Immunohistochemical evaluation of hedgehog signalling in epithelial/mesenchymal interactions in squamous cell carcinoma transformation: a pilot study

Precancerous lesions have been studied because of their carcinogenic potential and their association with squamous cell carcinoma (SCC) has been reported. In the tumour microenvironment, the processes of angiogenesis and tissue remodelling are regulated by a family of proteins (Hedgehog) described as being able to modulate epithelial/mesenchymal interactions. The objective of this study was to perform a comparative study of precancerous lesions and SCCs by immunohistochemistry for the presence of Sonic, Gli2, SMO and Patched proteins, members of the Hedgehog pathway. Sixteen cases diagnosed as actinic cheilitis associated with SCC were compared to normal oral mucosa. The sections were subjected to immunohistochemistry and the positively stained cells were counted by morphometric analysis. There was a significant progressive increase in expression of all proteins of the Hedgehog pathway, both in the epithelium and in the connective tissue, when sections of normal mucosa, dysplasia and carcinoma were compared (P < 0.05). Thus, one may suggest that the Hedgehog pathway in tumour transformation influences SCC, and more studies should be conducted to expand the understanding of the role of these proteins in neoplastic transformation.     

42例口腔鳞癌患者口腔粘膜和唾液菌群分布

目的:探讨口腔鳞癌对口腔菌群的影响。方法:42例口腔鳞癌患者常规联合根治术后给予头孢噻肟钠、奈替米星抗感染2周,分别检测其手术前后唾液、病变区粘膜或术区粘膜、正常粘膜可培养细菌的数量、构成比和检出率。结果:术前唾液细菌量(x=8110@108CFU/ml,lgx=819084)明显高于术后,术前病变区粘膜细菌量(x=5121@ 105CFU/cm2,lgx=517169)远高于对侧正常粘膜,优势菌群发生改变,病变区粘膜有外籍菌定植(白色念珠菌、绿脓杆菌)。术后切口区粘膜细菌量(x=4134@105CFU/cm2,lgx=516372)仍远高于对侧正常粘膜(x=7124@104CFU/ cm2,lgx=418599),链球菌属所占比例成倍增加。结论:口腔鳞癌可导致患者口腔菌群失调,增加感染的危险性及继发局部或全身感染。     

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口腔黏膜下纤维性变(oral submucous fibrosis,OSF)是一种慢性、隐匿性、具有癌变倾向的口腔黏膜病。本文对OSF的病名来由、病因、发病机制和病变的性质进行了系统的描述。     

Cytomorphometric analysis of squames obtained from normal oral mucosa and lesions of oral leukoplakia and squamous cell carcinoma

Ramaesh T, Mendis BRRN, Ratnatunga N, Thattil RQ: Cytomorphometric analysis of squames obtained from normal oral mucosa and lesions of oral leukoplakia and squamous cell carcinoma. J Oral Pathol Med 1998; 27: 83–6. © Munksgaard, 1998.
Cell and nuclear diameters (CD and ND) were measured in squames obtained from normal buccal mucosa and lesions of oral leukoplakia and squamous carcinoma (SCC) also from buccal mucosa. The study groups consisted of Group 1: normal buccal mucosa ( n = 40); Group 2: lesions with no epithelial dysplasia ( n = 58); Group 3: lesions with epithelial dysplasia ( n = 27); and Group 4: SCC lesions ( n = 51). The mean CD and ND values were: Group 1: 51.78 (± 0.11) and 8.36 (± 0.49); Group 2: 45.73 (± 0.16) and 8.31(± 0.68); Group 3: 41.32 (± 0.13) and 9.04 (± 0.46); Group 4: 38.58 (± 0.11) and 10.10 (± 0.56) urn, respectively. Correlation between the ND and CD was positive for Group 1 ( r = 0.78, P < 0.05) and Group 2 ( r = 0.33, P < 0.05). There were no significant correlations in Groups 3 and 4. ANOVA showed significant differences ( P < 0.05) for CD between all four groups. Except between Groups 1 and 2, the ND was significantly different ( P < 0.05) between all groups. The results indicate that ND and CD could possibly be sensitive parameters in the diagnosis of oral premalignant and malignant lesions.     

