The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular ...The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.展开更多
BACKGROUND Currently,the differentiation of jaw tumors is mainly based on the lesion’s morphology rather than the enhancement characteristics,which are important in the differentiation of neoplasms across the body.Th...BACKGROUND Currently,the differentiation of jaw tumors is mainly based on the lesion’s morphology rather than the enhancement characteristics,which are important in the differentiation of neoplasms across the body.There is a paucity of literature on the enhancement characteristics of jaw tumors.This is mainly because,even though computed tomography(CT)is used to evaluate these lesions,they are often imaged without intravenous contrast.This study hypothesised that the enhancement characteristics of the solid component of jaw tumors can aid in the differentiation of these lesions in addition to their morphology by dual-energy CT,therefore improving the ability to differentiate between various pathologies.AIM To evaluate the role of contrast enhancement and dual-energy quantitative parameters in CT in the differentiation of jaw tumors.METHODS Fifty-seven patients with jaw tumors underwent contrast-enhanced dual-energy CT.Morphological analysis of the tumor,including the enhancing solid component,was done,followed by quantitative analysis of iodine concentration(IC),water concentration(WC),HU,and normalized IC.The study population was divided into four subgroups based on histopathological analysis-central giant cell granuloma(CGCG),ameloblastoma,odontogenic keratocyst(OKC),and other jaw tumors.A one-way ANOVA test for parametric variables and the Kruskal-Wallis test for nonparametric variables were used.If significant differences were found,a series of independent t-tests or Mann-Whitney U tests were used.RESULTS Ameloblastoma was the most common pathology(n=20),followed by CGCG(n=11)and OKC.CGCG showed a higher mean concentration of all quantitative parameters than ameloblastomas(P<0.05).An IC threshold of 31.35×100μg/cm3 had the maximum sensitivity(81.8%)and specificity(65%).Between ameloblastomas and OKC,the former showed a higher mean concentration of all quantitative parameters(P<0.001),however when comparing unilocular ameloblastomas with OKCs,the latter showed significantly higher WC.Also,ameloblastoma had a higher IC and lower WC compared to“other jaw tumors”group.CONCLUSION Enhancement characteristics of solid components combined with dual-energy parameters offer a more precise way to differentiate between jaw tumors.展开更多
Immunohistochemistry is a technique with an interesting journey.It is one of the well-established and reliable technique in modern pathology and it is extremely useful in diagnosis of sinister pathologies with perplex...Immunohistochemistry is a technique with an interesting journey.It is one of the well-established and reliable technique in modern pathology and it is extremely useful in diagnosis of sinister pathologies with perplexing histopathology.Not only does it enhance the diagnostic abilities of a pathologist,but it also has a huge prognostic potential,a great aid in establishing stage of malignancies,determines phenotypic expressions of lymphoid neoplasms and monitors treatment progress and response to therapy.By employing and integrating the basics of varied branches like immunology,histology,microscopy and hematology,it has emerged as a magnificent tool over last few decades,saving pathologists and patients from the impact of serious diseases inflicting the human body.Furthermore,it has contributed immensely to all aspects of diseases related to oral cavity as well.This review has been thus taken to highlight the wide applications of this technique in General and Oral Pathology with an update.展开更多
The integrity of the basal stem cell layer is critical for epithelial homoeostasis.In this paper,we review the expression of oral mucosal stem cell markers(OM-SCMs)in oral submucous fibrosis(OSF),oral potentially mali...The integrity of the basal stem cell layer is critical for epithelial homoeostasis.In this paper,we review the expression of oral mucosal stem cell markers(OM-SCMs)in oral submucous fibrosis(OSF),oral potentially malignant disorders(OPMDs)and oral squamous cell carcinoma(OSCC)to understand the role of basal cells in potentiating cancer stem cell behaviour in OSF.While the loss of basal cell clonogenicity triggers epithelial atrophy in OSF,the transition of the epithelium from atrophic to hyperplastic and eventually neoplastic involves the reactivation of basal stemness.The vacillating expression patterns of OM-SCMs confirm the role of keratins 5,14,19,CD44,β1-integrin,p63,sex-determining region Y box(SOX2),octamer-binding transcription factor 4(Oct-4),c-MYC,B-cell-specific Moloney murine leukaemia virus integration site 1(Bmi-1)and aldehyde dehydrogenase 1(ALDH1)in OSF,OPMDs and OSCC.The downregulation of OM-SCMs in the atrophic epithelium of OSF and their upregulation during malignant transformation are illustrated with relevant literature in this review.展开更多
Although a few studies have shown that vascularity is increased from normal mucosa to dysplasia to carcinoma suggesting that disease progression in the oral mucosa is accompanied by angiogenesis. The role in lymph nod...Although a few studies have shown that vascularity is increased from normal mucosa to dysplasia to carcinoma suggesting that disease progression in the oral mucosa is accompanied by angiogenesis. The role in lymph node metastasis in oral squamous cell carcinoma (OSCC) is equivocal. Role of angiogenesis in OSCC development and metastasis is evaluated in this study. This retrospective study of 50 samples consisted of 9 normal buccal mucosa, 22 leukoplakias, and 19 OSCC. Polyclonal antibodies to von-Willebrand factor were used to highlight the microvessels. Images were captured and morphometric image analysis was done for microvessel density (MVD), area, and perimeter. Highest, as well as mean values of these three parameters were compared. MVD and perimeter, but not area, are significantly different between normal mucosa and OSCC, and leukoplakia and OSCC. There were no differences between normal mucosa and leukoplakia. MVD, area, and perimeter were not significantly different between the OSCC with and without lymph node metastasis. The highest and mean values of MVD are significantly correlated. In the development of OSCC, angiogenic phenotypic change occurs in carcinomas rather than in the pre-cancerous stage, and quantification of angiogenesis in OSCC does not predict the risk of lymph node metastasis.展开更多
