Survivin在口腔鳞癌组织中的表达及其与COX-2相关性研究

目的:探讨凋亡抑制基因Survivin在口腔鳞癌组织中的表达及其与COX-2表达的相关性。方法:运用S-P免疫组化技术,检测Survivin和COX-2蛋白在50例口腔鳞癌组织、10例正常口腔黏膜组织中的阳性率。结果:Survivin蛋白在10例正常口腔黏膜组织中呈阴性,而在50例口腔鳞癌组织中有42例阳性,占84%,差异有极显著性差异(P<0.01),COX-2蛋白在口腔鳞癌组织中的阳性率为86%(43/50)。Survivin蛋白阳性率与年龄和性别不相关,而与COX-2蛋白阳性呈正相关(P<0.05)。Survivin蛋白在低分化癌组织中的表达比在高分化癌中高,但在统计学上无明显差异性。结论:肿瘤组织中Survivin蛋白的高阳性表达对口腔鳞癌的发生发展起重要作用;COX-2蛋白在口腔鳞癌组织中也有高阳性表达,并与Survivin有相关性。两者可能存在共同的激活机制,从而抑制口腔鳞癌细胞的凋亡。     

口腔鳞状细胞癌中RhoA的表达及作用

目的探讨口腔鳞状细胞癌组织及其转移灶、癌旁组织、增生鳞状上皮和正常口腔黏膜中RhoA的表达及其意义。方法采用免疫组化检测40例口腔鳞状细胞癌,RT-PCR技术分析口腔鳞状细胞癌组织、癌旁组织、口腔鳞状细胞癌转移灶、鳞状上皮增生和正常口腔黏膜组织中RhoA的表达情况。结果RhoA在非癌组织均不表达或弱表达,40例口腔鳞癌中25例表达RhoA,阳性率为62.50%;两者之间具有显著差异(P<0.05)。低分化鳞癌中RhoA的阳性率为66.67%,中、高分化鳞癌中RhoA的阳性率为60.71%;两者之间有统计学差异(P<0.05)。16例有淋巴结转移的鳞癌组织中13例表达RhoA,阳性率为81.25%,24例无淋巴结转移的鳞癌组织中12例表达RhoA,阳性率为50%;两者之间有统计学差异(P<0.05)。RT-PCR检测RhoA mRNA的表达水平,鳞癌组织中RhoA mRNA光密度相对值明显高于癌旁组织、增生鳞状上皮和正常口腔黏膜组织(P<0.01),低于转移灶(P<0.05)。结论RhoA的表达与鳞状细胞癌分化程度、转移程度有关,有望作为鳞状细胞癌预后和转移的参考指标。     

口腔鳞状细胞癌血清中IL-18的检测及其病理、临床意义

目的 检测IL-18在口腔鳞状细胞癌（oral cavity squamous cell carcinoma，OCSCC）患者血清中的表达，探讨其与口腔鳞状细胞癌的相关性。方法 应用酶联免疫反应（enzyme-linked immunosorbent assay，ELISA）方法检测30例口腔鳞状细胞癌和10例正常对照血清中IL-18的表达水平。结果 口腔鳞状细胞癌患者血清中IL-18表达水平高于对照组（P〈0．05）；中、低分化，临床Ⅲ、Ⅳ期，颈淋巴结转移者明显高于高分化，Ⅰ、Ⅱ期，无淋巴结转移者（P〈0．05）；不同年龄、性别、肿瘤发生部位，IL-18表达无差异（P〉0．05）。结论 IL-18的表达水平与口腔鳞状细胞癌的病理分级、临床分期及淋巴结转移密切相关。     

STAT3、EGF和EGFR在口腔鳞癌中的表达及其意义

目的:探讨口腔鳞癌组织中STAT3、EGF及EGFR的表达情况及意义.方法:应用免疫组化SP法检测60例正常口腔黏膜组织、30例不典型增生组织及60例口腔鳞癌组织中STAT3、EGF及EGFR蛋白的表达.结果:口腔鳞癌癌变过程中STAT3蛋白表达在正常黏膜组织、不典型增生组织及癌组织中的表达率依次增高,分别为13.3%(8/60)、30.0%(9/30)、71.2%(43/60)组间比较差异有统计学意义(P<0.05);而EGF蛋白在正常口腔黏膜组织、不典型增生组织及口腔鳞癌组织中的表达率分别为25.0%(15/60)、46.7%(14/30)、76.7%(46/60),组间比较差异有统计学意义(P<0.05);EGFR在正常黏膜组织、不典型增生组织及癌组织中的表达率分别为15.0%(9/60)、36.7%(11/30)、70.0%(42/60),组间比较差异有统计学意义(P<0.05),三者呈正相关关系.口腔鳞癌组织中STAT3蛋白表达与癌的组织学分级、浸润深度及淋巴结转移密切相关(P<0.05); 结论:STAT3、EGF及EGFR在口腔鳞癌的浸润、转移及粘膜上皮癌变过程中起着重要作用,提示联合检测STAT3、EGF及EGFR可望成为口腔鳞癌早期诊断和判断预后的客观指标之一.     

