Difference between Keratinized- and Non-Keratinized-Originating Epithelium in the Process of Immune Escape of Oral Squamous Cell Carcinoma

Immune checkpoint inhibitors (ICIs), including anti-programmed cell death 1 ligand 1 (PD-L1) antibodies, are significantly changing treatment strategies for human malignant diseases, including oral cancer. Cancer cells usually escape from the immune system and acquire proliferative capacity and invasive/metastatic potential. We have focused on the two immune checkpoints, PD-1/PD-L1 and CD47/SIRPα, in the tumor microenvironment of oral squamous cell carcinoma (OSCC), performed a retrospective analysis of the expression of seven immune-related factors (PD-L1, PD-1, CD4, CD8, CD47, CD56 and CD11c), and examined their correlation with clinicopathological status. As a result, there were no significant findings relating to seven immune-related factors and several clinicopathological statuses. However, the immune checkpoint-related factors (PD-1, PD-L1, CD47) were highly expressed in non-keratinized epithelium-originated tumors when compared to those in keratinized epithelium-originated tumors. It is of interest that immunoediting via immune checkpoint-related factors was facilitated in non-keratinized sites. Several researchers reported that the keratinization of oral mucosal epithelia affected the immune response, but our present finding is the first study to show a difference in tumor immunity in the originating epithelium of OSCC, keratinized or non-keratinized. Tumor immunity, an immune escape status of OSCC, might be different in the originating epithelium, keratinized or non-keratinized.

Primary syphilis with a tongue ulcer mimicking tongue cancer: a case report

The main symptom in primary syphilis is a small, painless, sore or ulcer called a chancre on the penis, vagina, or around the anus, although chancres can sometimes appear in the mouth or on the lips, fingers, or buttocks. We present the case of a man in his early 60 s with a chief complaint of a painful tongue ulcer. An ulcerated, indurated, and hemorrhagic lesion (23 × 14 mm) was found on the ventral tongue surface, near the oral floor. Palpation identified several swollen, mobile, elastic cervical lymph nodes, with no tenderness. We initially diagnosed tongue cancer; however, during a subsequent detailed examination for a malignant tumor, including biopsy and obtaining additional history, his disease was finally identified as primary syphilis with multiple swollen cervical lymph nodes. Oral amoxicillin and probenecid were started, and after 14 days, there was partial reduction in the size of the submandibular lymph nodes and the ulcer on the left tongue margin. The number of patients with syphilis in Japan increased by eight times from 2012 to 2018. We suggest that dentists consider primary syphilis as a differential diagnosis for oral refractory ulcer with induration and obtain a detailed patient history.

Surveillance for Patients with Oral Squamous Cell Carcinoma after Complete Surgical Resection as Primary Treatment: A Single-Center Retrospective Cohort Study

BACKGROUND

The surveillance methods oral squamous cell carcinoma (OSCC) patients may be chosen by considering the risk for recurrence, and it is important to establish appropriate methods during the period in which latent/dormant cancer cells become more apparent. To investigate the appropriate surveillance of patients with OSCC based on the individual risk for recurrence and/or metastasis, we performed a retrospective cohort study after the complete surgical resection of OSCC as the primary treatment.

METHODS

The study was performed in 324 patients with OSCC who had been primarily treated with surgery from 2007 to 2020 at our hospital. We investigated the period, timing, and methods (visual examination, palpation and imaging using FDG-PET/CT or CECT) for surveillance in each case that comprised postsurgical treatment.

RESULTS

Regarding the time to occurrence of postsurgical events, we found that half of cases of local recurrence, cervical lymph node metastasis, and distant metastasis occurred within 200 days, and 75% of all of these events occurred within 400 days. However, the mean time for second primary cancer was 1589 days. The postsurgical events were detected earlier by imaging examinations than they were by visual examination and palpation.

CONCLUSIONS

For the surveillance of patients with OSCC after primary surgery, it is desirable to perform FDG-PET/CT within 3-6 months and at 1 year after surgery and to consider CECT as an option in between FDG-PET/CT, while continuing history and physical examinations for about 5 years based on individual risk assessment.

