Peroxiredoxin I expression in tongue squamous cell carcinomas as involved in tumor recurrence

Peroxiredoxin (Prx) I is an antioxidant protein expressed in proliferating cells. We investigated Prx I as marker for tongue cancer status by correlating clinical features with Prx I expression. Samples from 132 patients with squamous cell carcinoma in the tongue were examined by immunohistochemistry with an anti-Prx I antibody. Correlations between Prx I expression and the clinical features of tumors were statistically determined using univariate and multivariate analyses. Univariate analysis showed Prx I was significantly associated with local recurrence (P=0.033). By multiple logistic regression analysis, Prx I expression was associated with local recurrence (odds ratio: 2.84; 95% confidence interval: 1.09-7.43; P=0.034) and lymph node recurrence (odds ratio: 2.86; 95% confidence interval: 1.02-8.01; P=0.046). Our results suggested that Prx I expression indicates tumors with a high potential for recurrence. Prx I may be used clinically to guide treatment for squamous cell carcinoma of the tongue.     

Sublingual lymph node metastasis of early tongue cancer: report of two cases and review of the literature

Sublingual lymph node metastasis of early stage squamous cell carcinoma of the tongue (SCCT) is seldom reported. Lymphatic tissue in the floor of mouth, which intervenes between the tongue and neck, will be left behind by a primary tumour resection with discontinuous neck dissection. The authors present two cases of early stage SCCT with sublingual lymph node metastasis, review the literature, and discuss the management of the floor of mouth for early stage SCCT. The authors suggest that more attention should be paid to possible sublingual lymph node metastasis for T1/T2 SCC of the ventral tongue with deeply endophytic infiltration.     

舌鳞状细胞癌患者血清VEGF水平的定量分析(英文)

目的 血管生成是肿瘤发生、发展和转移过程中的关键步骤。最近,许多血管生成因子陆续被分离出来。血管内皮生长因子（VEGF）是其中的一种,对血管内皮细胞的有丝分裂具有选择性作用。本研究目的是检测舌癌患者血清中VEGF含量,并探讨其与舌癌的临床病理特征及预后的关系。方法 研究对象包括10名正常献血员和31名舌癌患者。采用双抗体夹心法 ELISA定量检测血清中 VEGF浓度。结果处理采用独立样本t检验（independent-samples t test）。结果 正常对照组血清中VEGF的平均浓度为148.80±64.17pgml-1（范围,59～231pg.ml-1）,舌癌患者血清中VEGF的平均浓度为567.97±338.17pgml-1（范围,136～1892pg·ml-1）,两者之间的差异具有显著性（P<0.001）。舌癌患者血清中VEGF水平的高低与转移和临床分期密切相关（P<0.05）,而与性别和肿瘤的分化程度无关（P>0.05）。 结论 VEGF水平升高是舌癌发生、发展和转移的重要原因。检测舌癌患者血清中VEGF含量有助于判断有无转移及预后。     

Association between geographic tongue and psoriasis: A systematic review and meta‐analyses

Geographic tongue (GT) has been described as a predictor of psoriasis. The objective of this study was to analyse the prevalence of GT in psoriatic and non‐psoriatic patients. For this purpose, we conducted a systematic review and meta‐analysis. A literature search was performed on PubMed, Embase, Web of Science and the Cochrane Database of Systematic Reviews. The search and selection process was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) criteria. Only case‐control studies were selected, and the prevalence of GT in both groups was compared. Eleven articles met the inclusion criteria, and the frequency of GT was statistically associated with psoriasis in ten studies. The pooled odds ratio (OR) was 3.53 (95% confidence interval [CI] 2.56‐4.86). There were no significant differences between the presence of GT and the clinical form. However, the Psoriasis Area and Severity Index (PASI) score was statistically higher in patients affected by GT in three of four studies. Psoriatic patients with GT also exhibited less improvement in the PASI score after treatment. One study found an association between GT and a negative impact on patients’ quality of life. Nevertheless, age, gender, toxic habits, psoriasis onset and duration of the disease were not clearly associated. The results support the concept of GT as a manifestation of psoriasis. Future research should focus on the repercussions of GT in psoriatic patients, due to the negative consequences on severity and treatment response.     

The prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area

Oral Diseases (2011) 17 , 210–216 Objectives: To determine the prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area. Subjects and Methods: A cross sectional study was conducted on 600 Malaysian outpatients (257 men, 343 women, mean age, 37.7 years) attending the Primary Dental Care Unit at the Faculty of Dentistry, University of Malaya. Demographic and medical data were recorded for all respondents. Results: One hundred eighty‐one patients (30.2%) (81 men, 100 women, mean age 42.0 years) were diagnosed with at least one tongue lesion (n = 207) at the time of examination. Of these, 24 patients (4%) had two or more tongue lesions present synchronously. Seven different lesions were diagnosed: fissured tongue (13.8%), crenated tongue (7.8%), pigmented tongue (6.2%), geographic tongue (2.2%), ankyloglossia (1.7%), hairy tongue (1.0%) and median rhomboid glossitis (0.2%). Their racial prevalences were Malays (n = 65, 10.8%), Indians (n = 62, 10.3%), Chinese (n = 53, 8.8%) and other race (n = 1, 0.2%). A significant relationship was observed between crenated tongue and race; between four types of tongue lesions (fissured tongue, geographic tongue, crenated tongue and pigmented tongue) and age; and between fissured tongue and gender (P < 0.05). Conclusions: Distribution characteristics of tongue lesions in Malaysians are important as local reference data in the daily clinical practice.     

HER family receptors expression in squamous cell carcinoma of the tongue: study of the possible prognostic and biological significance

J Oral Pathol Med (2010) 39 : 79–86
Objectives:  The squamous cell carcinoma of the tongue (SCCT) is biologically and epidemiologically distinct from other oral cavity cancers and is associated with lower overall survival rates. The role of HER family members (HER-1, HER-2/ neu , HER-3 and HER-4) in the pathogenesis and progression of head and neck squamous cell carcinomas has been demonstrated but no report have focused on SCCT. This study investigated, the expression of all members of the HER family, in a series of SCCT and studied the possible prognostic value and correlation with various clinico-pathological parameters.
Methods:  HER-1, HER-2/ neu , HER-3 and HER-4 expression was analysed by semi-quantitative immunohistochemical staining on paraffin embedded tissue specimens from 40 patients who underwent surgery for SCCT between 1996 and 2006.
Results:  HER-1 was overexpressed in 26 cases (65%), HER-2/ neu in two (5%), HER-3 in 19 (48%) and HER-4 in three cases (8%). No significant correlation was found between clinicopathological variables and expression of HER-1 and HER-2/ neu . HER-3 overexpression was significantly related to nodal stage, age (≥64 years) and decreased overall survival ( P  ≤ 0.05). HER-4 overexpression was significantly associated with low histological grade including when it was coexpressed with HER-3 but in this case the prognosis was worse ( P  < 0.05).
Conclusions:  These results suggest that HER-1 and HER-2/ neu when determined with stringent criteria are not useful indicators of prognosis in SCCT. Only HER-3 overexpression may help in identifying SCCT with greater malignant potential also when it is coexpressed with HER-4. Instead, as in other malignancies, HER-4 could play a protective role in SCCT.     

Prevalence study of tongue lesions in a Hungarian population

Abstract – The aim of the study was to assess the prevalence of tongue lesions in a district population, in Budapest, called regularly for X-ray lung examinations. Oral examinations of 7820 individuals were performed, 42% were over 60 yr of age, 42.9% were men and 57.1% women. Tongue alterations were found in 18.52% of the examined individuals, more frequently in women than in men. Lingua fissurata has been diagnosed in 8.8%, geographic tongue in 3.0% of the examined subjects. Atrophic lesions of the tongue were found in 6.37%, among them 5.42% central papillary atrophy (median rhomboid glossitis): 0.35% of the total sample. Manifest clinical symptoms of oral Candidiasis were found in 2.15% of the total sample, and in 4.28% of patients with tongue lesions. The occurrence of oral leukoplakia and lichen in patients with tongue lesions was respectively 0.47 and 0.07%. The prevalence of tongue alterations was consistent with the literary data, the oral screening attached to the X-ray lung examinations proved to be useful in detecting changes of the oral mucosa.     

