A gene expression profile for non-smoking and non-drinking patients with head and neck cancer

Oral Diseases (2012) 18 , 178–183 Objective: A small subset of patients with head and neck squamous cell carcinoma are non‐smoking and non‐drinking and have distinct clinical characteristics. We aimed to identify a possible different genetic profile for these patients when compared with their smoking and drinking counterparts. Materials and Methods: The gene expression data previously detected from primary tumors located in the oral cavity and oropharynx, using DNA microarray was analyzed for their differential expression between non‐smoking and non‐drinking patients (n = 15) and smoking and drinking patients (n = 89). Student’s T‐test (P < 0.05) and 10‐fold cross‐validation procedure (100 times repeated) were performed to determine differentially expressed genes. Results: Non‐smoking and non‐drinking patients were older, mostly female and had oral cavity‐localized tumors, whereas smoking and drinking patients were younger male patients with 81% oral cavity and 19% oropharynx tumors. A set of 49 differentially expressed genes were detected. Among others, seven genes related to interferon‐γ were upregulated and two genes linked to NFKB pathway were downregulated. Conclusions: Differentially expressed genes in non‐smoking and non‐drinking patients possibly indicate the presence of a different cellular response to carcinogenic events in these patients. Further studies are warranted to validate this gene set and explore possible therapeutic implications to improve prognosis for these patients.     

Clinicopathological features and immunohistochemical expression of p53, Ki‐67, Mcm‐2 and Mcm‐5 in proliferative verrucous leukoplakia

J Oral Pathol Med (2010) 39 : 447–452 Background: Proliferative verrucous leukoplakia (PVL) is a distinct and aggressive type of oral leukoplakia which affects elderly women without risk behavior and presents high rates of malignant transformation. The objective of the present study was to evaluate the clinicopathological characteristics and the distribution of cell proliferation markers, aiming to elucidate the distinct biological behavior of the PVL. Methods: Clinical and microscopical features of 12 patients with PVL were reviewed. Immunohistochemical analysis for p53, Ki‐67, Mcm‐2 and Mcm‐5 were performed and the data were correlated. Results: All patients were women, above 50 years of age, 91.7% were non‐smoker and 100% were non‐habitual drinker. Alveolar ridge (66.6%), tongue (50%) and buccal mucosa (41.6%) were the most affected sites. Four patients developed squamous cell carcinoma (SCC). The immunohistochemical findings showed higher positivity for p53, Ki‐67, Mcm‐2 and Mcm‐5 in SCCs. However, some patients with mild or moderate dysplasia, specially the patients who developed SCC, presented high expression of Mcm‐2 and Mcm‐5. Conclusions: High immunoexpression of Mcm‐2 and Mcm‐5 in mild and moderate dysplasia could be helpful to predict the malignant transformation of PVL.     

EGFR and Ki‐67 expression in oral squamous cell carcinoma using tissue microarray technology

J Oral Pathol Med (2010) 39 : 571–578 Objective: Our aim was to validate the use of tissue microarrays (TMA) in oral squamous cell carcinomas (OSCC) to analyse epidermal growth factor receptor (EGFR) and Ki‐67 expression. We also analysed the relationship that the expression of these markers may have with clinical, pathological and survival variables. Patients and methods: The study sample comprised 39 unselected patients diagnosed and treated for OSCC. We analysed Ki‐67 and EGFR expression by immunohistochemistry on formalin‐fixed, paraffin‐embedded surgical specimens. Whole sections (WS) were compared with double 1.5 mm core‐tissue microarrays. Results: High EGFR expression was observed both on TMA (in 98% of the cases) and WS (in 100% of the cases) with substantial agreement kappa value (0.720). EGFR expression was not significantly associated with clinical, pathological and survival variables on TMA and WS. Ki‐67 analysis showed a Spearman correlation of 0.741 with a Ki‐67 mean labelling index of 45% in TMA and 56.8% in WS. We found a significant relationship between gender and Ki‐67 labelling index on WS (P = 0.022) and TMA (P = 0.002). Clinical stage was the only parameter in multivariate analysis that had a significant predictive value. Conclusion: We demonstrate that dual 1.5 mm core TMA is a valid, rapid, economical and tissue‐saving way to study OSCC biopsies and that it presents strong correlation with the WS. EGFR overexpression in OSCC suggests that these tumours may be a candidate for therapy investigation directed to EGFR.     

