Evaluation of Oral Squamous Cell Carcinoma Patients Using Polymerase Chain Reaction Regarding the Prevalence of Human Papillomavirus Types 16 and 18

BACKGROUND

Epstein-Barr virus, human papillomavirus (HPV), and herpes simplex virus type 1 (HSV-1) are examples of viruses that have been associated with the development of oral squamous cell carcinoma (OSCC). These viruses can infect various epithelial tissues in the human body. The use of incredibly accurate cellular biology techniques, such as the polymerase chain reaction (PCR), which permits the rapid identification of viruses following infection, has increased. The parameters of human head and neck oncology have been widened.

AIM

In this study, using the PCR, the presence of HPV variants such as HPV 18 and HPV 16 in patients with OSCC was assessed.

MATERIALS AND METHODS

Tissue specimens were obtained from clinically presumed OSCC individuals taken as cases, and tissues from the retromolar region were obtained from people who experienced an operation for partially and completely impacted tooth and taken as controls. The study included 80 samples divided into two separate categories: case category (n = 40) = OSCC-diagnosed individuals; control category (n = 40) = controls with a comparable age. For verification of the diagnosis, a specimen of the tissue has been processed and sections have been stained and inspected for standard hematoxylin and eosin stain. Deoxyribonucleic acid (DNA) was extracted from the leftover histopathologically verified tissue specimens and then exposed to PCR for the assessment of HPV infiltration.

RESULTS

It was observed in this research that 22 cases out of 40 cases of OSCC were found positive for HPV-DNA. While 12 out of 40 age-matched healthy controls were found positive for HPV-DNA. Out of 40 cases of OSCC, 12 cases were found positive for HPV 16. While six out of 40 age-matched healthy controls were found positive for HPV 16. Six cases out of 40 cases of OSCC were found positive for HPV 16. While two out of 40 age-matched healthy controls were found positive for HPV 18. Four cases out of 40 cases of OSCC were found positive for HPV 16. While four out of 40 age-matched healthy controls were found positive for HPV 16 and HPV 18. On carrying out statistical analysis, the variation between the two categories was non-meaningful statistically (p = 0.662). However, the prevalence was greater in the case (OSCC) subgroup.

CONCLUSION

When evaluated against controls in the current investigation, OSCC cases had a greater level of HPV expression and a greater proportion of HPV 16 positives. However, there was no statistically noteworthy change.

Mucoepidermoid carcinoma: A retrospective clinicopathologic study of 25 cases

Background

Salivary gland tumors are rare and clinically represent a diverse group of neoplasms among which mucoepidermoid carcinoma (MEC) is a relatively common salivary gland tumor with varying potential for aggressive behavior. The purpose of the study was aimed at to analyze the relative frequency and correlate with age, sex, anatomical site and histological grade of MEC and compare the findings with epidemiological data from different geographic locations.

Materials and Methods

Twenty-five cases diagnosed with MEC during the period June 1985 to June 2004 (19 years) were retrieved from the Department of Pathology, Government Medical College and Hospital, Ambajogai, and clinical data were recorded and reviewed histopathologically.

Results

The relative frequency of MEC was 13.15%. Low-grade MEC (44%) was the most common, followed by intermediate-grade MEC (36%) and high-grade MEC (20%). The mean age for occurrence of MEC was 44.28 ± 13.29 years. MEC was predominant in females (60%) than males (40%). Thus, the overall female-male ratio was 1.5:1. Among minor salivary glands, palate (48%) was the most common site, and among major salivary glands, parotid gland (16%) was the common site.

Conclusion

Comparing the present data with previous studies on MEC, one may infer that some demographic characteristics and the predominance vary in different geographic regions. Analysis of the distribution and particular features of MEC in a specific population helps in establishment of appropriate treatment.

Evaluation of Proliferative Marker Ki-67 in Adenoid Cystic Carcinoma: A Retrospective Study

AIM

Adenoid cystic carcinoma (ACC) is a malignant tumor of salivary gland origin. Although the histologic appearance of ACC is low grade, management of this malignancy is a distinct therapeutic challenge because of its tendency for perineural involvement and potential for distant metastasis. Ki-67 antigen is expressed during the G1, S, G2 and M phases in the cell cycle but is absent in the quiescent G0 phase in tissue sections. Aim of the study was to review hematoxylin and eosin stained slides in order to confirm the previous histopathological diagnosis as per the criteria given by World Health Organisation (WHO) and to evaluate the expression of cell proliferation marker, Ki-67 antigen in Adenoid cystic carcinoma and correlate the expression of Ki-67 antigen histopathologically with different grades in Adenoid cystic carcinoma.

MATERIALS AND METHODS

Tissue samples of 32 cases (12 males and 20 females) were selected from minor salivary glands with age range from 21 to 70 years. Two paraffin-embedded sections of these total 32 cases each of 4 µm thick were cut on a rotary microtome. One section was stained using hematoxylin and Eosin (H&E) and the other was used for Immunohistochemical staining with Ki-67 antigen.

RESULTS

Among these 32 cases of Adenoid cystic carcinoma, Histologically 14 (43.75%) tumors were classified in grade I, 8 (25%) were in grade II, and 10 (31.25%) were in grade III. The average percentage of Ki-67 expression was 27.12% in grade I, 34.43% in grade II and 38.45% in grade III.

CONCLUSION

Ki-67 immunoreactivity increased with increase in histopathological grades of ACC.

CLINICAL SIGNIFICANCE

Since Ki-67 is a useful marker for assessing the proliferative potential of tumors, the prognosis of patients can definitely be predicted.