Identification of Binding Proteins for TSC22D1 Family Proteins Using Mass Spectrometry

TSC-22 (TGF-β stimulated clone-22) has been reported to induce differentiation, growth inhibition, and apoptosis in various cells. TSC-22 is a member of a family in which many proteins are produced from four different family genes. TSC-22 (corresponding to TSC22D1-2) is composed of 144 amino acids translated from a short variant mRNA of the TSC22D1 gene. In this study, we attempted to determine the intracellular localizations of the TSC22D1 family proteins (TSC22D1-1, TSC-22 (TSC22D1-2), and TSC22(86) (TSC22D1-3)) and identify the binding proteins for TSC22D1 family proteins by mass spectrometry. We determined that TSC22D1-1 was mostly localized in the nucleus, TSC-22 (TSC22D1-2) was localized in the cytoplasm, mainly in the mitochondria and translocated from the cytoplasm to the nucleus after DNA damage, and TSC22(86) (TSC22D1-3) was localized in both the cytoplasm and nucleus. We identified multiple candidates of binding proteins for TSC22D1 family proteins in in vitro pull-down assays and in vivo binding assays. Histone H1 bound to TSC-22 (TSC22D1-2) or TSC22(86) (TSC22D1-3) in the nucleus. Guanine nucleotide-binding protein-like 3 (GNL3), which is also known as nucleostemin, bound to TSC-22 (TSC22D1-2) in the nucleus. Further investigation of the interaction of the candidate binding proteins with TSC22D1 family proteins would clarify the biological roles of TSC22D1 family proteins in several cell systems.

Effectiveness of cetuximab as preemptive postsurgical therapy for oral squamous cell carcinoma patients with major risk: a single-center retrospective cohort study

A retrospective cohort study was performed to investigate the effectiveness of preemptive postsurgical therapy with cetuximab for patients with a major risk of recurrence or metastasis after clinical complete resection of primary oral squamous cell carcinoma (OSCC). The study period was from 2007 to 2019 for patients treated at the Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine. OSCC patients with major risk (n = 88) in the follow-up period were divided into groups with no postsurgical treatment (NP group), with standard postsurgical treatment (SP group), and with postsurgical treatment including cetuximab (CP group), and prognosis were compared among those groups. The 5-year overall survival rate was significantly higher in patients who received postsurgical treatment with cetuximab (CP) compared to that in the other two groups ((CP vs. NP, p = 0.028; CP vs. SP, p = 0.042). Furthermore, we performed multivariate analysis to evaluate the effects of the main components of the treatment. Among CDDP, radiotherapy, and cetuximab, only cetuximab significantly contributed to improved survival by univariate analysis (crude HR:0.228, 95%CI:0.05-0.968, p = 0.045). cetuximab also showed the same tendency in multivariate analysis, although p value did not reach significant level (Adjusted HR: 0.233, 95%CI: 0.053-1.028, p = 0.054). The results suggest that the postsurgical treatment with cetuximab as a preemptive postsurgical therapy after complete surgical resection of a visible tumor is considerably effective for OSCC patients with major risk, in other words, invisible dormant metastasis.

Clinical characteristics, treatment methods and prognoses of patients with oral squamous cell carcinoma in Japanese population: a single institution retrospective cohort study

BACKGROUND

The status of oral cancer therapy in elderly patients in Japan, where ageing is rapidly progressing, may serve as a model for other countries with similar demographics. There is controversy over what kind of treatment should be applied and how aggressively it should be applied to very elderly patients who have exceeded the average life expectancy. Given that 85 years is approximately the overall Japanese life expectancy at birth, we considered a threshold of 85 years and hypothesized that the prognosis of oral squamous cell carcinoma (SCC) patients aged ≥85 years was not inferior to that of those < 85 years. The aim of the present study was to investigate the clinical characteristics, treatment methods, and prognoses of Japanese oral SCC patients aged ≥85 years.

METHODS

A retrospective cohort study was performed. The data of patients with primary oral SCC (n = 358) from 2005 to 2018 in our institute were extracted from electronic medical records. A total of 358 patients with oral SCC were divided into two groups (≥85 years group [n = 26] and < 85 years group [n = 332]) based on the age threshold of 85 years at the first visit. Kaplan-Meier survival analyses and Cox proportional hazard models were used to analyse overall survival (OS) and hazard ratios (HRs) according to age group, treatment, and TNM classification.