Fibroblasts are the most abundant cellular components of connective tissue. They possess phenotypical heterogenicity and may be present in the form of smooth muscle cells or myofibroblasts(MFs). MFs are spindle-shaped...Fibroblasts are the most abundant cellular components of connective tissue. They possess phenotypical heterogenicity and may be present in the form of smooth muscle cells or myofibroblasts(MFs). MFs are spindle-shaped cells with stress fibres and welldeveloped fibronexus,and they display α-smooth muscle actin immunohistochemically and smoothmuscle myofilaments ultrastructurally. MFs play a crucial role in physiological and pathological processes. Derived from various sources,they play pivotal roles not only by synthesizing and producing extracellular matrix components,such as other connective tissue cells,but also are involved in force production. In the tissue remodelling phase of wound closure,integrinmediated interactions between MFs and type I collagen result in scar tissue formation. The tumour stroma in oral cancer actively recruits various cell types into the tumour mass,where they act as different sources of MFs. This article reviews the importance of MFs and its role in pathological processes such as wound healing,odontogenic cysts and tumours,salivary gland tumours,oral preneoplasia,and oral squamous cell carcinoma. Research oriented on blocking the transdifferentiation of fibroblasts into MFs can facilitate the development of noninvasive therapeutic strategies for the treatment of fibrosis and/or cancer.展开更多
BACKGROUND Metastatic adenocarcinoma of the jaw(MAJ)is a rare disease that accounts for 1%-3%of all oral and maxillofacial malignant tumours.Oral and maxillofacial pain may be the first symptom of metastatic spread of...BACKGROUND Metastatic adenocarcinoma of the jaw(MAJ)is a rare disease that accounts for 1%-3%of all oral and maxillofacial malignant tumours.Oral and maxillofacial pain may be the first symptom of metastatic spread of an occult primary tumour.Therefore,early identification of oral and maxillofacial pain by dental professionals is critical.AIM To explore the clinical and computerized tomography(CT)features of MAJ with oral and maxillofacial pain as the first symptom.METHODS The medical records of all patients who were treated in our hospital between January 2006 and February 2020,and diagnosed with MAJ with oral and maxillofacial pain as the first symptom,were reviewed retrospectively.Clinical data were collected on age,sex,medical history,clinical manifestations,site of metastasis,and site of the primary lesion.CT features were analysed in detail,and a radiological classification scheme comprising five types:Osteolytic,osteoblastic,mixed,cystic,and alveolar bone resorption was proposed.RESULTS The primary sites of MAJ were the lungs(n=6),liver(n=4),kidneys(n=2),prostate(n=1),and gastric cardia(n=1).Five tumours were classified as the osteolytic type,all with a permeative margin(100%,P<0.05),and three were classified as the mixed type,mostly with a moth-eaten margin(80%,P<0.05).The cystic(n=3)and alveolar bone resorption(n=1)types had geographic margins,and the osteoblastic type(n=1)had sclerotic margins.Moreover,nine tumours showed periosteal reaction and five showed a localised soft tissue mass,while the occurrence of jaw expansion was relatively rare.CONCLUSION MAJ has complex clinical and CT features.Oral and maxillofacial pain may be the first sign of a primary tumour affecting other sites.展开更多
Objective:To investigate the effect of lead on the production of IL-8 and cell proliferation in normal human oral keratinocytes（NHKs）.Methods:NHKs were prepared as outgrowths from normal human buccal mucosa.The cell...Objective:To investigate the effect of lead on the production of IL-8 and cell proliferation in normal human oral keratinocytes（NHKs）.Methods:NHKs were prepared as outgrowths from normal human buccal mucosa.The cells were treated with three concentrations of lead glutamate(4.5×10<sup>-5</sup>M,4.5×10<sup>-6</sup>M and 4.5×10<sup>-7</sup>M).NHKs grown in glutamic acid were used as control.The amounts of IL-8 secreted in the culture supernatants were evaluated at 12 and 24 h using enzyme-linked immunospecific assay（ELISA）.Cell proliferation was determined by the MTT colorimetric assay.Three cultures were used for each experiment,and three independent experiments were performed.Analysis of variance and Duncan’s multiple range tests were used for statistical analysis.Results:An elevation of IL-8 in culture supernatants of NHKs treated with lead at all concentrations at 12 and 24 h after exposure in a dose-dependent manner was revealed.A significant increase in cell numbers was observed only at 24 h exposed to 4.5×10<sup>- 5</sup>M lead glutamate.Conclusions:The capacity of NHKs,to secrete IL-8,enhanced by lead glutamate,is demonstrated here.Induction of cell proliferation is revealed only after exposure to high lead concentration.The elevation of secreted IL-8 is a probable initial sign for the acute inflammatory response and may be involved in the pathogenesis of lead stomatitis.展开更多
AIM: To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM).METHODS: The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemi...AIM: To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM).METHODS: The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemical SP staining in 64 paraffin-embedded tissue samples. Of them, 9 were from BLOM with dysplasia, 15 from BLOM without dysplasia,15 from oral squamous cell carcinoma (OSCC), 15 from oral precancerosis, and 10 from normal tissues. Cell proliferation, apoptosis and angiogenesis of tissue samples were also analyzed.RESULTS: The expression of Ki-67 in BLOM with dysplasia,oral precancerosis and OSCC was significantly higher than in BLOM without dysplasia and normal mucosa. The microvascular density (MVD) in BLOM with and without dysplasia, oral precancerosis, and OSCC was significantly higher than in normal mucosa. Apoptosis in BLOM and oral precancerosis was significantly higher than in OSCC and normal mucosa.CONCLUSION: Benign lymphoadenosis of oral mucosa has potentialities of cancerization.展开更多