Immunohistochemical Detection of Proliferative Marker Ki-67 in Benign and Malignant Salivary Gland Tumors

Introduction: Salivary gland tumors are the most histologically heterogeneous group of tumors with the greatest diversity of morphologic features among their cells and tissues. The present study was aimed at assessing the validity of Ki-67, a cell proliferation marker, as a prognostic factor in benign and malignant salivary gland tumors and to study whether it is related to age, sex, anatomical site, and size of the lesion in salivary gland tumors. Materials and methods: A retrospective study consisted of benign salivary gland tumors (BSGTs) (n = 15), malignant salivary gland tumors (n = 18), and normal salivary gland parenchyma (n = 15). Results: There was a significant difference of Ki-67 labeling index (LI, %) in normal salivary gland parenchyma, BSGTs, and malignant salivary gland tumors. The Ki-67 LI (%) in normal salivary gland parenchyma is negligible (0.27 ± 0.31%), whereas malignant salivary gland tumors showed very high Ki-67 LI (%) of 18.79 ± 18.06% compared with BSGTs being 0.76 ± 2.02%. There was a significant correlation statistically of mean ± standard deviation (SD) of Ki-67 LI (%) with the age of the patients being the maximum (32.68 ± 15.87%) in the 50 to 59 years age group, whereas sex, site of the lesion, and size of the lesion in salivary gland tumors had no significant correlation. Conclusion: The Ki-67 is a useful marker for assessing prolif-erative potential of tumors. Clinical significance: The Ki-67 LI% can be used as a reliable adjuvant diagnostic tool to differentiate between the subtypes and grading of certain malignant tumors, such as mucoepi-dermoid carcinoma (MEC), adenoid cystic carcinoma (AdCC), and acinic cell carcinoma (AcCC), which are usually difficult to diagnose on histopathological criteria alone. Keywords: Immunohistochemistry, Ki-67, Salivary gland neoplasms.

Morphological patterns of lip prints in Mangaloreans based on Suzuki and Tsuchihashi classification

INTRODUCTION

Cheiloscopy is the study of the furrows or grooves present on the red part or vermilion border of the human lips. The present study aims to classify the characteristics of lip prints and to know the most common morphological pattern specific to Mangalorean people of Southern India. For the first time, this study also assesses the association between gender and different lip segments within a population.

MATERIALS AND METHODS

A total of 200 residents of Mangalore (100 males and 100 females) were included of age ranging from 18 years to 60 years. Materials used to take the impression of lips included red lipstick, A4 size white bond paper and cellophane tape. The prints obtained were scanned using a Canon Image Scanner and stored in a folder on a personal computer. The images were cropped and inverted in gray scale using Adobe Photoshop software. Each lip print was divided into eight segments and was examined. Suzuki and Tsuchihashi's classification (1970) was used to classify the types of grooves, and the results were statistically analyzed. Six types of grooves were recorded in the Mangalorean's lips.

STATISTICAL ANALYSIS

Association between gender and different lip segments was tested using Chi-square analysis in the given population.

RESULTS

In males, the groove Type I' was the highest recorded followed by Type III, Type II, Type I, Type IV and Type V in descending order. In females, Type I' was the highest recorded followed by Type II, Type III, Type IV, Type I and Type V in descending order.

CONCLUSION

Males and females displayed statistically significant differences in lip print patterns for different lip sites: lower medial lip, as well as upper and lower lateral segments. Only the upper medial lip segment displayed no statistically significant difference in lip print pattern between males and females. This shows that the distribution of lip prints is generally dissimilar for males and females, with varying predominance according to lip segment.

Clinicopathological profile of head and neck cancers in the Western development region, Nepal: a 4-year snapshot

Regional cancer epidemiology is an important basis for determining the priorities for cancer control in different countries worldwide. There is no reliable information about the pattern of head and neck cancer in western Nepal and hence an attempt was here made to evaluate the situation based on hospital data, which provide the only source in the western region of Nepal. A clinicopathological analysis of head and neck cancers treated between 2003 and 2006 in Manipal Teaching Hospital affiliated to Manipal College of Medical Sciences, Pokhara, Western Development Region, Nepal was performed. A total of 105 head and neck cancer cases were identified with a male to female ratio of 1.8:1. The median ages of male and female patients were 62 and 64 years, respectively. Ninety-seven (92.4%) of the cancer patients were suffering from carcinoma, three (2.9%) had blastoma, three (2.9%) had sarcoma, and two (1.9%) had lymphoma. The majority (61.9%) of carcinoma cases were squamous cell carcinoma followed by anaplastic carcinoma (7.2%). Of the carcinoma cases, the most common site of primary lesion was larynx (19.6%), followed by the thyroid (14.4%), the tongue and hypopharynx with 10.3% cases each. Comparative analysis among males and females did not reveal any sex difference in type of head and neck cancers. The head and neck cancer pattern revealed by the present study provides valuable leads to cancer epidemiology in western Nepal and useful information for health planning and cancer control, and future research in western Nepal.

Fibroblastic variant of osteosarcoma: a challenge in diagnosis & management

Osteosarcoma of the jaws is a relative rare malignant bone tumor. Like, its counterpart in the long bones, osteosarcoma affecting the head and neck region shows distinct yet diverse clinical, histologic and prognostic characteristics. Its diagnosis is a challenge to histopathologists and is especially important in early stages to improve its prognosis. In the initial phase, it may present as nondescript swelling with an indolent growth rate, only to become overtly aggressive and malignant towards the later phase of the disease. This article reports on a case of an advanced osteosarcoma of the maxilla in a 42 year old woman who came for the evaluation of a swelling. The case was submitted for surgical intervention and was followed by one recurrence till the time of reporting. This case illustrates that immunohistochemical staining of Vimentin, S-100 and CD 68 markers are useful to confirm the histologic diagnosis of osteosarcoma, along with radiographic evaluation using CT scan and 3D imaging.