Aberrant expression of p53, p16INK4a and Ki‐67 as basic biomarker for malignant progression of oral leukoplakias

J Oral Pathol Med (2011) 40 : 629–635 Background: The risk of malignant progression of oral leukoplakia with and without dysplasia is unpredictable. Materials and methods: Leukoplakias without dysplasia of 35 patients, leukoplakias with dysplasia of 4 patients, and similar lesions obtained from tumor patients were retrospectively examined by immunohistochemistry for the expression of the proteins pRb, p53, p16^INK4a, Cyclin D1 and Ki‐67. The predictive power of combined aberrant expression patterns for the progression of leukoplakias without dysplasia was examined. Results: Increased expression of p53, Ki‐67 and Cyclin D1, and loss of p16^INK4a occurred in 45.9%, 38.9%, 29.4% and 32.4% of the leukoplakias without dysplasia, respectively. All alterations increased with progression but had poor positive predictive value. However, the combined p53/p16^INK4a/Ki‐67 aberration occurred in only three (9%) cases, of which two patients (66.7%) experienced progression to dysplasia and carcinoma in situ. The combined p53/p16^INK4a/Ki‐67 alteration had a negative predictive value (NPV) and sensitivity of 100%, specificity of 97% and positive predictive value (PPV) of 67%. By contrast, the combined p53/p16^INK4a/Cyclin D1 alteration had 97% NPV and sensitivity of 50%, specificity of 90% and only 25% PPV. Loss of pRb and concomitant overexpression of p16^INK4a were not observed arguing against an involvement of HPV in oral leukoplakia. Conclusions: We propose the combined p53/p16^INK4a/Ki‐67 alteration as a basic marker to define high risk leukoplakia patients. Lesions not showing this alteration appear to be harmless. Future studies should validate these findings and search for proteins which can further improve the PPV of the proposed basic marker.     

Immunohistochemical detection of Ki‐67 is not associated with tumor‐infiltrating macrophages and cyclooxygenase‐2 in oral squamous cell carcinoma

J Oral Pathol Med (2010) 39 : 565–570 Background: An inflammatory component consisting of cells and chemical mediators may influence the proliferation and dissemination of the oral squamous cell carcinoma (OSCC). In the present study, we evaluated the possible relationship between Ki‐67, tumor‐associated macrophages (TAMs), and COX‐2 in OSCCs. In addition, the immunodetection of these proteins was associated with different histological grades of malignancy, including invasive and in situ tumors. Methods: Twenty‐seven OSCC cases were examined by light microscopy using criteria adopted WHO, and immunohistochemistry for Ki‐67, CD68, and COX‐2 using EnVision System in invasive and in situ lesions. Immunohistochemical detection of these proteins was assessed and scored for COX‐2, and results were compared with their histological grades of malignancy. Results: A correlation between Ki‐67, COX‐2, and CD68 was not found. Histological grade of malignancy (HDM) was associated with the Ki‐67 immunostaining (P = 0.00), but this was not observed regarding both CD68 (P = 0.51) and COX‐2 (P = 0.89). Furthermore, there was a COX‐2 overexpression in 62.96% of the sample, and a high density of TAMs in both OSCCs and in situ carcinomas. Conclusions: Imunolabeling for Ki‐67 was directly correlated with less‐differentiated tumors, suggesting that this marker may contribute to understand the biological behavior of OSCC, and help to distinguish risk groups of OSCC. Furthermore, the lack of correlation between Ki‐67, COX‐2, and CD68 indicates that the latter two markers may play a pivotal role in oral carcinogenesis. However, further studies are needed to clarify their contribution for cell proliferation and tumor differentiation.     

Immunohistochemical study of the expression of fatty acid synthase and Ki‐67 in salivary gland tumors