Quality of life(QoL) is a vital and often required health outcome measure that is relevant to patient care. A healthy oral cavity enables person to perform daily activities without any limitations. However, any distur...Quality of life(QoL) is a vital and often required health outcome measure that is relevant to patient care. A healthy oral cavity enables person to perform daily activities without any limitations. However, any disturbance may result in impaired QoL. The oral health-remains an essential element of people's health and well-being. In recent years, the tradition of clinical practice and research has been changed by incorporating QoL assessment, as it helps in assessment of patients' needs and monitoring treatment responses. Oral potentially malignant disorders(OPMDs) are a group of chronic disorders including oral leukoplakia(OL), oral lichen planus and oral submucous fibrosis(OSF). It is evident that patients with OPMDs experience significant health-related symptoms, functional limitations and psycho-social impairment, compromising their Qo L. Moreover, the worsening of Qo L has been associated with advanced stages of OPMDs. Despite of increasing number of OPMD cases in recent decades, limited literature is available regarding QoL in this population. Although, there is higher prevalence of habit-related OPMDs, particularly OSF and OL in Southern Asian countries, only a few studies have been performed in these populations. Moreover, these studies administered generic Qo L instruments, which offer less sensitivity to clinical changes. However, condition-specific instruments are more sensitive and allows better measurement of QoL. As the impacts of different conditions on OHRQoL may vary, the development and validation of a QoL instrument specific to each clinical entity of OPMDs is currently needed.展开更多
Aim To analyse the cytomorphological features of keratinocytes in smears obtained from the oral mucosa of tobacco users and from oral squamous cell carcinoma lesions. Methodology Oral smears were obtained from clinica...Aim To analyse the cytomorphological features of keratinocytes in smears obtained from the oral mucosa of tobacco users and from oral squamous cell carcinoma lesions. Methodology Oral smears were obtained from clinically, normal appearing mucosa of oral squamous cell carcinoma patients (n=20) and from the mucosa of smokers (n=20), and apparently healthy individuals (n=20) were used as controls. The smears were histochemically stained and cytomorphological assessment of the keratinocytes was carried out. One-way ANOVA (Analysis of Variance) was used for comparing the parameters among multiple groups and Tukey-HSD test was used to compare the mean values between groups. Results The mean nuclear area of keratinocytes from the mucosa of tobacco users was 46 ± 2.57 and that of the oral squamous cell carcinoma lesion was 81.54 ± 4.31. While there was a significant (P=0.001) reduction in the cellular area of keratinocytes from oral squamous cell carcinoma lesion when compared with those from oral smears of tobacco users. Conclusion Cytomorphometric analysis of keratinocytes can serve as a useful adjunct in the early diagnosis of oral squamous cell carcinomas.展开更多
Poly Adenylate Binding Protein Interacting protein 1(PAIP1) plays a critical role in translation initiation and is associated with the several cancer types. However, its function and clinical significance have not yet...Poly Adenylate Binding Protein Interacting protein 1(PAIP1) plays a critical role in translation initiation and is associated with the several cancer types. However, its function and clinical significance have not yet been described in oral squamous cell carcinoma(OSCC) and its associated features like lymph node metastasis(LNM). Here, we used the data available from Gene Expression Omnibus(GEO), The Cancer Genome Atlas(TCGA), and Clinical Proteomic Tumor Analysis Consortium(CPTAC) to analyze PAIP1 expression in oral cancer. The publicly available data suggests that PAIP1 mRNA and protein levels were increased in OSCC. The high PAIP1 expression was more evident in samples with advanced stage, LNM, and worse pattern of invasion. Moreover, the in vitro experiments revealed that PAIP1 knockdown attenuated colony forming, the aggressiveness of OSCC cell lines, decreasing MMP9 activity and SRC phosphorylation. Importantly, we found a correlation between PAIP1 and pSRC through the analysis of the IHC scores and CPTAC data in patient samples. Our findings suggest that PAIP1 could be an independent prognostic factor in OSCC with LNM and a suitable therapeutic target to improve OSCC patient outcomes.展开更多
Polygonum cuspidatum is used as a traditional medicinal herb for the therapy of various diseases including several types of cancers. In the present study, we focused on addressing the anti-cancer activity and molecula...Polygonum cuspidatum is used as a traditional medicinal herb for the therapy of various diseases including several types of cancers. In the present study, we focused on addressing the anti-cancer activity and molecular mechanism of methanol extract of Polygonum cuspidatum (MEPC) in HSC-2 human oral cancer cells. The effect of MEPC on oral cancer cells was estimated by 3-(4,5-dimethylthiazol-20yl)-(3-carboxymethoxyphenyl)-2-(4-sulphophenyl)-2H-tetrazolium (MTS) assay, 4’-6-diamidino-2-phenylindole (DAPI) staining and Western blot analysis. MEPC inhibited the cell viability and induced apoptosis through the induction of death receptor (DR) 5. MEPC also increased the expression of C/EBP homologous protein/growth arrest and the DNA damage-inducible gene 153 (CHOP), a transcription factor induced by ER stress. Thus, we concluded that the induction of CHOP leading to DR5 up-regulation is required for the anti-cancer activity of MEPC in HSC-2 cells and MEPC may be a promising drug candidate for oral cancer.展开更多
Withaferin A (WA) is a bioactive compound derived from a medicinal plant Withania somnifera and has potential therapeutic effects against various types of cancers. The purpose of this study is to investigate an apopto...Withaferin A (WA) is a bioactive compound derived from a medicinal plant Withania somnifera and has potential therapeutic effects against various types of cancers. The purpose of this study is to investigate an apoptotic effect of WA and identify its molecular target in HSC-3 and HSC-4 human oral cancer cell lines using Trypan blue exclusion assay, DAPI staining and western blotting. WA inhibited cell viability and induced apoptosis in a concentration- or time-dependent manner, as evidenced by induction of nuclear condensation and fragmentation, activation of caspase 3 and poly (ADP-ribose) polymerase (PARP) cleavage. WA-induced apoptosis was partly diminished by Z-VAD, a pancaspase inhibitor. WA also increased Bim and Bax protein in HSC-3 and HSC-4 cells, respectively. These results suggest that WA may be a potential chemotherapeutic drug candidate against human oral cancer.展开更多
