Flow cytometric analysis of benign and malignant tumors of the oral and maxillofacial region

One hundred eight fresh tissue samples obtained from normal tissues, benign tumors, and malignant tumors of the oral and maxillofacial region were analyzed for nuclear DNA content and cell kinetics by flow cytometric analysis (FCM). Mean DNA indices for 22 normal tissues and 18 benign tumors were 1.00 and 1.02, respectively, and all samples but one showed diploid pattern. On the other hand, the value for 68 malignant tumors was 1.38, and 66% of them showed an aneuploid pattern. The S phase and G2 + M phase cell populations for malignant tumors were 17.2% and 7.0%, respectively. With the exception of G2 + M phase cell population, all values for malignant tumors were significantly higher than those of normal tissue and benign tumors. Although statistical differences were not observed in most of the values, they were higher in squamous cell carcinomas than in malignant salivary gland tumors. The incidence of aneuploidy and DNA index showed a tendency to increase with the increase of T classification, in N2 and N3 tumors, and in the group of patients with recurrence or who died. The DNA index and the type of DNA ploidy were well correlated to malignancy grade determined by six histologic parameters, whereas the S phase cell population was correlated to mitosis. The analysis by the two-dimensional diagnostic supporting system showed that more than 80% of malignant tumors can be correctly diagnosed by combined values of DNA index and S phase cell population. The results indicate that nuclear DNA analysis by FCM is quite useful as a supplement to histologic diagnosis and evaluation of malignancy grade.     

口腔颌面部非何杰金氏淋巴瘤流式细胞DNA分析及意义探讨

目的:探讨流式细胞学各项指标与非何杰金氏淋巴瘤(NHL)发病部位、临床分期、病理分级、细胞类型及预后的关系和流式细胞学对NHL的诊断价值。方法:采用流式细胞仪测定50例口腔颌面部NHL及10例反应性增生淋巴结(RLN)石蜡包埋组织的DNA倍体、细胞周期各参数,并分析各参数及其与预后的关系。结果:10例RLN皆为二倍体,而NHL二倍体率为54%,异倍体率为46%,二者有显著性差异。SPF值、S+G2/M值与非何杰金氏淋巴瘤恶性程度密切相关,SPF值、S+G2/M值随肿瘤的恶性程度增大而增大。结论:口腔颌面部淋巴瘤流式细胞学检测具有一定诊断学价值,但其运用一定要与形态学相结合。同时SPF、S+G2/M等指标可以反映其细胞增殖状况及病理学恶性程度。     

Proliferating cell nuclear antigen (PCNA) expression in oral squamous cell carcinomas

Proliferating cell nuclear antigen (PCNA) is a nuclear protein synthesized in the late G₁ and S phase of the cell cycle which can be detected immunohistochemically in paraffin-embedded tissue as a useful marker for the proliferating fraction of cells in tissue specimens. Thirty-eight cases of oral squamous cell carcinoma were studied in groups according to clinical staging and histological grading (UICC system), these included 5 cases of T1, 13 cases of T2, and 20 cases of T3, and 19 cases of G1, 12 cases of G2, and 7 cases of G3. The mean percentage of PCNA positively stained tumor cells in this series was 29.2. The mean percentages of PCNA-positive cells in each stage and grade were: T1 (13.7%), T2 (24.4%), and T3 (34.3%); G1 (30.5%), G2 (248%), and G3 (33.2%). The results indicate that the percentage of PCNA positively stained tumor cells in oral squamous cell carcinoma was significantly greater when tumor size was larger than 2 cm (T1 versus T2/T3). However, there was no significant difference between T2 and T3. There was no correlation between the number of PCNA-stained tumor cells and histological grade.     