RESULTS

There was no difference in the 5-year OS rate between the ≥85 years and < 85 years groups (80.8% vs. 82.2%, P = 0.359). This finding was the same in the operative (94.7% vs. 85.8%, P = 0.556) and non-operative (42.9% vs. 33.2%, P = 0.762) groups, indicating that age did not affect prognosis. Mortality was lower in the operative group than in the non-operative group (adjusted HR: 0.276, 95% CI: 0.156-0.489, P < 0.001), suggesting that surgery is a superior method. However, non-surgical treatment was selected at a higher rate in the ≥85 years group (26.9% vs. 11.1%, P = 0.028).

CONCLUSIONS

This study suggests the prognosis of ≥85-year-old patients was not inferior to that of < 85-year-old patients. We recommend that surgery as the first choice treatment for ≥85-year-old patients with oral SCC who can tolerate surgery should be performed.

How Different is the Core of ^{25}F from ^{24}O_{g.s.} ?

The structure of a neutron-rich ^{25}F nucleus is investigated by a quasifree (p,2p) knockout reaction at 270A  MeV in inverse kinematics. The sum of spectroscopic factors of π0d_{5/2} orbital is found to be 1.0±0.3. However, the spectroscopic factor with residual ^{24}O nucleus being in the ground state is found to be only 0.36±0.13, while those in the excited state is 0.65±0.25. The result shows that the ^{24}O core of ^{25}F nucleus significantly differs from a free ^{24}O nucleus, and the core consists of ∼35% ^{24}O_{g.s.}. and ∼65% excited ^{24}O. The result may infer that the addition of the 0d_{5/2} proton considerably changes neutron structure in ^{25}F from that in ^{24}O, which could be a possible mechanism responsible for the oxygen dripline anomaly.

Ion-production efficiency of a singly charged ion source developed toward a 11C irradiation facility for cancer therapy

The ion-production efficiency of a newly developed singly charged ion source (SCIS) has been investigated to discuss the possibility of it being used in an isotope separation on-line system that provides ¹¹C ions for heavy-ion cancer therapy with simultaneous verification of the irradiation field using positron emission tomography. The SCIS uses a low-energy hollow electron beam to produce singly charged carbon ions efficiently. To deliver sufficient ¹¹C ions to the treatment room from a limited amount of ¹¹C molecules, which are produced from a boron compound target and proton-beam irradiation via the ¹¹B(p,n)¹¹C reaction, the SCIS must have high ion-production efficiency. To realize this high efficiency, the SCIS was designed using a three-dimensional particle-in-cell code in previous work. With the fabricated SCIS, we performed experiments to measure the efficiency of producing CO₂ ⁺ ions from nonradioactive ¹²CO₂ molecules and C⁺ ions from nonradioactive ¹²CH₄ molecules. We found that the SCIS achieved efficiencies of ε_C⁺ =4×10^-3 (0.4%) for C⁺ production and ε_{CO2 ⁺} =0.107 (10.7%) for CO₂ ⁺ production.

Singly charged ion source designed using three-dimensional particle-in-cell method

A singly charged ion source (SCIS) has been designed using a newly developed three-dimensional particle-in-cell (PIC) code. The SCIS is to be used in an isotope separation on-line (ISOL) system that provides ¹¹C ions for heavy-ion cancer therapy with simultaneous verification of the dose distribution using positron emission tomography. The SCIS uses low-energy electron beams to produce singly charged carbon ions efficiently and maintain a high vacuum in the ISOL system. Because the SCIS has to realize a production efficiency of 1% if its carbon ions are to be used in the ISOL system, a suitable design for the SCIS was investigated by using the developed PIC code to study the beam trajectories of the electrons and extracted ions. The simulation results show that hollow electron beams are produced in the designed SCIS resulting in a high effective electron current. The results also predict that the designed SCIS would realize ion-production efficiencies (IPEs) of ε _SCIS ≃ 6.7% for C O 2 + production from CO₂ gas and ε _SCIS ≃ 0.1% for C⁺ production from CH₄ gas. Moreover, to examine the validity of the developed code and confirm that the SCIS was able to be designed appropriately, the space-charge-limited current of the electron gun and the total IPE obtained by adding the IPEs of each ion were compared between the experiment and the simulation.