Verruciform xanthoma is a rare tumor-like lesion, predominantly affecting the oral mucosa. Although several studies of verruciform xanthoma have been reported, the characteristic features and pathogenesis have not bee...Verruciform xanthoma is a rare tumor-like lesion, predominantly affecting the oral mucosa. Although several studies of verruciform xanthoma have been reported, the characteristic features and pathogenesis have not been fully clarified. The purpose of the present study is to perform immunohistochemical analysis using markers of proliferative cell activity and cytokeratins, and to perform comparative analysis between cytological and histological features in order to clarify the characteristic features of verruciform xanthomas. Histological findings showed exophitic proliferation of stratified squamous epithelium and accumulation of foamy macrophages between epithelial processes. Immunohistochemically, accumulated foamy cells showed positive immuno-reactivity for CD68, and positive cells were also present in the epithelium. Expression of pancy-tokeratin was observed in most layers of the epithelium, whereas cytokeratin 13 was also detected in prickle cell layers. Positive reactivity for Ki-67 was observed in epithelial cell nuclei. Positive reactivity was largely distributed in basal and/or parabasal cell layers, and the positive cell rate was 20%. In addition, exfoliative cytological findings showed hyperkeratotic epithelial cells with picnosis, thus suggesting the characteristics of hyperplastic epithelium in verruciforma, although foamy cells were not observed in the cytological specimens. These results suggest that benign morphological characteristics with local cellular immune response of verruciform xanthoma may be evaluated based on immunohistochemical expression of cytokeratin and Ki-67, as well as exfoliative cytological findings.展开更多
Background: Oral lesions have been reported to be early clinical features of HIV infection. The objective of this study was to establish the prevalence of oral lesions and the management outcome using HAART in HIV Ser...Background: Oral lesions have been reported to be early clinical features of HIV infection. The objective of this study was to establish the prevalence of oral lesions and the management outcome using HAART in HIV Seropositive patients attending a tertiary hos- pital in Lagos, Nigeria. Methods: This was a prospective study in 114 newly diagnosed adult HIV infected patients (not on antiretroviral therapy), who attended the PEPFAR clinic at Lagos University Teaching Hospital. They were assessed for oral lesions which were evaluated using EEC/WHO—Classification on the diagnostic criteria for oral lesions in HIV. Data were collected using an interviewer administered questionnaire. Oral examination was carried out and oral lesions detected were recorded. Presence or absence of oral lesions was evaluated following 3 months use of HAART. Results: 114 patients were enrolled into the study, 49(43.0%) males and 65(57.0%) females, with age range of 18-63 years. 42 (36.8%) presented with oral lesions, 19 (45.2%) of which had multiple lesions. Oral Candidiasis which accounted for 47.7% was the most common oral lesion observed followed by Oral Hairy Leukoplakia (21.6%) and oral hyperpigmentation (10.8%). Pseudomembraneous Candidiasis was the most common variant of oral Candidiasis seen. Prevalence of oral lesions was significantly associated with low CD4 count and high viral load. Eighty four percent (84%) of oral lesions disappeared following 3 months of HAART treatment. Conclusion: Oral lesions are common features of HIV and a marker for progression of the disease to AIDS. There was significant reduction in oral lesions following 3 months treatment with HAART.展开更多
<strong>Background: </strong>Dental students play a role in both oral and general health education in their communities, so it is important that they have good knowledge to enable them offer good counsel. ...<strong>Background: </strong>Dental students play a role in both oral and general health education in their communities, so it is important that they have good knowledge to enable them offer good counsel. Knowing the relationship between periodontal disease and systemic conditions will put them in better stead when giving oral health education. The aim of this study was to assess the level of knowledge among dental students of the relationship between periodontal diseases and systemic conditions, and to determine whether there was a correlation between this knowledge and their oral hygiene practices. <strong>Methods:</strong> This was a cross-sectional study among dental students of the University of Port Harcourt, Rivers State, Nigeria. Consenting participants were given a self-administered questionnaire eliciting socio-demographic information, knowledge about the relationship between periodontal diseases and systemic diseases, as well as oral hygiene practices. Each correct response on knowledge was scored as 1, while incorrect responses were scored 0, with a maximum score of 7. Participants’ knowledge was graded as poor (0 - 2), fair (3 - 5) and good (6 - 7). Data was analyzed using IBM SPSS version 21. p ≤ 0.05 was considered statistically significant. Spearman’s ranked correlation was used to assess the correlation between knowledge of the relationship between periodontal diseases and systemic diseases and oral hygiene practices. <strong>Results:</strong> There were 109 dental students (58 males, 51 females) in this study, with a mean age of 24.1 ± 3.6 years. Preclinical students were 43 (39.4%) while clinical students were 66 (60.6%). All (100%) participants knew that oral health was important to systemic health, with 89.9% knowing that periodontal disease was specifically linked to systemic disease. Only 50.5% of participants knew that there was a link between periodontal disease and diabetes mellitus. Sixty-four (58.7%) of the participants regularly cleaned in between their teeth. The most commonly used interdental cleaning aid was toothpick (45.0%). Clinical students had significantly better knowledge on the relationship between periodontal disease and systemic disease compared to pre-clinical students (p = 0.001). There was positive correlation between knowledge about periodontal disease and its link with systemic disease and better oral hygiene practices, but this was not statistically significant. <strong>Conclusion: </strong>The majority of dental students had a fair knowledge about the relationship between periodontal diseases and systemic diseases.展开更多
文摘The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.
