脱落细胞用于口腔癌变早期诊断的研究进展

口腔癌具有高复发和易转移等特点,临床亟待一种非损伤性的用于口腔癌前病变和口腔癌早期诊断与筛查的有效技术.口腔脱落细胞技术作为一种方便快速和非损伤的检测方法,被广泛用于口腔癌前病变和口腔癌的早期筛查、风险评估、分子标志物检测等研究中.本文就口腔脱落细胞的采集技术、口腔脱落细胞的分析以及存在问题与展望等作一综述.     

唾液生物标志物在口腔癌筛查中的应用

唾液含有丰富的DNA、RNA、蛋白质、微生物及代谢产物。它作为一种无创、安全的来源,可以替代血液用于疾病的诊断和预后。随着微阵列技术、全基因组测序、全转录组测序等高通量技术的快速发展,研究发现唾液是一个潜在的巨大生物标志物储存库,已有多种疾病特异性唾液标志物被挖掘。本文整合了已报道的有关口腔癌及癌前筛查的唾液生物标志物,探讨了唾液作为该领域生物标志物的优缺点及改进策略,以期为将来口腔癌的早期诊断及治疗提供参考。     

口腔癌和癌前病变临床检测的现状

口腔癌是世界上第六位常见肿瘤,尽管近年对口腔癌的外科手术、放疗及化疗技术在不断进步,但患者的5年存活率仍然不到50%。因此如何争取早期发现口腔癌变的蛛丝马迹就成为众多学者研究的热点。本文就口腔癌和癌前病变临床检测的现状作一综述。     

高通量技术在口腔癌标志物检测中的应用

肿瘤特异性标志物的筛选和鉴定对口腔癌的诊断、疗效判断、复发与转移检测、预后评价和机制研究等有着非常重要的意义.传统检测方法的灵敏性和特异性不高,高通量技术的产生和发展促进了肿瘤标志物研究的进一步发展.本文就高通量肿瘤标志物检测方法在口腔癌研究中的应用作一综述.     

唾液外泌体在口腔鳞状细胞癌的研究进展

口腔鳞状细胞癌 (oral squamous cell carcinoma,OSCC)是影响人类健康的主要恶性肿瘤之一。由于缺少早期筛查及检测的肿瘤生物标记物,导致晚期口腔癌的致死率达到50%。外泌体(exosomes)是细胞释放到细胞外的纳米级囊泡,广泛分布于唾液中,携带生物活性分子,介导肿瘤细胞和肿瘤微环境之间的相互作用。随着对外泌体研究的深入,发现外泌体与口腔疾病的诊断和治疗有着密切的关系,可作为口腔癌早期筛查的理想标志物。本文就唾液中外泌体在口腔鳞状细胞癌的研究进展作一综述,为口腔癌早期诊断的研究提供参考。     

口腔癌前病变及其癌变潜能监测的研究进展

口腔癌前病变的早期发现、早期诊断对口腔癌的防治十分重要。本文从形态诊断方法、形态定量分析技术、组织化学与免疫学技术、癌基因及其蛋白产物的表达回顾了近年口腔粘膜癌前病变及其癌变潜能监测的研究状况。     

脱落细胞学在口腔癌早期诊断上的应用

脱落细胞学检查是评估粘膜病损的重要手段,被用于多种癌症的辅助诊断.近年来,随着薄层液基细胞学技术和计算机全自动细胞图像分析系统等的发展,使得粘膜脱落细胞学检查被广泛应用于癌前病变和癌症的早期筛查、风险评估以及肿瘤复发的监测.本文就脱落细胞学检查在口腔癌早期诊断中的应用作一综述.     

口腔癌前病变及其癌变潜能监测的研究进展

口腔癌前病变的发现，早期诊断对口腔癌的防治十分重要，本文从形态诊断方法，形态定量分析技术，组织化学与免疫学技术，癌基因及其蛋白产物的表达回顾了近年口腔粘膜癌前病变及其癌变潜能监测的研究状况。     

口腔癌的中间标志物及在化学预防研究中的应用

在口腔癌的化学预防研究中,用癌变过程中的中间终点标志物替代化学预防研究的最后终点可以缩短化学预防的观察时间,减少样本量,通过检测中间终点,可以筛选高危人群,探讨化学预防剂预防口腔癌的机制。本文从癌前病变,基因标志物,细胞生长标志物,细胞分化标志物和酶标志物这五方面对口腔癌的中间标志物及其在化学预防口腔癌研究中的应用概况做一综述。     

口腔癌的早期诊断

口腔癌是一种常见的多发病,严重危害人类的身心健康。早期发现口腔癌前病变和口腔癌对于口腔癌预后具有重大意义。本文就近年来口腔癌早期诊断的研究进展作一综述。     

Role of saliva in oral dryness,oral feel and oral malodour

Patients who believe they have oral malodour often have a dry mouth condition instead. Here we have examined its relation to oral malodour, real or perceived. A direct relationship between the thickness of the film of residual saliva on mucosal surfaces throughout the mouth and perception of a dry mouth was observed. On the hard palate, the thickness of this film proved to be diagnostic for a dry mouth and corresponded to lower resting saliva flow and pH levels (P< 0.001). Intra-muscular administration of the anti-sialogogue, Robinul, accurately produced the dry mouth condition. Using a sulphide monitor, loss of volatile sulphur compounds into mouth air progressively occurred as the mouth became drier. Mouth pH and Eh on the dorsum of the tongue correspondingly fell. Mouth breathing led to tongue and palate moisture loss thus enabling escape of malodour volatiles into mouth air. Measurement of oral dryness should make it possible to differentiate genuine malodour from dry mouth related pseudo-malodour subjects, and in turn, the latter from patients that are halitophobic. This should facilitate identification of such patients and avoid error in their clinical management.     