口腔种植患者的口腔护理行为调查分析

目的：了解口腔种植患者的口腔护理行为,为口腔种植患者的口腔护理健康教育提供依据。方法：对在福建省级机关医院口腔科完成口腔种植义齿修复半年以上的患者进行问卷调查。结果：3.2%患者每天刷牙3次;34.8%患者刷牙时间大于3分钟;50.2%左右患者经常使用牙线和牙缝刷;30.3%患者经常使用冲牙器;仅6.7%患者做到戒烟;49.4%患者不按医嘱定期复查;65.2%患者未能进行牙周洁治。结论：口腔种植患者在口腔专业维护方面存在偏差,应加强健康教育,同时应特别注意文化程度较低的人群。     

Morphometric computer‐assisted image analysis of oral epithelial cells in normal epithelium and leukoplakia

J Oral Pathol Med (2010) 39 149–154 Background: There are very few studies documenting morphometric parameters of normal oral mucosa and leukoplakia. The present study was undertaken to establish the morphometric parameters of the parabasal and spinous cells of normal oral epithelium. Analysis of changes occurring in these cells in leukoplakia was also done. Methods: This study was conducted on tissue sections of clinically normal oral mucosa and leukoplakia. Morphometric analysis was done for parabasal and spinous cells. Statistical analysis was done using one way ANOVA and Mann–Whitney test. Results: Morphometric parameters were greater in the spinous cells than in parabasal cells in normal oral mucosa. Leukoplakia showed greater cellular and nuclear parameters than normal mucosa. Conclusion: Normal oral epithelium showed site‐wise difference in cell and nuclear measurements. Nuclear parameters showed a statistically significant change than cellular parameters in dysplasia. These changes were expressed in the earliest stage of transformation to dysplasia.     

口腔卫生师的职业与职责

口腔卫生师(hygienist)是口腔医疗卫生保健的特殊职业,是口腔卫生保健的专业人才,是口腔疾病预防的主力,作为口腔医学的重要组成部分,组成了口腔医疗的基本结构单元.口腔卫生师有明确的职业特征和社会属性,在大众的口腔医疗卫生保健中发挥独特的重要作用.口腔卫生师通过口腔卫生宣教,提高大众的口腔健康素质和修养;通过口腔照...     

Evaluation of oral mucosal diseases: inter- and intra-observer analyses

J Oral Pathol Med (2012) 41 : 68–72 Background: Essential to the diagnosis and management of oral mucosal diseases are visual evaluation and monitoring of the oral cavity. Digital photography has recently become an important clinical tool. The aims of this study were to (i) evaluate inter‐ and intra‐observer differences between oral medicine and other dental specialists when assessing changes in oral mucosal pathology and (ii) assess the influence of calibration labels incorporated into the clinical images on the reliability and consistency of evaluation. Methods: Ten oral medicine specialists (OM) and 10 other dental specialists (DS) participated in the study. Pairs of images captured with an intraoral camera at two time points from 17 cases of mucosal diseases were presented to the participants. Each pair of photographs was presented with a calibration label (showing length and white to black hues) and again without one. The participants were asked to respond to a questionnaire evaluating changes in size, color, location, and severity for each image pair. Results: Oral medicine specialists had better absolute agreement and consistency than DS when evaluating the changes in the images; however, these parameters did not exceed 52% in either group. The incorporation of a calibration label in the images increased agreement and consistency of evaluations in both groups. Conclusions: Follow‐up evaluations of oral mucosal lesions are performed better by oral medicine practitioners compared to other dental specialists. The incorporation of a calibration label in the clinical images seems to enhance evaluation.     

211例口腔白斑的临床分析

目的：研究口腔白斑癌变和发病部位以及临床表现的关系。方法：对１８年来在我院就诊的２１１例临床和组织确诊为口腔白斑的患者进行了综合分析。结果：龈、舌、颊等部位为白斑高发区，其中有１４例白斑癌变，癌变率为６．６４％。结论：口腔白斑类型以颗粒型、溃疡型、疣状型癌变率较高。癌变高发部位为舌部，舌部又以舌侧缘（包括舌腹和舌缘）的癌变率为著。     

Malignant transformation of oral leukoplakia in a well‐defined cohort of 144 patients

Objectives

Oral leukoplakia is a potentially malignant disorder of the oral mucosa. The aim of this retrospective study was to identify the factors that possibly predict malignant transformation in a well‐defined cohort of patients with a long‐term follow‐up. All leukoplakias were staged according to a clinicopathological classification and staging system. Furthermore, a certainty factor has been used with which the diagnosis has been established.