Study of NK cell activity in patients with oral maxillofacial squamous cell carcinoma

NK cell activity of peripheral blood lymphocytes against K562 cell line were tested with 125IUdR release assay in 50 normal controls and 50 patients with oral maxillofacial benign tumors and 178 patients with oral maxillofacial squamous cell carcinoma. The data show NK cell activity of patients with primary squamous cell carcinoma is lower than that of normal controls and that of patients with benign tumors (P less than 0.001 and P less than 0.001). NK cell activity of patients with benign tumors is not different from that of normal controls (P greater than 0.05). NK cell activity of patients with II and III grade squamous cell carcinoma is lower than that of patients with I grade squamous cell carcinoma (P less than 0.01). Stage-related NK cell activity is not observed and there is no significant difference between patients with and without lymph-node metastasis. NK cell activity of patients with recurrent squamous cell carcinoma is not only lower than non-recurrent patients and normal controls (P less than 0.001) but also lower than primary squamous cell carcinoma patients (P less than 0.01). The non-recurrent patients have normal NK cell activity. The results indicate that the patients with oral maxillofacial squamous cell carcinoma have impairment of NK cell function. NK cell activity of the patients depresses within one week of operation and returns preoperative level two weeks after operation. Chemotherapy inhibits NK cell activity, which may not return two weeks after chemotherapy. These give reference to clinicians. NK cell activity may be a parameter in monitoring the immunofunction of oral maxillofacial malignant tumor patients.     

A clinicopathologic study on basaloid squamous cell carcinoma in the oral and maxillofacial region

Basaloid squamous cell carcinoma (BSCC) is a rare distinct variant of squamous cell carcinoma (SCC). To investigate its clinical behavior and prognosis, 15 patients with BSCC in the oral and maxillofacial region were clinically analyzed and compared with 15 patients with conventional SCC matched for site, stage, gender and age. To understand its immunohistochemical features, sections for cytokeratin AE1/AE3, CK 13. CK 7, CK 8, proliferating cell nuclear antigen (PCNA) and p53 were reviewed from 12 patients with BSCC. The rate of cervical lymph node metastasis of BSCC was as high as 67% and that of distant metastasis 13%. The tumor recurrence rate was 33% and the 3-year and 5-year survival rates were 53% and 32%, respectively. For conventional SCC, the cervical lymph node metastasis rate was 27%, that of distant metastasis 7%, tumor recurrence rate was 33%, and 3-year and 5-year survival rates were 80% and 70%, respectively. In most BSCC patients (10/12) the PCNA index was over 50%. Twelve BSCC patients were diagnosed with grade II or III conventional SCC when the original records of the primary diagnosis for the 15 patients with BSCC were reviewed. The biological behavior and prognosis of BSCC are similar to those of poorly differentiated SCC.     

口腔黏膜鳞癌术后复发相关因素的观察和研究

目的：分析影响口腔鳞癌预后及复发的临床病理因素,为进行综合治疗及其预后评价提供临床依据。方法：对407例原发口腔鳞癌患者以病变部位、肿瘤厚度、临床T分期、区域淋巴结转移、治疗方式、手术方式、术后组织学分级等指标研究与口腔鳞癌术后及复发相关的因素。结果：口腔鳞癌术后的复发率与病变部位、肿瘤厚度、临床T分期、区域淋巴结转移及组织学分级等因素有关,诱导化疗联合手术的综合治疗可有效降低口腔鳞癌的复发率。结论：临床工作中,我们应综合分析各种临床病理因素,对与术后复发关系较为密切的因素进行仔细评估,制定出有效的预防措施,提高口腔鳞癌的手术治愈率及生存率,降低复发率。     

超声热化疗联合根治性手术在口腔颌面部晚期鳞癌患者中的应用及护理

目的 研究超声热化疗在口腔颌面部晚期鳞癌患者中的应用效果及围术期护理。方法 以我院就诊的36例口腔颌面部晚期鳞癌患者为研究对象,将其分为对照组和实验组,每组18人。对照组只进行化疗,然后进行手术治疗。实验组采用上海熙洛有限公司生产的YUT-1超声肿瘤热疗仪热疗加化疗后实施手术方案。结果 术后一年比较治疗效果。热化疗组和化疗组的RR分别为77.8%和38.9%,热化疗组的RR明显高于化疗组（P<0.05）。结论 超声热化疗联合根治性手术共同治疗口腔颌面部的晚期鳞癌,有明显的加强和增敏效果,治疗的同时会使患者大量出汗,疲劳,甚至灼伤热疗区域的皮肤。对此,我们要加强热化疗患者的围术期护理工作,提高疗效,提高晚期癌症患者的生存质量。     