SMAD4在舌鳞状细胞癌中的表达及意义

目的检测SMAD4在舌鳞状细胞癌中的表达水平,并分析其与肿瘤细胞分化程度及淋巴结转移之间的相关性。方法收集正常口腔黏膜组织石蜡标本8例、舌鳞癌组织石蜡标本38例。采用免疫组化方法检测正常组织及肿瘤组织中SMAD4表达水平。结果 SMAD4蛋白在舌鳞癌组织中的表达显著低于正常舌黏膜组织(P<0.05)。SMAD4蛋白在癌细胞中的整体表达水平在高分化鳞癌与中低分化鳞癌组中无明显统计学差异(P>0.05),但其核表达量在高分化鳞癌组显著高于中低分化组(P<0.05)。伴淋巴结转移鳞癌组中SMAD4在细胞核内的表达量低于不伴淋巴结转移鳞癌组(P<0.05)。结论SMAD4在舌鳞状细胞癌中的表达水平,尤其是核表达水平与舌鳞癌的细胞分化程度及淋巴结转移相关。     

细胞角蛋白19在口腔鳞状细胞癌中的表达及意义

目的:研究细胞角蛋白19 (cytokeratin 19,CK19)在口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)中的表达,探讨两者之间的相关性.方法:收集正常口腔黏膜、单纯上皮增生、上皮异常增生和OSCC患者活检标本49例,采用免疫组织化学、蛋白质印迹比较各组织中CK19的表达;收集未接受过放疗和化疗的OSCC患者16例及健康人群17例的血清,采用ELISA方法检测血清中CK19的可溶性片段CYFRA21-1的水平.采用SPSS17.0软件包进行数据处理.结果:CK19表达于有上皮异常增生的复层鳞状上皮基底上层和OSCC尤其是低分化鳞癌的癌细胞中,随上皮异常增生程度加重,CK19表达的阳性率、表达强度显著增加.OSCC患者血清CYFKA21-1含量显著高于健康对照组(P＜0.01).结论:CK19表达增加是口腔黏膜癌变过程中的早期事件,其异常表达可作为早期诊断OSCC的辅助指标之一.     

口腔鳞状细胞癌中Slug及E-cadherin的表达

目的探讨口腔鳞状细胞癌(OSCC)中Slug及E-cadherin表达及差异性。方法收集口腔鳞癌标本30例,正常口腔黏膜组织20例,使用rt-PCR的方法检测Slug及E-cadherin mRNA的表达情况,分析其病理特征相关性。结果口腔鳞癌组织中Slug的表达高于正常口腔黏膜组织(P<0.05),而口腔鳞癌组织中E-cadherin的表达低于正常口腔黏膜组织(P<0.05),Slug和E-cadherin表达与TNM分期、淋巴结是否转移相关(P<0.05),而与性别、年龄、细胞分化程度、肿瘤浸润大小无关(P>0.05)。结论口腔鳞状细胞癌中Slug和E-cadherin的表达与肿瘤的发展、侵袭、转移密切相关。     

线粒体促凋亡因子Omi/HtrA2在口腔鳞癌组织中的表达及意义

目的 探讨Omi/HtrA2在口腔鳞癌组织中的表达及其在口腔鳞癌发生发展中的作用及意义.方法 采用RT-PCR与免疫组织化学方法,检测20例低分化口腔鳞状细胞癌、20例高分化口腔鳞状细胞癌、20例口腔乳头状瘤、20例癌旁组织切除标本中Omi/HtrA2 mRNA与蛋白的表达情况,并与口腔正常组织标本中Omi/HtrA2mRNA与蛋白的表达情况作比较.结果 Omi/HtrA2蛋白在正常组织和癌旁组织中未检测到表达,在口腔鳞癌组(高、低分化)与口腔乳头状瘤组织中均有表达.Omi/HtrA2蛋白表达在高分化鳞癌组织中的表达水平高于低分化鳞癌组织、口腔乳头状瘤组织和癌旁组织(P＜0.05).Omi/HtrA2基因在高分化口腔鳞癌组织中的表达水平高于低分化口腔鳞癌组织、口腔乳头状瘤组织以及癌旁和正常组织(P＜0.05).结论 Omi/HtrA2在口腔鳞状细胞癌组织中有表达,表明Omi/HtrA2可能参与口腔鳞癌的发生发展过程.     