Abstract 4117: AMD070, a novel orally bioavailable CXCR4 inhibitor, inhibits the metastases of oral cancer via SDF-1/CXCR4 system

We have demonstrated that the stromal cell-derived factor (SDF)-1/CXCR4 system is involved in metastatic processes in oral cancer. Moreover, we have also reported that blocking CXCR4 with AMD3100, a CXCR4 antagonist, may be a potent anti-metastatic therapy for CXCR4-related head and neck cancer. Recently, AMD070 has been described as a novel orally bioavailable inhibitor of CXCR4, being minimally invasive than AMD3100. In this study, we examined the effect of AMD070 on the SDF-1/CXCR4 dependent-metastases in oral cancer cells, B88-SDF-1, which express high levels of SDF-1 and CXCR4.

We examined the effect of CXCR4-specific antagonists, AMD3100 and AMD070 on the cell growth, cell migration and cell invasion of B88-SDF-1 cells. Both antagonists did not affect the anchorage-dependent growth of B88-SDF-1 cells, but did inhibit the SDF-1/CXCR4 dependent-migration of the cells. Moreover, AMD070 significantly suppressed anchorage-independent growth and invasion of B88-SDF-1 cells. Next we examined the effect of AMD070 to distant metastasis in vivo. Daily administration of AMD070 per os significantly inhibited the metastasis of B88-SDF-1 cells to the lungs of nude mice. These results indicated that AMD070 might be a novel orally bioavailable inhibitor on the metastases of oral cancer by the SDF-1/CXCR4 system.

Citation Format: Makoto Kinouchi, Daisuke Uchida, Nobuyuki Kuribayashi, Takahiro Wakui, Kyoko Kuribayashi, Maki Okubo, Masahiro Saito, Eri Masuyama, Hitoshi Kawamata. AMD070, a novel orally bioavailable CXCR4 inhibitor, inhibits the metastases of oral cancer via SDF-1/CXCR4 system. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4117.

A singly charged ion source for radioactive ¹¹C ion acceleration

A new singly charged ion source using electron impact ionization has been developed to realize an isotope separation on-line system for simultaneous positron emission tomography imaging and heavy-ion cancer therapy using radioactive (11)C ion beams. Low-energy electron beams are used in the electron impact ion source to produce singly charged ions. Ionization efficiency was calculated in order to decide the geometric parameters of the ion source and to determine the required electron emission current for obtaining high ionization efficiency. Based on these considerations, the singly charged ion source was designed and fabricated. In testing, the fabricated ion source was found to have favorable performance as a singly charged ion source.

Cryogenic molecular separation system for radioactive (11)C ion acceleration

A (11)C molecular production/separation system (CMPS) has been developed as part of an isotope separation on line system for simultaneous positron emission tomography imaging and heavy-ion cancer therapy using radioactive (11)C ion beams. In the ISOL system, (11)CH4 molecules will be produced by proton irradiation and separated from residual air impurities and impurities produced during the irradiation. The CMPS includes two cryogenic traps to separate specific molecules selectively from impurities by using vapor pressure differences among the molecular species. To investigate the fundamental performance of the CMPS, we performed separation experiments with non-radioactive (12)CH4 gases, which can simulate the chemical characteristics of (11)CH4 gases. We investigated the separation of CH4 molecules from impurities, which will be present as residual gases and are expected to be difficult to separate because the vapor pressure of air molecules is close to that of CH4. We determined the collection/separation efficiencies of the CMPS for various amounts of air impurities and found desirable operating conditions for the CMPS to be used as a molecular separation device in our ISOL system.

Effects of basicity and FeO concentration on the retention of 137Cs and 60Co in slag made from non-metallic radioactive wastes

Simulated non-metallic wastes containing 60Co, 137Cs and 152Eu were melted to examine the effects of basicity and FeO concentration on the retention of the radioactive nuclides in a resulting solidified product (Al2O3-CaO-FeO-SiO2 quaternary slag). The retention of 60Co was almost independent of chemical composition of slag. On the other hand, the retention of 137Cs decreased with an increase of the basicity of slag, defined as a ratio of CaO to SiO2 in wt. independent of FeO concentration. Energy dispersive X-ray fluorescence spectroscopic analysis and Mössbauer spectroscopic measurement were also conducted for the solidified product. Mössbauer spectra indicated that Fe2+ ions as well as Ca2+ ions existed as network modifying cations in a silicate network structure of slag. Referring to a structure model of silicate glasses, it is inferred that the retention of 137Cs reflects differences in chemical properties between Ca2+ and Fe2+ in the internetwork region formed by modifying cations and anionic non-bridging oxygen.