E-cad和CD44v6在口腔鳞癌中的表达及意义

目的 探讨黏附分子E-cad和CD44v6在口腔鳞癌中的表达及其与口腔颌面部鳞癌病理分级和侵袭转移的关系.方法 采用免疫组织化学抗生蛋白链菌素-生物素标记染色技术,对54例口腔颌面部鳞癌组织和15例口腔颌面部正常组织进行E-cad和CD44v6表达的检测.结果 口腔鳞癌组织E-cad阳性表达率(50.00%)低于口腔正常组织的阳性表达率(86.67%),其差异有统计学意义(P＜0.05);E-cad和CD44v6的阳性表达率随鳞癌分化程度的降低而降低(P＜0.05);有淋巴结转移的鳞癌原发灶与无淋巴结转移的原发灶比较,前者E-cad阳性表达率(21.43%)低于后者(60.00%),其差异有统计学意义(P＜0.05).E-cad的表达与CD44v6的表达具有显著相关性(P＜0.01).结论 E-cad的低表达与口腔颌面部鳞癌病理分级和转移关系密切.CD44v6在低分化鳞癌组织中低表达.E-cad与CD44v6的联合检测可作为口腔鳞癌发生发展和侵袭转移的参考指标.     

口腔鳞状细胞癌高危型人乳头状瘤病毒感染的检测

目的 观察口腔鳞癌及口腔粘膜高危型人乳头状瘤病毒（HPV）感染情况,探讨HPV感染与临床及病理资料的关系。方法 用多聚酶链反应（PCR）检测73例口腔鳞癌及40例正常口腔粘膜石蜡包埋组织中HPV16、HPV18的DNA。统计分析其与临床及病理资料的关系。结果 口腔鳞癌HPV16／HPV18 DNA阳性率为74％（54／73）,正常口腔粘膜为55％（22／40）。口腔鳞癌与正常口腔粘膜HPV阳性率存在显著性差异（P＝0．040）。统计分析显示：HPV感染与患者的性别、年龄有关,与其它因素（肋瘤发生部位、嗜烟酒情况、肿瘤病理分级、临床分期）无关。结论 高危型HPV感染与口腔鳞癌的发生有关。口腔粘膜中HPV感染普遍存在,提示HPV在口腔肿瘤的发生中并非独立发挥作用。     

口腔颌面部鳞癌组织中p16基因变异的初步研究

目的 检测口腔颌面部鳞癌中p16基因的缺失和突变，以了解p16基因在口腔颌面部恶性肿瘤发生发展过程中的作用。方法 应用聚合酶链反应－单链构象多态性分析（PCR－SSCP）技术，检测33例原发性口腔颌面部鳞癌的石蜡标本，将p16基因的变异频率与口腔颌面部鳞癌的临床分期，组织学分级及淋巴结转移进行统计学分析。结果 p16基因的缺失率为21％，点突变率为6％，变异频率为27％。临床Ⅰ、Ⅱ、Ⅲ、Ⅳ期每两期之间无显著性差异（P＞0．05）；而临床Ⅰ、Ⅱ期和Ⅲ、Ⅳ期之间有显著性差异（P＜0．05）。组织学分级和有，无淋巴结转移之间p16基因变异无显著性差异（P＞0．05）。结论 p16基因的缺失和突变是口腔颌面部鳞癌中常见的分子事件，它的失活在口腔颌面部鳞癌的发生发展中起着重要作用，说明其变异与肿瘤的临床分期密切相关，随着肿瘤临床进程的发展，其变异频率增高。研究未发现其变异与肿瘤组织学分级和淋巴结转移之间存在相关关系。     