A comparison of airway interventions and gastrostomy tube placement in infants with Robin sequence

The purpose of this study was to evaluate feeding impairment following non-operative or operative management of airway obstruction in a large series of infants with Robin sequence (RS) by rate of G-tube placement. A retrospective study was conducted at Boston Children’s Hospital including 225 patients (47.1% female) with RS treated between 1976 and 2018. Subjects were grouped by intervention required for successful management of airway obstruction: non-operative only (n = 120), tongue–lip adhesion (TLA, n = 75), mandibular distraction osteogenesis (MDO, n = 21), or tracheostomy (n = 9). The operative group had a higher rate of G-tube placement (58.1%) than the non-operative group (28.3%, P < 0.0001). Subjects in the TLA and tracheostomy groups had higher odds of G-tube placement than subjects in the MDO group: odds ratio (OR) 5.5 (95% confidence interval (CI) 1.8–17.3, P = 0.004) and OR 27.0 (95% CI 3.2–293.4, P = 0.007), respectively. Syndromic patients and those with gastrointestinal anomalies also had higher odds of G-tube placement: OR 3.5 (95% CI 1.7–7.2, P = 0.001) and OR 5.9 (95% CI 1.6–21.0, P = 0.007), respectively. Infants with RS who require an airway operation and those with a syndromic diagnosis or gastrointestinal anomalies are more likely to require placement of a G-tube. Of the operative groups, MDO was associated with the lowest G-tube rate, compared to TLA and tracheostomy.     

Combination of fluorescence visualization and iodine solution-guided surgery for local control of early tongue cancer

The control of enclosed oral epithelial dysplasia is important for the control of oral cancer. Fluorescence visualization and iodine solution are able to detect oral epithelial dysplasia and surrounding oral cancer. The purpose of this study was to clarify the effectiveness of combining fluorescence visualization and iodine solution-guided surgery for early tongue cancer. Participants comprised 264 patients with primary early tongue cancer who underwent surgery. The surgical margin was set at 10 mm outside the clinical tumour, and 5 mm outside the area of fluorescence visualization loss, and 5mm outside the iodine unstained area. The 5-year disease-free survival rate was 87.1% vs 76.1% (P = 0.016) and the 5-year local control rate was 98.6% vs 93.0% (P = 0.008) for combination-guided surgery when compared to conventional surgery. Positive margin rates were 0% for cancer, and 6.5% and 0% for low- and high-grade dysplasia, respectively, with combination-guided surgery (P = 0.257). Multivariate analysis revealed that combination-guided surgery (odds ratio 0.140, 95% confidence interval 0.045–0.437; P < 0.001) and intraoperative frozen section examination (odds ratio 0.302; 95% confidence interval 0.115–0.791; P = 0.015) were significantly associated with local control. The combination of fluorescence visualization and iodine solution are effective in selecting surgical margins for early tongue cancer.     

Prevalence of tongue lesions in Hungarian children

OBJECTIVE: The aim of this study was to investigate the prevalence of tongue lesions in Hungarian children in relation to age, sex, systemic diseases and allergies. MATERIAL AND METHODS: A total of 1017 preschool and school children aged 1-14 years were examined. The age, sex and tongue lesions diagnosed were recorded together with any history of systemic diseases and allergies. RESULTS: Tongue lesions were found in 35.11% of all the children examined. Fissured tongue was the most frequent lesion (29.2%), apparently associated with age and sex. It occurred more commonly in boys, and in older children, than in girls and younger children. Geographic tongue was found in 5.7%, occurred more often in boys, and a relationship existed between fissured and geographic tongue. Among the children with geographic tongue 44.82% also had fissured tongue. These findings agree in general with the epidemiological data reported on population samples elsewhere in the world. Crenated tongue occurred in 0.68%, central papillary atrophy in 0.78%, and partial ankyloglossia in 0.88% of the children examined: confirming the rarity of these lesions. Although there was no obvious correlation with systemic diseases, geographic tongue appeared to be coincident with a history of allergic diathesis in some cases. CONCLUSION: In some cases early recognition of tongue lesions may provide useful diagnostic markers for some diseases.     