文摘BACKGROUND Currently,the differentiation of jaw tumors is mainly based on the lesion’s morphology rather than the enhancement characteristics,which are important in the differentiation of neoplasms across the body.There is a paucity of literature on the enhancement characteristics of jaw tumors.This is mainly because,even though computed tomography(CT)is used to evaluate these lesions,they are often imaged without intravenous contrast.This study hypothesised that the enhancement characteristics of the solid component of jaw tumors can aid in the differentiation of these lesions in addition to their morphology by dual-energy CT,therefore improving the ability to differentiate between various pathologies.AIM To evaluate the role of contrast enhancement and dual-energy quantitative parameters in CT in the differentiation of jaw tumors.METHODS Fifty-seven patients with jaw tumors underwent contrast-enhanced dual-energy CT.Morphological analysis of the tumor,including the enhancing solid component,was done,followed by quantitative analysis of iodine concentration(IC),water concentration(WC),HU,and normalized IC.The study population was divided into four subgroups based on histopathological analysis-central giant cell granuloma(CGCG),ameloblastoma,odontogenic keratocyst(OKC),and other jaw tumors.A one-way ANOVA test for parametric variables and the Kruskal-Wallis test for nonparametric variables were used.If significant differences were found,a series of independent t-tests or Mann-Whitney U tests were used.RESULTS Ameloblastoma was the most common pathology(n=20),followed by CGCG(n=11)and OKC.CGCG showed a higher mean concentration of all quantitative parameters than ameloblastomas(P<0.05).An IC threshold of 31.35×100μg/cm3 had the maximum sensitivity(81.8%)and specificity(65%).Between ameloblastomas and OKC,the former showed a higher mean concentration of all quantitative parameters(P<0.001),however when comparing unilocular ameloblastomas with OKCs,the latter showed significantly higher WC.Also,ameloblastoma had a higher IC and lower WC compared to“other jaw tumors”group.CONCLUSION Enhancement characteristics of solid components combined with dual-energy parameters offer a more precise way to differentiate between jaw tumors.
文摘Immunohistochemistry is a technique with an interesting journey.It is one of the well-established and reliable technique in modern pathology and it is extremely useful in diagnosis of sinister pathologies with perplexing histopathology.Not only does it enhance the diagnostic abilities of a pathologist,but it also has a huge prognostic potential,a great aid in establishing stage of malignancies,determines phenotypic expressions of lymphoid neoplasms and monitors treatment progress and response to therapy.By employing and integrating the basics of varied branches like immunology,histology,microscopy and hematology,it has emerged as a magnificent tool over last few decades,saving pathologists and patients from the impact of serious diseases inflicting the human body.Furthermore,it has contributed immensely to all aspects of diseases related to oral cavity as well.This review has been thus taken to highlight the wide applications of this technique in General and Oral Pathology with an update.
文摘The integrity of the basal stem cell layer is critical for epithelial homoeostasis.In this paper,we review the expression of oral mucosal stem cell markers(OM-SCMs)in oral submucous fibrosis(OSF),oral potentially malignant disorders(OPMDs)and oral squamous cell carcinoma(OSCC)to understand the role of basal cells in potentiating cancer stem cell behaviour in OSF.While the loss of basal cell clonogenicity triggers epithelial atrophy in OSF,the transition of the epithelium from atrophic to hyperplastic and eventually neoplastic involves the reactivation of basal stemness.The vacillating expression patterns of OM-SCMs confirm the role of keratins 5,14,19,CD44,β1-integrin,p63,sex-determining region Y box(SOX2),octamer-binding transcription factor 4(Oct-4),c-MYC,B-cell-specific Moloney murine leukaemia virus integration site 1(Bmi-1)and aldehyde dehydrogenase 1(ALDH1)in OSF,OPMDs and OSCC.The downregulation of OM-SCMs in the atrophic epithelium of OSF and their upregulation during malignant transformation are illustrated with relevant literature in this review.