J Oral Pathol Med (2010) 40 : 467–475 Background: The enzyme fatty acid synthase plays a fundamental role in the biosynthesis of fatty acids. Several recent studies have demonstrated a high fatty acid synthase expression in malignant tumors. Few studies have been conducted in oral and salivary gland tumors describing the fatty acid synthase expression. Methods: This study evaluated and compared, by immunohistochemical reaction, the expression of fatty acid synthase and Ki‐67 in salivary gland tumors. The immunohistochemical study used the streptavidin–biotin–peroxidase technique, with antibodies anti‐fatty acid synthase and anti‐Ki‐67. The fatty acid synthase was analyzed by scores, considering the intensity of labeling, quantity of labeled cells and histological component. The Ki‐67 was analyzed by counting of one thousand cells, calculating the quantity of positive cells in regions with higher density of labeling. Statistical analysis was performed using the Pearson and Mann–Whitney correlation tests. Results: There was greater fatty acid synthase expression in pleomorphic adenoma compared to other tumors, and predominance of Ki‐67 in malignant tumors. Among these, the mucoepidermoid carcinoma presented the highest proliferation rate. The expression of fatty acid synthase and Ki‐67 did not present correlation between the tumors analyzed, except in pleomorphic adenomas, with statistically significant relationship between them. Conclusion: It is suggested that the fat metabolism in salivary gland tumors is related to maintenance of cell differentiation. Its expression prevailed in benign tumors, while Ki‐67 prevailed in the mucoepidermoid carcinoma, demonstrating its high proliferation rate, followed by the cystic adenoid carcinoma and polymorphous low grade adenocarcinoma.     

Co-expression of Ki-67 and p53 protein in ameloblastoma and keratocystic odontogenic tumor

Abstract

Objectives. The purpose of this study was to evaluate the cell proliferation and p53 protein expression in ameloblastomas (ABs), keratocystic odontogenic tumor (KCOT) and dentigerous cyst (DC). Method. The immunohistochemistry were carried out for Ki-67 and p53 protein expression by using MIB-1 clone and DO-7 clone, respectively, in ABs (n = 23), KCOT (n = 32), DC (n = 30), normal oral mucosa (NOM) (n = 12) and fetal oral mucosa (FOM) (n = 10). Results. Both the Ki-67 LI Labeling index (LI) and p53 LI was significantly higher in ABs than KCOT, DC, NOM and FOM. The Ki-67 LI and p53 LI was significantly higher in KCOT as compared to DC. Ki-67 LI and p53 LI was observed in descending order in ABs, KOCT, FOM, NOM and DC. There was significant correlation between Ki-67 expression and p53 expression in ABs, KCOT, DC and NOM. The densely stained p53 positive cells were noted higher in ABs than KCOT. The very few densely p53 positive cells were noted in DC, NOM and FOM. Conclusion. The results suggest that the p53 protein expression does not necessarily imply an association with malignant disease and/or p53 gene mutation, but a tendency to be expressed in an increasing quantitative and qualitative manner, as the biologic behavior of odontogenic cyst or tumors becomes more aggressive. p53 over-expression may promote cell proliferation in odontogenic lesions. Thus, it can be stipulated that Ki-67 and p53 protein expression can be used as a prognostic marker in odontogenic lesions.     

Tumor angiogenesis in keratocystic odontogenic tumor assessed by using CD‐105 antigen

J Oral Pathol Med (2011) 40 : 263–269 Background: The purpose of this study was to assess and compare angiogenesis with proliferative activity in Keratocystic odontogenic tumors (KCOT) and dentigerous cysts (DC) by using monoclonal mouse anti‐human antibody against CD105 (endoglin). Material and Methods: Angiogenesis was assessed in 38 KCOT, 27 DCs and 19 Normal Oral Mucosa (NOM) by measuring the Mean Vascular Density (MVD), Total Vascular Area (TVA) and Mean Vascular Area (MVA). Cell proliferation was assessed by obtaining Ki‐67 Labeling Index (Ki‐67LI) in all the groups. Results: Statistically significant difference was observed in MVD, TVA, MVA and Ki‐67 LI between the KCOT, DC and NOM (P = 0.000). The MVD, TVA, MVA and Ki‐67 LI were significantly higher in KCOT than in DC and NOM (P = 0.000). The Ki‐67 LI was significantly higher in NOM than in DC (P = 0.000). MVD (P = 0.032) and TVA (P = 0.038) were significantly higher in NOM than in DC. There was significant positive correlation between Ki‐67 LI and MVD, Ki‐67 and TVA and Ki‐67 and MVA. Conclusion: The result suggests that CD105 (endoglin) is strongly expressed in microvessels of KCOT compared with that in Dentigerous cyst and Normal oral mucosa. Thus, it suggests that angiogenesis may be associated with locally aggressive biological behavior of KCOT. These findings further stress on the hypothesis that the stroma of KCOT could be regarded not just as a structural support of the cyst wall, but as playing a part in the neoplastic behavior of cyst.     