Sentinel lymph node biopsy for early stage tongue cancer—a 14-year single-centre experience

This study was performed to report the usage of sentinel lymph node biopsy (SLNB) in clinical stage I or II tongue cancer patients with cN0 necks seen over a 14-year period. Data were collected prospectively, and a retrospective analysis was performed of 41 patients with early stage oral squamous cell carcinoma of the tongue and a cN0 neck. Sentinel lymph node (SLN)-positive patients underwent elective neck dissection, whereas SLN-negative patients were kept under careful observation. Seven of the 41 (17%) patients enrolled in the study were found to have occult metastases. The patients were followed up for a mean duration of 92 months (range 60–144 months). The neck recurrence rate for SLN-positive patients was 0% and for SLN-negative patients was 3%. The authors recommend the routine use of SLNB in patients with early stage oral squamous cell carcinoma of the tongue and a cN0 neck. Furthermore, special focus should be placed on isolated tumour cells, as their presence is of high clinical relevance.     

40例舌癌组织VEGF表达及微血管密度观察

目的:探讨血管内皮生长因子(VEGF)表达及微血管密度(MVD)与舌癌组织临床病理指标的关系.方法:40例手术切除的舌癌原发病灶蜡块标本常规切片,免疫组化染色法观察各标本VEGF表达及MVD.结果:VEGF阳性表达的舌癌组织有较高的微血管密度(p＜0.01);VEGF表达和MVD在淋巴结转移组间有显著性差异(p＜0.01)、病理分型组间有显著性差异(p＜0.05),而在原发病灶临床分级组间差异无统计学意义(p＞0.05).结论:VEGF表达和MVD与舌癌病理分型及淋巴转移关系密切,可作为预测性检测指标.     

Autopsy findings in the tongues of 20 patients with AIDS

An extensive examination of the tongue was performed at autopsy in 20 consecutive patients who had died with AIDS. Abnormalities in the tongue were detected in 18 (90%) of the cases; the commonest lesions were ulceration (11), candidosis (8) and small foci of hyperkeratosis (10). The most extensive lesions were caused by Aspergillus infection (1), non-Hodgkin's lymphoma juxtaposed with Kaposi's sarcoma (1), herpetic infection (1) and candidosis (5). The disease causing death was identified in the tongue in two cases. There was a surprisingly low prevalence of oral hairy leukoplakia. which may be related to anti-viral or retroviral therapy.     

A preliminary and clinical study of radiation therapy for tongue carcinoma

Four hundred and seventy-four patients with squamous cell carcinomas of the tongue were treated with radiation therapy at the Department of Radiology, Osaka University Hospital between 1978 and 1987. Brachytherapy was mainly employed for the majority of the patients with T1 and T2 lesions, whereas the combination of external irradiation and brachytherapy was the treatment of choice for the patients with infiltrative T2 and more advanced lesions. Patients treated with brachytherapy alone were given an estimated tumor dose of about 70Gy within a week. Patients treated with the combined therapy received an estimated tumor dose of about 30Gy to 50Gy within 3 to 5 weeks from external irradiation, followed by 50Gy to 60Gy within a week from brachytherapy. The treatments used in this study improved the survival. The 2-year local control rates were 85% in T1, 77% in T2, 60% in T3 and 33% in T4 lesions. The 5-year actuarial survival rates according to the T stage were 78% in T1, 64% in T2, 50% in T3 and 40% in T4 lesions. One hundred and four patients(28%) of three hundred and sixty nine patients who had negative lymph nodes clinically had cervical lymph node metastases subsequently. Whereas twenty six patients(25%) of one hundred and five patients who had positive lymph nodes clinically proved to be false positive. The incidence of osteoradionecrosis was 6.0% in patients treated with the combination of external irradiation(30Gy) and brachytherapy(60Gy), while it was 1.7% in patients treated with brachtherapy alone(70Gy). Brachytherapy is a fairly good therapeutic technique for the majority of the patients with tongue cancers. The multicombined treatment modality could provide the chance for cure of advanced lesions.     

Scalloped tongue is associated with nocturnal intermittent hypoxia among community‐dwelling Japanese: the Toon Health Study