文摘Although a few studies have shown that vascularity is increased from normal mucosa to dysplasia to carcinoma suggesting that disease progression in the oral mucosa is accompanied by angiogenesis. The role in lymph node metastasis in oral squamous cell carcinoma (OSCC) is equivocal. Role of angiogenesis in OSCC development and metastasis is evaluated in this study. This retrospective study of 50 samples consisted of 9 normal buccal mucosa, 22 leukoplakias, and 19 OSCC. Polyclonal antibodies to von-Willebrand factor were used to highlight the microvessels. Images were captured and morphometric image analysis was done for microvessel density (MVD), area, and perimeter. Highest, as well as mean values of these three parameters were compared. MVD and perimeter, but not area, are significantly different between normal mucosa and OSCC, and leukoplakia and OSCC. There were no differences between normal mucosa and leukoplakia. MVD, area, and perimeter were not significantly different between the OSCC with and without lymph node metastasis. The highest and mean values of MVD are significantly correlated. In the development of OSCC, angiogenic phenotypic change occurs in carcinomas rather than in the pre-cancerous stage, and quantification of angiogenesis in OSCC does not predict the risk of lymph node metastasis.
文摘Fibroblasts are the most abundant cellular components of connective tissue. They possess phenotypical heterogenicity and may be present in the form of smooth muscle cells or myofibroblasts(MFs). MFs are spindle-shaped cells with stress fibres and welldeveloped fibronexus,and they display α-smooth muscle actin immunohistochemically and smoothmuscle myofilaments ultrastructurally. MFs play a crucial role in physiological and pathological processes. Derived from various sources,they play pivotal roles not only by synthesizing and producing extracellular matrix components,such as other connective tissue cells,but also are involved in force production. In the tissue remodelling phase of wound closure,integrinmediated interactions between MFs and type I collagen result in scar tissue formation. The tumour stroma in oral cancer actively recruits various cell types into the tumour mass,where they act as different sources of MFs. This article reviews the importance of MFs and its role in pathological processes such as wound healing,odontogenic cysts and tumours,salivary gland tumours,oral preneoplasia,and oral squamous cell carcinoma. Research oriented on blocking the transdifferentiation of fibroblasts into MFs can facilitate the development of noninvasive therapeutic strategies for the treatment of fibrosis and/or cancer.
基金Supported by the Jiangsu Province Natural Science Foundation of China,No.BK20150089the Nanjing Science and Technology Development Fund,No.201503038.
文摘BACKGROUND Metastatic adenocarcinoma of the jaw(MAJ)is a rare disease that accounts for 1%-3%of all oral and maxillofacial malignant tumours.Oral and maxillofacial pain may be the first symptom of metastatic spread of an occult primary tumour.Therefore,early identification of oral and maxillofacial pain by dental professionals is critical.AIM To explore the clinical and computerized tomography(CT)features of MAJ with oral and maxillofacial pain as the first symptom.METHODS The medical records of all patients who were treated in our hospital between January 2006 and February 2020,and diagnosed with MAJ with oral and maxillofacial pain as the first symptom,were reviewed retrospectively.Clinical data were collected on age,sex,medical history,clinical manifestations,site of metastasis,and site of the primary lesion.CT features were analysed in detail,and a radiological classification scheme comprising five types:Osteolytic,osteoblastic,mixed,cystic,and alveolar bone resorption was proposed.RESULTS The primary sites of MAJ were the lungs(n=6),liver(n=4),kidneys(n=2),prostate(n=1),and gastric cardia(n=1).Five tumours were classified as the osteolytic type,all with a permeative margin(100%,P<0.05),and three were classified as the mixed type,mostly with a moth-eaten margin(80%,P<0.05).The cystic(n=3)and alveolar bone resorption(n=1)types had geographic margins,and the osteoblastic type(n=1)had sclerotic margins.Moreover,nine tumours showed periosteal reaction and five showed a localised soft tissue mass,while the occurrence of jaw expansion was relatively rare.CONCLUSION MAJ has complex clinical and CT features.Oral and maxillofacial pain may be the first sign of a primary tumour affecting other sites.
文摘Objective:To investigate the effect of lead on the production of IL-8 and cell proliferation in normal human oral keratinocytes（NHKs）.Methods:NHKs were prepared as outgrowths from normal human buccal mucosa.The cells were treated with three concentrations of lead glutamate(4.5×10<sup>-5</sup>M,4.5×10<sup>-6</sup>M and 4.5×10<sup>-7</sup>M).NHKs grown in glutamic acid were used as control.The amounts of IL-8 secreted in the culture supernatants were evaluated at 12 and 24 h using enzyme-linked immunospecific assay（ELISA）.Cell proliferation was determined by the MTT colorimetric assay.Three cultures were used for each experiment,and three independent experiments were performed.Analysis of variance and Duncan’s multiple range tests were used for statistical analysis.Results:An elevation of IL-8 in culture supernatants of NHKs treated with lead at all concentrations at 12 and 24 h after exposure in a dose-dependent manner was revealed.A significant increase in cell numbers was observed only at 24 h exposed to 4.5×10<sup>- 5</sup>M lead glutamate.Conclusions:The capacity of NHKs,to secrete IL-8,enhanced by lead glutamate,is demonstrated here.Induction of cell proliferation is revealed only after exposure to high lead concentration.The elevation of secreted IL-8 is a probable initial sign for the acute inflammatory response and may be involved in the pathogenesis of lead stomatitis.