术前洛铂化疗对口腔鳞癌抑癌基因PTEN表达的影响

目的:研究口腔鳞癌在洛铂术前化疗后PTEN蛋白的表达变化及其临床意义。方法:60例口腔癌患者随机分为2组,术前未行化疗为对照组,术前化疗者为实验组,应用免疫组织化学SP法检测口腔癌患者正常口腔黏膜组织及其癌组织中PTEN蛋白的表达,HE染色法进行临床病理学分析。结果:2组60例正常口腔黏膜组织中PTEN蛋白全部表达,阳性率为100%;对照组中,口腔鳞癌组织中PTEN蛋白的阳性表达率为76.7%,显著低于正常口腔黏膜组织;对照组在高、低分化口腔鳞癌组织中PTEN蛋白的阳性表达率分别为100%、57.1%,差异有统计学意义(P<0.05);PTEN表达阳性率与患者的年龄、性别无显著相关性(P>0.05),与淋巴结转移、病理分级及其临床肿瘤大小之间相关(P<0.05)。实验组口腔鳞癌组织中PTEN蛋白的阳性表达率为100%,显著高于对照组的76.7%(P<0.05),与正常口腔黏膜组织比较无显著相关性(P>0.05)。结论:PTEN基因在口腔鳞癌的发生发展过程起着一定的作用,对判断预后具有一定的意义。术前洛铂化疗可提高口腔鳞癌组织中PTEN的表达。     

口腔鳞状细胞癌Fas基因表达与细胞凋亡关系的研究

目的　探讨Fas基因mRNA及蛋白表达水平与人口腔鳞状细胞癌细胞凋亡的关系。方法　应用Northern 杂交、双参数流式术(TUNEL法)检测人口腔鳞状细胞癌中Fas mRNA及蛋白的表达,鳞癌细胞的细胞周期与凋亡水平。结果　5例正常口腔黏膜标本中均有Fas mRNA及蛋白的表达。在口腔鳞癌组织中,Fas mRNA及蛋白的表达与口腔鳞癌组织病理学分级有关(P<0·005),与口腔鳞癌组织分化程度和凋亡指数呈正相关。结论　口腔鳞癌中 Fas基因的表达与组织病理学分级及细胞凋亡之间关系密切。     

Clinical and pathological aspects on some odontogenic tumors

Odontogenic tumors constitute a very diverse group of lesions that reflects the complex processes of odontogenesis. Controversies over their classification/subtyping, terminology and diagnosis have been persisted, which has direct bearings on therapeutic and/or prognostic implications.     

Can you be too old for oral implants? An update on ageing and plasticity in the oro‐facial sensorimotor system

This review focuses on the capacity of the brain for plasticity and the utility and efficacy of oral implants in helping to restore oro‐facial sensorimotor functions, especially in elderly patients. The review first outlines the components of the oro‐facial sensorimotor system which encompasses both oro‐facial tissues and a number of brain regions. One such region is the sensorimotor cortex that controls the activity of the numerous oro‐facial skeletal muscles. These muscles are involved in a number of functions including reflexes and the more complex sensorimotor functions of mastication, swallowing and speech. The review outlines the use by the brain of sensory inputs from oro‐facial receptors in order to provide for exquisite sensorimotor control of the activity of the oro‐facial muscles. It highlights the role in this sensorimotor control played by periodontal mechanoreceptors and their sensory inputs to the brain, and how oral implants in concert with the plastic capacity of the brain may, at least in part, compensate for reduced sensorimotor functioning when teeth are lost. It outlines findings of ageing‐related decrements in oro‐facial sensorimotor functions and control. The changes in oro‐facial tissues and the brain that underlie these ageing‐related functional alterations are also considered, along with adaptive and compensatory processes that utilise the brain's capacity for plasticity. The review also notes the evidence t hat rehabilitation that incorporates adjunctive approaches such as sensorimotor training paradigms in addition to oral prostheses such as implants may enhance these processes and help maintain or facilitate recovery of sensorimotor functioning in the elderly.     

Tumor microenvironment in oral cancer: novel approaches for immunotherapy

Squamous cell carcinoma of the head and neck (SCCHN), which arises from the squamous mucosal epithelium of the oral cavity, pharynx and larynx, is a major health problem in the US and other parts of the world, especially in developing countries.     