Midkine expression in oral squamous cell carcinoma and leukoplakia

J Oral Pathol Med (2012) 41 : 21–26 Background: Midkine (MK), a 13‐kDa heparin‐binding growth factor, is overexpressed in various human cancers. However, its role in the development and progression of oral cavity squamous cell carcinoma (OCSCC) is still unclear. Thus, the aim of this study was to evaluate the expression of MK in samples of OCSCC, leukoplakia, and healthy oral mucosa (control). Methods: Surgically excised specimens from patients with primary OCSCC (n = 28) were immunostained for MK, Ki‐67, PCNA, p53, bcl‐2, Bax, and CD31. Besides this, MK expression was also investigated in leukoplakia and normal oral mucosa. The relationship of MK⁺ cells with clinical parameters (tumor location, tumor size, lymph node metastasis, and survival) and microscopic parameters (WHO histological grading, intensity of inflammation, proliferation index, apoptosis, and angiogenesis) was also evaluated. Results: The results showed that MK expression was increased in OCSCC in relation to leukoplakia and normal mucosa. Furthermore, MK expression was increased in late‐stage tumors (T3/T4) compared with early‐stage lesions (T1/T2). MK‐positive lesions also showed increased expression of the anti‐apoptotic protein bcl‐2. Conclusion: OCSCC, particularly late‐stage tumors, exhibits increased MK expression, which may be involved in tumor progression via upregulation of anti‐apoptotic genes, as shown by the augmented bcl‐2 positivity in MK‐positive tumors.     

Proliferative,apoptotic and angiogenic potentials in jaws and long bones osteosarcomas: a comparative immunohistochemical study

J Oral Pathol Med (2010) 39 : 681–686 Background: Osteosarcomas (OS) of the jaws are uncommon lesions that represent less than 10% of all skeletal OS. It has a behavioral pattern which is less aggressive than their long bones counterparts. This study performed an immunohistochemical comparison between jaws and long bones OS. Methods: The study involved 15 jaws and 15 long bones OS tissue samples for the period from 1986 to 2005. Age, sex, histologic subtypes and grades were recognized. The samples were immunohistochemically stained with monoclonal antibodies to Ki‐67, P53 and vascular endothelial growth factor (VEGF). Results: The mean age of the patients with jaw OS was a decade higher than that of long bones OS. A slight male predominance in jaw OS was found (1.14:1), which was more pronounced in long bones OS (2:1). The chondroblastic subtype was the predominant in jaws (66.66%), whereas (60%) of long bones OS were of osteoblastic subtype. The Ki‐67 labeling index and the VEGF expression were significantly higher in long bones as compared with jaws OS, whereas there was no significant difference regarding the P53 expression between jaws and long bones OS. Conclusions: Jaws and long bones OS bear a comparable cell cycle dysregulation when quantified with P53 immunostaining, whereas the long bones OS have a higher proliferative and angiogenic capacity than their jaw counterparts when evaluated with Ki‐67 and VEGF immunoexpressions respectively.     

Saliva and Serum Levels of B‐Cell Activating Factors and Tumor Necrosis Factor‐α in Patients With Periodontitis

Background: B‐lymphocytes play a central and critical role in the adaptive immune response against invading pathogens. This study evaluates saliva and serum levels of APRIL (a proliferation‐inducing ligand), B‐cell activating factor (BAFF), tumor necrosis factor‐α (TNF‐α), interleukin (IL)‐6, and IL‐10 in patients with chronic periodontitis (CP) or aggressive periodontitis (AgP) and periodontally healthy individuals. Methods: Twenty‐five patients with AgP, 20 patients with CP, and 20 periodontally healthy individuals were included. Smoking status was recorded, and all individuals were divided into non‐smokers and smokers. Saliva and serum samples were collected before clinical periodontal measurements. APRIL, BAFF, TNF‐α, IL‐6, and IL‐10 levels in serum and saliva samples were determined by enzyme‐linked immunosorbent assay. Statistical analysis was performed using multivariate analysis of variance and bivariate correlation. Results: Serum and saliva levels of TNF‐α, APRIL, BAFF, IL‐6, and IL‐10 were similar in CP and AgP groups. Serum levels of TNF‐α, APRIL, and BAFF and saliva levels of BAFF were significantly higher in periodontitis groups than healthy controls (P <0.05). Non‐smokers with CP or AgP had lower levels of saliva TNF‐α and APRIL and serum APRIL and IL‐6 than smokers with CP or AgP (P <0.05). Saliva APRIL and serum TNF‐α and IL‐6 levels were significantly higher in healthy smokers than healthy non‐smokers (P <0.05). Clinical periodontal parameters correlated positively with TNF‐family cytokines and negatively with IL‐10 (P <0.05). Conclusions: Within the limits of this study, it may be suggested that elevated salivary and serum TNF‐α, APRIL, and BAFF in patients with periodontitis may contribute to the dominance of B cells in periodontitis lesions. Moreover, higher levels in healthy smokers than non‐smoking counterparts may play a role in detrimental effects of smoking on periodontal tissues.     