文摘AIM: To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM).METHODS: The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemical SP staining in 64 paraffin-embedded tissue samples. Of them, 9 were from BLOM with dysplasia, 15 from BLOM without dysplasia,15 from oral squamous cell carcinoma (OSCC), 15 from oral precancerosis, and 10 from normal tissues. Cell proliferation, apoptosis and angiogenesis of tissue samples were also analyzed.RESULTS: The expression of Ki-67 in BLOM with dysplasia,oral precancerosis and OSCC was significantly higher than in BLOM without dysplasia and normal mucosa. The microvascular density (MVD) in BLOM with and without dysplasia, oral precancerosis, and OSCC was significantly higher than in normal mucosa. Apoptosis in BLOM and oral precancerosis was significantly higher than in OSCC and normal mucosa.CONCLUSION: Benign lymphoadenosis of oral mucosa has potentialities of cancerization.
文摘Quality of life(QoL) is a vital and often required health outcome measure that is relevant to patient care. A healthy oral cavity enables person to perform daily activities without any limitations. However, any disturbance may result in impaired QoL. The oral health-remains an essential element of people's health and well-being. In recent years, the tradition of clinical practice and research has been changed by incorporating QoL assessment, as it helps in assessment of patients' needs and monitoring treatment responses. Oral potentially malignant disorders(OPMDs) are a group of chronic disorders including oral leukoplakia(OL), oral lichen planus and oral submucous fibrosis(OSF). It is evident that patients with OPMDs experience significant health-related symptoms, functional limitations and psycho-social impairment, compromising their Qo L. Moreover, the worsening of Qo L has been associated with advanced stages of OPMDs. Despite of increasing number of OPMD cases in recent decades, limited literature is available regarding QoL in this population. Although, there is higher prevalence of habit-related OPMDs, particularly OSF and OL in Southern Asian countries, only a few studies have been performed in these populations. Moreover, these studies administered generic Qo L instruments, which offer less sensitivity to clinical changes. However, condition-specific instruments are more sensitive and allows better measurement of QoL. As the impacts of different conditions on OHRQoL may vary, the development and validation of a QoL instrument specific to each clinical entity of OPMDs is currently needed.
文摘Aim To analyse the cytomorphological features of keratinocytes in smears obtained from the oral mucosa of tobacco users and from oral squamous cell carcinoma lesions. Methodology Oral smears were obtained from clinically, normal appearing mucosa of oral squamous cell carcinoma patients (n=20) and from the mucosa of smokers (n=20), and apparently healthy individuals (n=20) were used as controls. The smears were histochemically stained and cytomorphological assessment of the keratinocytes was carried out. One-way ANOVA (Analysis of Variance) was used for comparing the parameters among multiple groups and Tukey-HSD test was used to compare the mean values between groups. Results The mean nuclear area of keratinocytes from the mucosa of tobacco users was 46 ± 2.57 and that of the oral squamous cell carcinoma lesion was 81.54 ± 4.31. While there was a significant (P=0.001) reduction in the cellular area of keratinocytes from oral squamous cell carcinoma lesion when compared with those from oral smears of tobacco users. Conclusion Cytomorphometric analysis of keratinocytes can serve as a useful adjunct in the early diagnosis of oral squamous cell carcinomas.
基金supported the research work through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT, and Future Planning [2020R1F1A1050880], [2021R1A2C1006470], and [2019R1A2C1085896]
文摘Poly Adenylate Binding Protein Interacting protein 1(PAIP1) plays a critical role in translation initiation and is associated with the several cancer types. However, its function and clinical significance have not yet been described in oral squamous cell carcinoma(OSCC) and its associated features like lymph node metastasis(LNM). Here, we used the data available from Gene Expression Omnibus(GEO), The Cancer Genome Atlas(TCGA), and Clinical Proteomic Tumor Analysis Consortium(CPTAC) to analyze PAIP1 expression in oral cancer. The publicly available data suggests that PAIP1 mRNA and protein levels were increased in OSCC. The high PAIP1 expression was more evident in samples with advanced stage, LNM, and worse pattern of invasion. Moreover, the in vitro experiments revealed that PAIP1 knockdown attenuated colony forming, the aggressiveness of OSCC cell lines, decreasing MMP9 activity and SRC phosphorylation. Importantly, we found a correlation between PAIP1 and pSRC through the analysis of the IHC scores and CPTAC data in patient samples. Our findings suggest that PAIP1 could be an independent prognostic factor in OSCC with LNM and a suitable therapeutic target to improve OSCC patient outcomes.
文摘Polygonum cuspidatum is used as a traditional medicinal herb for the therapy of various diseases including several types of cancers. In the present study, we focused on addressing the anti-cancer activity and molecular mechanism of methanol extract of Polygonum cuspidatum (MEPC) in HSC-2 human oral cancer cells. The effect of MEPC on oral cancer cells was estimated by 3-(4,5-dimethylthiazol-20yl)-(3-carboxymethoxyphenyl)-2-(4-sulphophenyl)-2H-tetrazolium (MTS) assay, 4’-6-diamidino-2-phenylindole (DAPI) staining and Western blot analysis. MEPC inhibited the cell viability and induced apoptosis through the induction of death receptor (DR) 5. MEPC also increased the expression of C/EBP homologous protein/growth arrest and the DNA damage-inducible gene 153 (CHOP), a transcription factor induced by ER stress. Thus, we concluded that the induction of CHOP leading to DR5 up-regulation is required for the anti-cancer activity of MEPC in HSC-2 cells and MEPC may be a promising drug candidate for oral cancer.