CBCT与RVG对下颌恒切牙根管形态评估的对比研究

目的:对比CBCT法与数字化X线成像法(RVG)对下颌恒切牙根管形态评估的差异。方法:对101颗离体牙进行唇舌向及近远中向数字化X线片拍摄和CBCT高清牙列模式扫描,对图像进行根管数目、Vertucci根管分型、根管钙化和根尖口开口位置的评估,并通过CBCT图像建立偏角度投照的三角函数模型,计算偏向投照的角度。结果:CBCT法显示有30颗为双根管,RVG近远中向投照显示有36颗为双根管,卡方检验显示对根管数目和Vertucci根管分型两种方法均具有显著性差异(P<0.05)。两种方法对根管钙化和根尖口开口位置的评估均不具有显著性差异。30颗双根管牙中下颌恒切牙唇舌向双根管的最大距离(LaL)在0~1.5 mm之间的,85.7%的为Vertucci III型,LaL在1.5~2 mm之间的,66.7%为Vertucci IV和V型。以根尖片上双根管显示距离为1 mm计算,LaL在1~2 mm之间的,偏向投照角度为26.6°~45.0°,LaL在0.1~1 mm之间的,偏向投照角度为45.0°~84.3°。结论:CBCT高清牙列模式扫描和RVG投照对于根管数目和Vertucci根管分型的评估具有显著性差异,对于根管钙化和根尖口开口位置的评估不具有显著性差异。LaL在1~2 mm之间时,偏角度投照的临床可操作性较强。     

Integrating other therapies with radiation for head neck cancer: search for optimal solution

Purpose: To review the role of concurrent chemoradiotherapy protocols with special emphasis on selection of appropriate chemotherapy drug, its timing and schedule with respect to radiation fractionation.     

牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形远期疗效评价

目的：评价牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形的远期疗效。方法伴牙槽骨缺损的成人错畸形3例,平均年龄29岁。经正颌-正畸联合会诊制订治疗计划,按照牙槽骨再生正畸及正颌-正畸联合治疗模式,分别进行系统治疗并随访2~3 a。结果3例患者均顺利完成治疗,面型及咬合关系获得良好改善;牙槽骨缺损区正畸牙移动到位且未见医源性牙周并发症,牙槽骨缺损区骨量增加明显且远期效果稳定。结论针对伴牙槽骨缺损的成人患者,牙槽骨再生正畸是一种较为理想的技术。     

Chemotherapy using new superselective intra-arterial infusion for advanced oral cancer

Purpose: We developed a new method of superselective intra-arterial infusion via the superficial temporal artery (HFT method: Hattori, Fuwa and Tohnai reported) and preoperatively performed daily concurrent radiotherapy and chemotherapy with docetaxel (DOC) and cisplatin (CDDP) using this method for 46 patients with stage Ⅲ, Ⅳ oral cancer.     

Navigation-guided oral and maxillofacial surgery (reconstructive and plastic, orthognathic, oncology)

Purpose: Advance in the field of compeer assisted surgery enables the surgical procedures to be less invasive and more accurate for the support of diagnosis imaging, pre-operative simulation and intraoperative navigation.     

Clinical evaluation of demineralized bone allograft in a hyaluronic acid carrier for sinus lift augmentation in humans: a computed tomography and histomorphometric study

OBJECTIVES: Natural and synthetic graft materials are used routinely in sinus floor augmentations to help support implants in atrophic maxillary ridges. This clinical study was based on the hypothesis that the clinical effectiveness of demineralized freeze-dried bone allograft/demineralized bone matrix (DFDBA/DBM) in sinus lifts varies when used in combination bone graft substitute materials. To test this hypothesis, DFDBA was used together with one of three materials: in saline plus anorganic bone (DFDBA: Bio-Oss; in hyaluronic acid (DFDBA: HY, 32 : 68, w/w; DBX alone; DBX plus Bio-Oss; and DBX plus tricalcium phosphate granules (beta-TCP). MATERIAL AND METHODS: Thirty-two sinus lift procedures, eight per group, were performed on 26 patients. Before surgery and at 8 months post-surgery when implants were placed, ridge heights were visualized by computed tomography (CT) and measured by morphometric analysis. Cores of bone were removed by trephine at the sites of implant placement; these biopsies from the graft sites were used for histomorphometric analysis. RESULTS: All 32 sinus lift elevations were successful when measured by CT, increasing from an average 2.84+/-0.2 mm before treatment to 15.2+/-0.6 mm after treatment. The percent of each biopsy that was occupied by new bone and incorporated bone graft materials varied with each treatment: DFDBA+Bio-Oss, DBX+Bio-Oss, or DBX alone was higher than that for DBX+beta-TCP by approximately 10%. When comparing only newly formed bone, DBX+beta-TCP treatment resulted in 50% less bone than the other three preparations. All grafted sites received implants as per the treatment plan for each patient. CONCLUSIONS: This study confirmed the hypothesis that new bone formation is dependent on the DFDBA formulation used and demonstrated that DBX, alone or in combination with other materials, can be used successfully for sinus floor elevation.