Efficacy of stabilisation splint therapy combined with non‐splint multimodal therapy for treating RDC/TMD axis I patients: a randomised controlled trial

Stabilisation splint therapy has long been thought to be effective for the management of temporomandibular disorders (TMD). However, the superiority of stabilisation splint therapy compared to other TMD treatments remains controversial. The aim of this study was to determine the efficacy of stabilisation splint therapy combined with non‐splint multimodal therapy for TMD. A total of 181 TMD participants were randomly allocated to a non‐splint multimodal therapy (NS) group (n = 85) or a non‐splint multimodal therapy plus stabilisation splint (NS+S) group (n = 96). Non‐splint multimodal therapy included self‐exercise of the jaw, cognitive–behavioural therapy, self‐management education and additional jaw manipulation. Three outcome measurements were used to assess treatment efficacy: mouth‐opening limitation, oro‐facial pain and temporomandibular joint sounds. A two‐factor repeated‐measures analysis of variance (anova ) was used to evaluate the efficacy of the two treatment modalities (NS vs. NS+S), and Scheffe's multiple comparison test was used to compare the treatment periods. Subgroup analyses were performed to disclose the splint effects for each TMD diagnostic group. All three parameters significantly decreased over time in both groups. However, there were no significant differences between the two treatment groups in the total comparison or subgroup analyses; an exception was the group with degenerative joint disease. No significant difference between the NS and NS+S treatment approaches was revealed in this study. Therefore, we conclude that the additional effects of stabilisation splint are not supported for patients with TMD during the application of multimodal therapy.     

Ras gene mutation is not related to tumour invasion during rat tongue carcinogenesis induced by 4‐nitroquinoline 1‐oxide

J Oral Pathol Med (2011) 40 : 325–333 Background: The aim of this study was to investigate whether mutations in the genes H‐ras and K‐ras were related to the mechanism of invasion as a result of the immunoexpression of H‐Ras, Ki‐67, alpha‐smooth muscle actin (SMA) and vascular endothelial growth factor (VEGF) during 4‐nitroquinoline 1‐oxide (4NQO)‐induced rat tongue carcinogenesis. Methods: Male Wistar rats were distributed into three groups of 10 animals each and treated with 50 ppm 4NQO solution through their drinking water for 4, 12 and 20 weeks. Ten animals were used as negative control. Results: Although no histopathological abnormalities were induced in the epithelium after 4 weeks of carcinogen exposure, Ki‐67 was overexpresssed in the ‘normal’ oral epithelium. In pre‐neoplastic lesions at 12 weeks following carcinogen exposure, the levels of Ki‐67 were increased (P < 0.05) when compared to negative control. Ki‐67, alpha‐SMA and VEGF were also overexpressed in squamous cell carcinomas induced after 20 weeks of treatment with 4NQO. No significant statistical differences (P > 0.05) were found in H‐ras protein expression for all experimental periods evaluated that corresponded to normal oral mucosa, hyperplasia, dysplasia and squamous cell carcinomas. In the same way, no mutations in H‐ras or K‐ras genes were found. Conclusions: Our results support the idea that expression of Ki‐67 plays a crucial role during malignant transformation being closely related to neoplastic conversion of the oral mucosa cells. However, it seems that mutations in the ras genes are not involved to experimental tongue carcinogenesis induced by 4NQO.     

