(s)
- R. Keerthika
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - Anju Devi
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - Mala Kamboj
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - N. Sivakumar
- Department of Oral and Maxillofacial Pathology & Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Gopikrishnan Vijayakumar
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - Anjali Narwal
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - Akhil Girdhar
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
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