Material and methods

The group consisted of 144 patients. The size, presence and degree of epithelial dysplasia were incorporated into a clinicopathological classification and staging system. Initial management consisted of surgical excision, CO₂ laser vaporisation or observation only. The mean follow‐up period was 51.2 months (s.d. = 39.33, range 12–179 months).

Results

In 16 of 144 patients (11%), malignant transformation occurred between 20 and 94 months (mean 57.0 months) after the first visit, the annual malignant transformation rate being approximately 2.6%. A large size of the lesion (≥ 4 cm) showed to be the only statistically significant predictor of malignant transformation (P = 0.034).

Conclusion

A size of ≥ 4 cm showed to be the only significant predicting factor of malignant transformation in oral leukoplakia. No other epidemiological, aetiological, clinical or histopathological parameters were of statistical significance.     

Oral health of Rhodesia African first year student teachers

A basic oral health survey was carried out on a random sample of first year African student teachers attending four teachers' colleges in Rhodesia. The number examined and interviewed was 309. Methods and criteria used are those described in the second (1977) edition of the World Health Organization manual Oral health surveys - Basic methods. Prevalences of dental caries were 31.0% for the 142 male students and 59.5% for the 167 female students. The difference is statistically significant (P less than 0.001). Mean DMFTs were 0.74 for men and 2.02 for women. The prevalences of "intense gingivitis" were 52.8% for male students and 34.7% for female students. This difference also is significant (P less than 0.005). The major treatment requirements are for one-surface fillings and prophylaxis with oral hygiene instruction. Dental service utilization is low. Less than 10% of the sample had obtained dental care in the previous 12 months. The main reason for seeking care was pain. Self-assessments of oral health needs were not valid. The stated desire for fillings is greater than for extractions. A need has been demonstrated for dental health education aimed at the prevention of disease and the encouragement, use and demand for quality care services.     

150例口腔黏膜白斑的回顾分析

目的：研究口腔黏膜白斑癌变和发病部位及临床表现的关系。方法：对15年来诊治的150例临床和组织学确诊为口腔白斑的病例进行回顾性分析。结果：龈、舌、颊等部位为白斑高发区，其中有14例白斑癌变，癌变率为9．33％。结论：口腔白斑以颗粒型、溃疡型、疣状型癌变率较高。癌变高发部位为舌部，舌部又以舌侧缘（包括舌腹和舌缘）的癌变率为著。     

A national epidemiological survey of oral mucosal lesions in Malaysia

Abstract The prevalence of oral mucosal lesions in Malaysia was determined by examining a representative sample of 11 707 subjects aged 25 years and above throughout the 14 states over a period of 5 months during 1993/1994. A two-stage stratified random sampling was undertaken. A predetermined number of enumeration blocks, the smallest population unit in the census publication was selected from each state. With the selected enumeration block, a systematic sample of living quarters was chosen with a random start. The survey instrument included a questionnaire on sociodemographic characteristics and a clinical examination. The clinical examination was carried out by 16 specially trained dental public health officers and the diagnosis calibrated with a final concordance rate of 92%. The age in the sample ranged from 25 to 115 years with a mean of 44.5+14.0. The sample comprised 40.2% males and 59.8% females; 55.8%. were Malays, 29.4% Chinese,10.0% Indians and 1.2% other ethnic groups. Oral mucosal lesions were detected in 1131 (9.7%.) subjects. 5 (0.04%) had oral cancer, 165 (1.4%) had lesions or conditions that may be precancerous (leukoplakia. erythroplakia, submucous fibrosis and lichen planus) and 187 (1.6%) had betel chewer's mucosa. The prevalence of oral precancer was highest amongst Indians (4.0%) and other Bumiputras (the indigenous people of Sabah and Sarawak) (2.5%) while the lowest prevalence was amongst the Chinese (0.5%).