Evaluation of immunohistochemical expression of p53, p21, p27, cyclin D1, and Ki67 in oral and oropharyngeal squamous cell carcinoma

J Oral Pathol Med (2012) 41 : 40–46 Background: The purpose of this study was to evaluate whether the immunohistochemical expression of p53, p21, p27, cyclin D1, and Ki67 can predict therapy response and survival in patients with oral and oropharyngeal squamous cell carcinoma treated with preoperative chemoradiation. Methods: Biomarker expression was evaluated by immunohistochemistry in formalin‐fixed, paraffin‐embedded pretreatment biopsies of 111 homogenously treated patients. We assessed the association between clinicopathological variables including response to neoadjuvant chemoradiotherapy as well as the survival of the patients and the expression of the biomarkers as both dichotomized (positive vs. negative) and continuous variables. Results: Biomarker overexpression on the basis of pre‐selected cutoff points was seen in 66 of 111 (59%) cases for p53, in 77 (69%) for p21, in 48 (43%) for p27, in 81 (73%) for cyclin D1, and in 54 (49%) cases for Ki67, respectively. None of the examined biomarkers was able to predict response to neoadjuvant chemoradiotherapy or was associated with survival outcome. Post‐treatment pathologic TNM stage (P < 0.001), pathologic response (P < 0.001), and perineural invasion (P < 0.001) were the only factors having a significant effect on recurrence‐free survival. Post‐treatment pathologic N stage (P = 0.005), post‐treatment pathologic TNM stage (P < 0.001), pathologic response (P < 0.001), and perineural invasion (P = 0.001) had a significant impact on overall survival. Conclusions: Our results suggest that the biomarkers p53, p21, p27, cyclin D1, and Ki67 have no impact on treatment response and survival in patients with oral and oropharyngeal cancer treated with preoperative chemoradiation.     

Oral appliance treatment in moderate and severe obstructive sleep apnoea patients non‐adherent to CPAP

The aim of this retrospective study was to evaluate the effect of individually adjusted custom‐made mandibular advancement device/oral appliance (OA) in treatment of patients with moderate and severe obstructive sleep apnoea (OSA), who were non‐adherent to continuous positive airway pressure (CPAP) therapy. During 2007‐2013, 116 patients with moderate (n = 82) and severe (n = 34) OSA non‐adherent to CPAP treatment were referred for dental management with an individually adjusted OA at a specialist sleep clinic. Ten of the participants (8·6%) were lost to follow‐up, leaving the data set to consist of 106 patients (71 men/35 women, mean age 57 year, range 28‐90). Nocturnal respiratory polygraphic recordings were performed at baseline and follow‐up. Average time between baseline polygraphy and follow‐up was 12 months. A successful OA treatment outcome was based on polygraphy at the follow‐up and divided into three groups: 1 = AHI <5; 2 = 5 ≤ AHI <10 and >50% reduction in baseline AHI; and 3. >50% reduction in baseline AHI. If there was a ≤ 50% reduction in baseline AHI at the follow‐up, the treatment was considered as a failure. The overall treatment success rate was 75%. There was no significant difference in success rates between patients in the moderate and severe categories (69% and 77%, respectively). Low oxygen saturation (SpO_{2 nadir)} had a high predictive value for OA treatment failure. OA treatment of patients non‐adherent to CPAP is efficient and especially promising for the severe OSA group who are at greatest risks for developing serious comorbidities, if left untreated.     

Environmental Tobacco Smoke and Periodontitis in United States Non‐Smokers, 2009 to 2012

Background: Epidemiologic studies using half‐mouth designs for assessment of periodontal disease prevalence have reported that environmental tobacco smoke (ETS) exposure of non‐smokers is associated with a two‐ to three‐fold increase in the odds of developing periodontitis. In response to the possibility of under‐reporting of periodontitis, the Centers for Disease Control updated periodontal examination procedures in 2009 for the National Health and Nutritional Examination Survey (NHANES), including full‐mouth, six‐site periodontal probing, and attachment loss assessment. Aims of this study are to estimate prevalence of periodontitis among United States non‐smoking adults exposed to ETS, report the values of the improved methods for estimating disease prevalence, and evaluate the predictive contribution of ETS exposure to periodontitis. Methods: A cross‐sectional study was conducted using NHANES data from the 2009 to 2012 examination cycle. To address these aims, oral examination data were used to determine prevalence of periodontitis among United States non‐smoking adults and to test the influence of ETS exposure on occurrence of periodontitis. Results: There was a 28% increase in the odds of periodontitis for those with any ETS exposure compared with those with no measurable exposure (Wald χ² test statistic [df] = 6.58 [1], P = 0.01; 95% confidence interval = 1.06 to 1.55). Conclusion: ETS exposure increases the risk of an individual developing periodontitis.     