Study on work load of matrons under shift work in a special nursing home for the elderly

In order to find out the work load of matrons under shift work in a special nursing home for the elderly (SNH), six healthy female matrons volunteered to participate in the present study. For each subject, care working time, heart rate, walking steps, estimated energy expenditure and working time in different postures were determined during day shift work (540 min) and night shift work (960 min). Although the time on duty, working and recess were significantly longer in night shift work than day shift work, the percentages of working and recess time to duty time were nearly the same regardless of shift work. The longest care work in each shift work was individual care of residents in the SNH. The maximum, minimum and mean heart rate and percentages to estimated maximal heart rate were similar in each shift work. Although total walking steps in night shift work were significantly larger than those in day shift work, steps per hour did not differ between them. The estimated total energy expenditure (kcal) was significantly higher in night shift work than in day shift work; however, the work intensity (kcal/kg/min) was significantly higher in day shift work. The longest length and larger percentage of working time were observed in standing posture in each shift work. These findings suggest that physical activity and energy expenditure of matrons under either shift work in the SNH seem to be high. Further studies are needed to clarify the work load of matrons engaged in SNH to formulate countermeasures.

Determination of mechanical properties of impacted human morsellized cancellous allografts for revision joint arthroplasty

This paper deals with the characterization of mechanical properties of impacted morsellized cancellous allograft (IMCA) produced by dynamic compaction of allograft femoral heads ground by commercially available bone mills, i.e. rotating rasp and reciprocating type bone mills. Various ranges and profiles of particle size in the graft aggregates were obtained using these bone mills, and the effect of number of compaction as well as the distribution of particle sizes on the mechanical properties of IMCA under quasistatic compression and shear loading conditions was discussed. The morsellized cancellous allograft prepared by the reciprocating type bone mill showed a broad distribution of particle sizes, and gave IMCA superior mechanical properties to the graft with a more uniform size distribution, or prepared by the rotating rasp type bone mills. The increase of number of compaction also improved the mechanical properties of IMCA in compression.

Heart rate variability in response to psychological test in hand-arm vibration syndrome patients assessed by frequency domain analysis

To investigate heart rate variability in response to psychological tests (Japanese version of Stroop color word test and mirror drawing test) in 29 hand-arm vibration syndrome (HAVS) patients, 16 of them with vibration-induced white finger (VWF) and 13 without VWF, and 10 healthy controls of similar age, heart rate variability during spontaneous and deep (6 cycles a minute) breathing in supine position before and after exposure to the psychological tests was examined calculating frequency domain components such as low frequency (LF) power-index of both the sympathetic and parasympathetic activity, high frequency (HF) power-index of the parasympathetic activity and LF/HF-index of the sympathovagal balance. The group of all patients and the group without VWF indicated significant increase in LF/HF in the deep breathing measurement after exposure to the psychological tests. The result suggests that the sympathetic tone in the sympathovagal balance predominated in the HAVS patients which means that they had larger sensitivity of the sympathetic nervous system to the psychological tests.

Effects of room temperature, seasonal condition and food intake on finger skin temperature during cold exposure test for diagnosing hand-arm vibration syndrome

For diagnosing the hand-arm vibration syndrome, peripheral circulation and sensory tests immersing one hand in cold water at 10 degrees C for 10 min have been performed widely in Japan. The authors investigated the effects of room temperature, seasonal condition and food intake on the test results, especially finger skin temperature. Six healthy males were examined repeatedly under six different room temperatures at 10 degrees C, 15 degrees C, 20 degrees C, 22.5 degrees C, 25 degrees C and 30 degrees C. Eight healthy males were examined under room temperatures at 10 degrees C, 20 degrees C and 30 degrees C, repeatedly in winter, spring, summer and autumn. Six healthy males were examined in summer under room temperature at 22.5 degrees C repeatedly 1 hr after, 3 hr after meal and after fasting for 13 hr. The finger skin temperature was strongly affected by room temperature. The finger skin temperature was also affected by seasonal condition. No remarkable effect of food intake was observed. For estimating circulatory function of the upper extremities using the finger skin temperature, the room temperature should be strictly controlled and the effect of seasonal condition must be taken into consideration.