口腔粘膜癌前病变、鳞癌的DNA倍体和AgNOR测定及其相关性的初步研究

〕对１９例口腔粘膜癌前病变及鳞癌用流式细胞仪作ＤＮＡ定量测定，同时用Ｐｌｏｔｏｎ改良银染法作ＡｇＮＯＲ定量计数。结果显示：ＤＮＡ异倍体检出率为鳞癌组＞异常增生组＞ＯＬＰ、ＬＫ组（无异常增生组），鳞癌组与ＯＬＰ、ＬＫ组间差异有显著性；ＡｇＮＯＲ值鳞癌组＞异常增生组＞ＯＬＰ、ＬＫ组，各组间有显著性差异，ＤＮＡ倍体含量与ＡｇＮＯＲ值间相关性显著。提示：ＤＮＡ含量测定与ＡｇＮＯＲ计数对鉴别口腔粘膜良、恶性病变有一定价值，二者意义相近且互补，为口腔粘膜病理学诊断提供了一个新的量化指标，有助于临床对癌前病变的早期诊断     

Characterization of epithelial cell activity in patients with oral cancer

Accurate, predictive assessment of the clinical behaviour and progression of individual oral cancers and premalignant lesions requires reproducible and quantitative analyses of diseased tissue. In this paper we describe the use of in vitro double labelling (sequential tritiated thymidine and bromodeoxyuridine staining of proliferating epithelial cells) to calculate S phase labelling indices (LIs), estimation of S phase duration (tS), and measurement of variables of flux to and from S for excised specimens of oral squamous cell carcinoma, premalignant lesions, and clinically normal mucosa from patients with oral cancer. There was a significant increase in mean LIs in buccal mucosa leukoplakias (14.5%) compared with normal mucosa (10.3%); P = 0.03. LIs were also increased in patients with cancers of the floor of mouth and ventral tongue but neither these changes nor alterations in flux parameters or S Phase durations were significant. Twenty-one kinetic profiles of dysplastic and malignant tissue were compared with conventional histopathological results, however, and these showed a 2.2% increase in LIs with each increase in grade of dysplasia (P = 0.004) and a 12% increase in LIs with each reduction in tumour differentiation (P = 0.02).     

DNA content and PCNA immunoreactivity in oral precancerous and cancerous lesions

Thirty-three dysplastic lesions showing varying degrees of atypia located in the oral cavity and 83 squamous cell carcinomas located in the oral cavity and tongue (n = 56) or in the lips (n = 27) were analysed by means of proliferating cell nuclear antigen (PCNA) immunoreactivity and image cytometric DNA measurements. The results show that in dysplastic lesions increasing cellular atypia correlated to elevated proliferative activity and aneuploidy occurring in the basal cell layers. In highly differentiated squamous carcinomas increased PCNA immunoreactivity and aneuploidy was preferentially observed focally (grade 1 tumours) or in the invasive zones (grade 2 tumours). In contrast, more poorly differentiated carcinomas (grade 3 and 4 tumours) showed strongly elevated proliferative activity and aneuploidy throughout the entire tumour mass.     

组蛋白修饰在口腔鳞状细胞癌中的研究进展

口腔鳞状细胞癌(oral squamous cell carcinoma, OSCC)是口腔颌面部最常见的恶性肿瘤,而OSCC患者就诊时往往疾病已发展到晚期阶段并出现肿瘤转移,导致预后不佳。OSCC的发病机制尚不清楚,目前早期有效监测OSCC发生、侵袭、转移及复发的分子靶点仍需要进一步探究。当前的研究显示,各种组蛋白修饰改变了染色质结构,进而影响相关下游基因的转录活性,调控基因表达水平,在OSCC的生物学检测、病理分级与分期、预后判断中均发挥重要作用。该文主要对组蛋白的甲基化、乙酰化、磷酸化、泛素化、二磷酸腺苷核糖基化等修饰在OSCC中的研究进展进行综述。     