PLUNC protein expression in major salivary glands of HIV‐infected patients

Oral Diseases (2011) 17 , 258–264 Objective: To analyse and compare the expression of Palate, Lung, and Nasal Epithelium Clone (PLUNC) proteins in salivary glands from patients with and without AIDS (control group) using autopsy material. Methods: We analysed the expression of PLUNCs using immunohistochemistry in parotid (n = 45), submandibular (n = 47) and sublingual gland (n = 37) samples of AIDS patients [30 with normal histology, 21 with mycobacteriosis, 14 with cytomegalovirus (CMV) infection, 30 with chronic non‐specific sialadenitis, and 30 HIV‐negative controls. In situ hybridization (ISH) for SPLUNC 2 in the HIV‐negative group was performed. Results: SPLUNC 1 expression was detected in the mucous acini of submandibular and sublingual glands, and SPLUNC 2 were seen in the serous cells. LPLUNC 1 expression was only positive in the salivary ducts. There was a higher expression of SPLUNC 2 in AIDS patients with CMV infection and mycobacteriosis when compared with all other groups. The intensity of staining for SPLUNC 2 was greater around the lesions than the peripheral ones. ISH for SPLUNC 2 showed perinuclear positivity in the serous cells in all HIV‐negative cases. Conclusions: SPLUNC 1 and LPLUNC 1 proteins were similarly expressed in the salivary glands of AIDS patients and non‐HIV patients. CMV infection and mycobacteriosis increase SPLUNC 2 expression in serous cells in the salivary gland of AIDS patients.     

Attitudes of final‐year dental students to bleaching of vital and non‐vital teeth in Cardiff,Cork, and Malmö

Summary The aim of this study was to determine attitudes of final‐year dental students in Cardiff, Cork and Malmö towards tooth whitening. Following receipt of ethical approval, pre‐piloted questionnaires were distributed to final‐year dental students in Cork, Cardiff, and Malmö as close as possible to graduation. The questionnaire sought information relating to various opinions and attitudes towards the use of bleaching techniques including safety of bleaching, confidence in the provision of bleaching, recommendations to patients, teaching received, awareness of restrictions on the use of bleaching products and management of simulated clinical scenarios. Eighty three per cent (n = 116) of questionnaires were returned. Cork dental students had the most didactic teaching (2‐h vital, 1‐h non‐vital bleaching) compared to Cardiff or Malmö students (0 h each). More Cork students regarded bleaching as safe (76%, n = 28) than Cardiff (70%, n = 32) or Malmö (36%, n = 12) students. More than 50% of Cork students feel they know enough about bleaching to provide it in practice, significantly more than Cardiff (<25%) or Malmö (<25%) students. The majority of students would provide vital bleaching after qualification (100% (n = 37) Cork; 82% (n = 27) Malmö; 76% (n = 35) Cardiff). In simulated clinical scenarios, more Cork students would propose bleaching treatments (89%n = 33) than Malmö (64%n = 21) or Cardiff (48%n = 22) students. Variations exist in the attitudes and approaches of three European dental schools towards bleaching. Dental students need to be best prepared to meet the needs of their future patients.     

口腔癌前病变、口腔鳞癌中诱导型一氧化氮合酶与p53蛋白表达及细胞增殖情况的相互关系的研究

目的探讨诱导型一氧化氮合酶(inducible netric oxide synthase,iNOS)在口腔鳞癌发展过程中的表达及与p53蛋白表达和细胞增殖的相互关系. 方法采用免疫组化SABC法检测10例正常口腔黏膜、8例上皮单纯增生、20例上皮异常增生和32例口腔鳞癌组织中iNOS、p53及Ki-67蛋白的表达. 结果口腔鳞癌发展过程中存在着iNOS、p53、Ki-67表达的上调;三种蛋白的表达与上皮异常增生的病理分级有关(P<0.05),与鳞癌的病理分级无关;各组中iNOS和p53表达之间均存在显著正相关(P<0.05);iNOS阳性表达的鳞癌组织中Ki-67标记指数较阴性者显著增高(P<0.05).结论iNOS与p53蛋白互为反馈影响,在口腔鳞癌发展过程中意义重大;鳞癌中iNOS的阳性表达可能提示该组织的快速增殖优势.