文摘Withaferin A (WA) is a bioactive compound derived from a medicinal plant Withania somnifera and has potential therapeutic effects against various types of cancers. The purpose of this study is to investigate an apoptotic effect of WA and identify its molecular target in HSC-3 and HSC-4 human oral cancer cell lines using Trypan blue exclusion assay, DAPI staining and western blotting. WA inhibited cell viability and induced apoptosis in a concentration- or time-dependent manner, as evidenced by induction of nuclear condensation and fragmentation, activation of caspase 3 and poly (ADP-ribose) polymerase (PARP) cleavage. WA-induced apoptosis was partly diminished by Z-VAD, a pancaspase inhibitor. WA also increased Bim and Bax protein in HSC-3 and HSC-4 cells, respectively. These results suggest that WA may be a potential chemotherapeutic drug candidate against human oral cancer.
文摘Verruciform xanthoma is a rare tumor-like lesion, predominantly affecting the oral mucosa. Although several studies of verruciform xanthoma have been reported, the characteristic features and pathogenesis have not been fully clarified. The purpose of the present study is to perform immunohistochemical analysis using markers of proliferative cell activity and cytokeratins, and to perform comparative analysis between cytological and histological features in order to clarify the characteristic features of verruciform xanthomas. Histological findings showed exophitic proliferation of stratified squamous epithelium and accumulation of foamy macrophages between epithelial processes. Immunohistochemically, accumulated foamy cells showed positive immuno-reactivity for CD68, and positive cells were also present in the epithelium. Expression of pancy-tokeratin was observed in most layers of the epithelium, whereas cytokeratin 13 was also detected in prickle cell layers. Positive reactivity for Ki-67 was observed in epithelial cell nuclei. Positive reactivity was largely distributed in basal and/or parabasal cell layers, and the positive cell rate was 20%. In addition, exfoliative cytological findings showed hyperkeratotic epithelial cells with picnosis, thus suggesting the characteristics of hyperplastic epithelium in verruciforma, although foamy cells were not observed in the cytological specimens. These results suggest that benign morphological characteristics with local cellular immune response of verruciform xanthoma may be evaluated based on immunohistochemical expression of cytokeratin and Ki-67, as well as exfoliative cytological findings.
文摘Background: Oral lesions have been reported to be early clinical features of HIV infection. The objective of this study was to establish the prevalence of oral lesions and the management outcome using HAART in HIV Seropositive patients attending a tertiary hos- pital in Lagos, Nigeria. Methods: This was a prospective study in 114 newly diagnosed adult HIV infected patients (not on antiretroviral therapy), who attended the PEPFAR clinic at Lagos University Teaching Hospital. They were assessed for oral lesions which were evaluated using EEC/WHO—Classification on the diagnostic criteria for oral lesions in HIV. Data were collected using an interviewer administered questionnaire. Oral examination was carried out and oral lesions detected were recorded. Presence or absence of oral lesions was evaluated following 3 months use of HAART. Results: 114 patients were enrolled into the study, 49(43.0%) males and 65(57.0%) females, with age range of 18-63 years. 42 (36.8%) presented with oral lesions, 19 (45.2%) of which had multiple lesions. Oral Candidiasis which accounted for 47.7% was the most common oral lesion observed followed by Oral Hairy Leukoplakia (21.6%) and oral hyperpigmentation (10.8%). Pseudomembraneous Candidiasis was the most common variant of oral Candidiasis seen. Prevalence of oral lesions was significantly associated with low CD4 count and high viral load. Eighty four percent (84%) of oral lesions disappeared following 3 months of HAART treatment. Conclusion: Oral lesions are common features of HIV and a marker for progression of the disease to AIDS. There was significant reduction in oral lesions following 3 months treatment with HAART.
文摘<strong>Background: </strong>Dental students play a role in both oral and general health education in their communities, so it is important that they have good knowledge to enable them offer good counsel. Knowing the relationship between periodontal disease and systemic conditions will put them in better stead when giving oral health education. The aim of this study was to assess the level of knowledge among dental students of the relationship between periodontal diseases and systemic conditions, and to determine whether there was a correlation between this knowledge and their oral hygiene practices. <strong>Methods:</strong> This was a cross-sectional study among dental students of the University of Port Harcourt, Rivers State, Nigeria. Consenting participants were given a self-administered questionnaire eliciting socio-demographic information, knowledge about the relationship between periodontal diseases and systemic diseases, as well as oral hygiene practices. Each correct response on knowledge was scored as 1, while incorrect responses were scored 0, with a maximum score of 7. Participants’ knowledge was graded as poor (0 - 2), fair (3 - 5) and good (6 - 7). Data was analyzed using IBM SPSS version 21. p ≤ 0.05 was considered statistically significant. Spearman’s ranked correlation was used to assess the correlation between knowledge of the relationship between periodontal diseases and systemic diseases and oral hygiene practices. <strong>Results:</strong> There were 109 dental students (58 males, 51 females) in this study, with a mean age of 24.1 ± 3.6 years. Preclinical students were 43 (39.4%) while clinical students were 66 (60.6%). All (100%) participants knew that oral health was important to systemic health, with 89.9% knowing that periodontal disease was specifically linked to systemic disease. Only 50.5% of participants knew that there was a link between periodontal disease and diabetes mellitus. Sixty-four (58.7%) of the participants regularly cleaned in between their teeth. The most commonly used interdental cleaning aid was toothpick (45.0%). Clinical students had significantly better knowledge on the relationship between periodontal disease and systemic disease compared to pre-clinical students (p = 0.001). There was positive correlation between knowledge about periodontal disease and its link with systemic disease and better oral hygiene practices, but this was not statistically significant. <strong>Conclusion: </strong>The majority of dental students had a fair knowledge about the relationship between periodontal diseases and systemic diseases.