基质金属蛋白酶-7和c-myc在口腔鳞状细胞癌中的表达和意义

目的研究基质金属蛋白酶-7(MMP-7)与c-myc在口腔鳞状细胞癌组织中的表达及其意义。方法应用免疫组化EliVisionTM法分别检测MMP-7和c-myc在49例口腔鳞状细胞癌和5例正常口腔黏膜上皮中的表达情况。结果1)MMP-7和c-myc在口腔鳞状细胞癌组织中的阳性表达率分别为83.7%和77.6%。2)在不同病理分级、不同临床分期和有无淋巴转移的口腔鳞状细胞癌组织中MMP-7阳性表达率的差异有统计学意义(P<0.05)。3)在不同病理分级和有无淋巴转移的口腔鳞状细胞癌组织中c-myc阳性表达率的差异亦有统计学意义(P<0.05)。4)口腔鳞状细胞癌组织中MMP-7和c-myc的表达呈正相关(P<0.05)。结论MMP-7和c-myc在口腔鳞状细胞癌组织中均有高表达,在口腔鳞状细胞癌的发病过程中,其高表达具有协同效应,共同促进口腔鳞状细胞癌的发生和发展。     

Influences of survivin expression on cisplatin sensitivity of tongue squamous cell carcinoma in vitro and in vitro

Tongue squamous cell carcinoma (TSCC) is the most common malignancy in oral and maxillofacial region. Liking other tumors in the body, it is a genetic disorder that is strongly linked to imbalance between cell proliferation and apoptosis.     

口腔癌及口咽癌病理诊断规范

口腔癌及口咽癌是口腔颌面部最常见的恶性肿瘤。规范化的口腔癌及口咽癌病理诊断报告不仅应提供给临床准确的病理诊断,还应包括与患者预后评估、治疗策略选择相关的信息。由中华口腔医学会口腔病理学专业委员会牵头组织成立专家组,对口腔癌及口咽癌病理标本固定、取材及报告内容等进行研讨与规范,形成《口腔癌及口咽癌病理诊断规范》。此规范涵盖了近年来在口腔癌和口咽癌临床病理方面的一些重要变化,如口腔癌肿瘤T分期应考虑肿瘤侵袭深度、肿瘤N分期应考虑有无淋巴结外扩展、口咽癌中新亚型人乳头状瘤病毒相关性鳞状细胞癌等。希望通过本规范的制定,提高我国口腔癌及口咽癌病理报告质量,为临床治疗及预后评估提供依据。     

口腔颌面癌瘤的颈淋巴结转移及颈淋巴清扫术的临床研究

目的 探讨口腔颌面癌瘤颈淋巴结转移的部分规律及其与颈淋巴清扫术间的关系。方法 对250例行颈淋巴清扫联合根治术的口腔颌面癌病例进行回顾性研究。结果 口腔颌面癌颈淋巴结转移率为18．8％，其中鳞癌的颈淋巴结转移率为23．4％，腺上皮源性癌颈淋巴结转移率为9．6％，颈淋巴结转移临床诊断与病理诊断符合率为58．4％，漏诊率为9．1％。结论 鳞状上皮细胞癌比腺上皮源性癌更易发生颈淋巴结转移；临床诊断阳性的颈淋巴结应实施颈淋巴清扫术，对N0期颈淋巴结应采取适时监测，当其转为阳性时可再行手术治疗。     

口腔癌及口咽癌病理诊断规范

口腔癌及口咽癌是口腔颂面部最常见的恶性肿瘤。规范化的口腔癌及口咽癌病理诊断报告不仅应提供给临床准确的病理诊断,还应包括与患者预后评估、治疗策略选择相关的信息。由中华口腔医学会口腔病理学专业委员会牵头组织成立专家组,对口腔癌及口咽癌病理标本固定、取材及报告内容等进行研讨与规范,形成《口腔癌及口咽癌病理诊断规范》。此规范涵盖了近年来在口腔癌和口咽癌临床病理方面的一些重要变化,如口腔癌肿瘤T分期应考虑肿瘤侵袭深度、肿瘤N分期应考虑有无淋巴结外扩展、口咽癌中新亚型人乳头状瘤病毒相关性鳞状细胞癌等。希望通过本规范的制定,提高我国口腔癌及口咽癌病理报告质量,为临床治疗及预后评估提供依据。