Scalloped tongue is considered as a possible clinical finding of obstructive sleep apnoea (OSA). There are few evidence of the association between scalloped tongue and OSA. To examine the association between scalloped tongue and nocturnal intermittent hypoxia (NIH), a surrogate marker of OSA, among a general Japanese population. Study participants were 398 men and 732 women aged 30–79 years who participated in the Toon Health Study from 2011 to 2014. Scalloped tongue was classified into three categories: none, mild and moderate‐to‐severe. Moderate‐to‐severe NIH was defined as the 3% oxygen desaturation index of ≥15 events/h during sleep for one night with pulse oximetry. The multivariable‐adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for moderate‐to‐severe NIH were calculated according to scalloped tongue categories using a logistic regression model. There were 69 (6·1%) moderate‐to‐severe NIH cases in this population. The multivariable‐adjusted ORs (95% CIs) of moderate‐to‐severe NIH were 1·59 (0·85–2·95) for mild and 2·39 (1·10–5·17) for the moderate‐to‐severe scalloped tongue group compared with the group without scalloped tongues. When stratified by overweight status (BMI <25 or ≥25 kg m^?2), the respective ORs (95% CIs) were 2·83 (1·06–7·55) and 4·74 (1·28–17·49) among overweight individuals, and 0·94 (0·40–2·70) and 1·52 (0·57–4·05) among non‐overweight individuals. Scalloped tongue was associated with higher prevalence of moderate‐to‐severe NIH among the general Japanese population and this association was more evident in overweight individuals.     

Effect of a repeated tongue‐lift motor task for tongue function

This study investigated the effect of repeated tongue motor tasks on suprahyoid muscle activity and tongue pressure. Fourteen participants performed three series of a standardized tongue‐lift training (TLT) task on each of five consecutive days. Electromyographic (EMG) activity from suprahyoid muscles and tongue pressure were recorded. In the first and third TLT series, participants were instructed only to target different force levels. During the second TLT series, visual feedback of the force level was given. One series consisted of three measurements [at 10%, 20%, and 40% of maximum voluntary contraction (MVC), respectively]. The coefficient of determination of the target force level–EMG curve and the target force level–tongue pressure curve was calculated from all series. There were no statistically significant day‐to‐day differences in EMG‐root mean square (RMS) values and tongue pressure during MVC. The coefficients of determination of tongue pressure in the first series on day 1 were statistically significantly lower than the coefficients of determination in the first series on day 5. These findings suggest that the control of tongue pressure improved, while the maximum force remained constant. These results could have implications for treatment paradigms related to learning for patients with compromised tongue function, such as swallowing disorders or dysphagia.     

Cystatin B与Cystatin C在舌鳞状细胞癌中的表达及意义

目的　研究半胱氨酸蛋白酶抑制剂B(Cystatin B)与半胱氨酸蛋白酶抑制剂C(Cystatin C)在舌鳞状细胞癌中的表达及意义并探讨其在舌鳞状细胞癌中的作用.方法　收集于2010年1月—2011年1月在中国医科大学附属口腔医院口腔颌面外科就诊的50例舌鳞状细胞癌病例标本及临床病理资料,行免疫组化方法检测Cystatin B与Cystatin C在舌鳞状细胞癌及癌旁正常组织中的表达,进行统计分析。结果　在舌鳞状细胞癌组织和癌旁正常舌黏膜组织中,Cystatin B的阳性表达率分别为72.0%(36/50)和36.0%(18/50),两者比较有统计学意义(P＜0.05);Cystatin C的阳性表达率分别为68.0%(34/50)和38.0%(19/50),两者比较有统计学意义(P<0.05)。Cystatin B与Cystatin C在不同病理分级中的表达强度分别有统计学意义(P＜0.05),与患者的年龄、性别及有无淋巴结转移均无关(P＞0.05)。结论　Cystatin B与Cystatin C在舌鳞状细胞癌的诊断及病理分级中具有一定的作用。     

The prevalence of tongue lesions in 5150 Turkish dental outpatients

OBJECTIVE: The aim of this study was to assess the prevalence of nine tongue conditions and relate to data obtained about oral hygiene or habits in Turkish dental outpatients. SUBJECTS: A total of 5150 subjects (2837 women, 2313 men) were included in this study. RESULTS: Of the 5150 subjects, 2690 subjects were detected as having tongue lesions with a prevalence of 44.2 and 62.0% for women and men, respectively. The difference was found to be statistically significant (P < 0.0001). There was a strong correlation between tongue lesions and increasing age. There was also a strong association between tongue lesions and smoking, black tea drinking, and fair or poor oral hygiene. Hairy and coated tongue was significantly higher in males. Contrary to this, papillary atrophy was more prominent in women. CONCLUSION: A strong correlation was found between tongue lesions and age, sex, oral hygiene and habits in Turkish dental outpatients. An efficient oral health program such as the elimination of risk habits and attention to cultural practices may improve tongue hygiene.