Detection of survivin mRNA in healthy oral mucosa, oral leucoplakia and oral cancer

Background:  Survivin is involved in modulation of cell death and cell division processes. Survivin expression in normal adult tissues has not been fully understood, although it is markedly lower than in cancer, where it is over-expressed.
Objective:  To investigate survivin expression in normal, potentially malignant and cancerous oral mucosa.
Methods:  We measured survivin mRNA levels by real-time RT-PCR in specimens of oral mucosa (15 from normal mucosa, 17 from potentially malignant lesions, 17 from neoplasms). Scores were compared using Kruskal–Wallis test and post hoc according to Conover. Chi-squared test was used for dichotomous data.
Results:  The median relative levels of survivin mRNA resulted six for normal mucosa, eight for potentially malignant lesions, 13 for cancers: differences among these three groups were statistically significant, as between cancer and potentially malignant lesions. Expression in normal mucosa and potentially lesions group showed no significant difference. Low, but not marginal expression of survivin in normal mucosa is a new finding, and it could be explained with the higher sensibility of our methods.
Conclusions:  Survivin expression in oral potentially malignant lesions might indicate a progressive deregulation of expression paralleling oncogenesis, particularly during the first stages of process, suggesting a putative predictive role for survivin.     

Evidence-based practice of oral pathology and oral medicine

Oral pathology is the specialty area of dentistry that deals with the diagnosis and management of oral diseases and more specifically, diseases other than dental caries, periodontal disease, restorative dentistry, and orthodontic therapy. Oral medicine represents the clinical arm of oral pathology and deals with diagnosis and treatment of soft-tissue lesions, whereas oral histopathology is the specialty area that focuses on the microscopic diagnosis of soft- and hard-tissue lesions of the head and neck area. The diagnosis and treatment of oral pathologic conditions is often based on empirical decision-making and many approaches to treatment have not been well-supported by clinicopathologic studies. The need for evidence-based, scientifically documented approaches to both diagnosis and treatment is eminent. Specific diagnostic criteria are lacking for many oral diseases, and therapeutic strategies have not been assessed by the gold standard of placebo-controlled, double-blind trials. Additionally, there are scientific data in the published literature that continue to be ignored by dental practitioners who manage patients with oral pathologic conditions. In this article, specific disease entities that are commonly managed by oral pathologists and oral medicine practitioners will be discussed with recommendations for future scientific studies that can serve as a framework for evidence-based diagnostic and therapeutic approaches.     

Effect of oral anticipatory guidance on oral health and oral hygiene practices in preschool children

Thirty children (6 to 18 months), enrolled in a dental program since birth, make up the intervention group. Control group consisted of thirty children who were of similar age and gender but had never been to a dental office. The presence of visible dental plaque and the performance of oral hygiene differed statistically between both groups. The dental program was effective in reducing visible dental plaque, and in establishing oral health habits among parents and young children.     

Physiotherapeutic treatment improves oral opening in oral submucous fibrosis

Background:  In oral submucous fibrosis (OSF) fibrous bands and burning mucosal pain restrict oral opening to limit speech and eating. The pathogenesis of OSF remains unclear, while surgical and pharmacological treatments have limited success, and are often inaccessible in communities using areca nut where OSF is prevalent. Improved outcomes are reported for surgical treatment when followed by physiotherapy. We tested the hypothesis that physiotherapy alone can modify tissue remodelling in OSF to increase oral opening.
Materials and methods:  Fifty-four Nepali OSF patients were managed for 4 months in three randomly assigned groups receiving either: five times daily physiotherapy by inter-positioning tongue spatulas between teeth and adding a new spatula every 5–10 days; local injection of hyaluronidase with steroids; or no active treatment.
Results:  More males presented with OSF than females ( p  < 0.05). All patients reported reduced opening and 47% had mucosal pain. Progressive mucosal involvement was always in the same order, starting with the soft palate, and then progressing to the fauces, unilateral buccal mucosa, bilateral buccal mucosa, floor of mouth and finally lip mucosa ( p  < 0.006). Physiotherapy improved oral opening ( p  < 0.0005), but not oral pain, while no clear improvement was seen in untreated patients as well as patients managed by injection.
Conclusions:  We conclude OSF in the Nepali population progresses in a predictable pattern, and that physiotherapy is effective for increasing the oral opening. We further suggest physiotherapy can be readily used to improve OSF in communities with otherwise limited health resources.     

Influence of oral health and lifestyle on oral malodour

Objective: To assess the influence of oral health and lifestyle on the prevalence of oral malodour among university students. Materials and methods: Self‐administered questionnaires. Chi‐square test was used to detect any significant association between malodour and various variables. Results: 9% of males and 6% of females complained of malodour, while 36% of males and 31% of females did not complain of malodour. Nevertheless, 12% of the males and 6% of females were unable to decide. The highest percentage of respondents not complaining of malodour were non‐smokers (55%). A significant number of respondents were free from caries (48%), gingival disease (55%) and also were not complaining of malodour. Statistically, a significant association was found between malodour and gingival disease (p < 0.05) and between malodour and the use of a toothbrush on a daily basis (p < 0.001). Conclusions: The results highlight the influence of oral self‐care and lifestyle on malodour. Public awareness, diagnosis and treatment of malodour are primarily the responsibility of dentists. Malodour can have a distressing effect and the affected person may avoid socialising.