Correlation Between Dysplasia and Ploidy Status in Oral Leukoplakia

Oral leukoplakia and other potentially malignant disorders (PMD) may progress to oral squamous cell carcinoma (OSCC). The gold standard for assessing the potential for malignant transformation remains histologic examination with the aim of grading the dysplastic changes. However, not all lesions with dysplasia will progress to OSCC. DNA ploidy has been suggested as a method to predict the clinical behaviour of PMD. This study reports on the use of high-resolution flow cytometry to determine the ploidy status of formalin-fixed, paraffin-embedded material from PMD compared to their dysplasia grade on histology. Aneuploidy was found in 13 % of mild, 31 % of moderate, and 54 % of severe dysplasia cases. This difference was statistically significant (p = 0.011). The differences in ploidy status were more significant when grouping the dysplasia into low-risk and high-risk categories (p = 0.008). These findings indicate that the ploidy status of PMD as determined by high-resolution flow cytometry may be of value in predicting biological behaviour in PMD such as leukoplakia.     

Oral Manifestations of Dermatologic Disease: A Focus on Lichenoid Lesions

Lichenoid changes in the oral mucosa can be encountered in a wide range of lesions with varied etiologies including immune-mediated disorders, reactions to systemic medications and to dental materials. Dysplasia of the oral cavity can exhibit a lichenoid histology, which may mask the potentially cancerous component. Another unusual clinical disease, proliferative verrucous leukoplakia, can often mimic oral lichen planus clinically requiring careful correlation of the clinical and pathologic features.     

A Brief Review of Common Oral Premalignant Lesions with Emphasis on Their Management and Cancer Prevention

Long-term outcomes associated with oral cancer and its management over the past several decades has caused concern and the value of mass oral cancer screenings has come under scrutiny. Though not all oral carcinomas are preceded by premalignant lesions as clinically visible morphological alterations occur secondary to the cellular or molecular changes, certain high risk lesions have been identified. Their management remains controversially polarized between surgical excision to prevent malignant change and conservative medical or surveillance techniques. Though oral cancer is one of the “major killers” of modern times, there seem to be no widely accepted criteria for decision making in clinical practice, the evidence base is scanty and uncertainty persists throughout investigation, diagnosis, and treatment. In this article, we have briefly discussed the common premalignant lesions, with an emphasis on their evidence based management and prevention.     

Malignant Transformation Rate of Non-reactive Oral Hyperkeratoses Suggests an Early Dysplastic Phenotype

The presence of epithelial dysplasia (ED) in oral leukoplakia is the single most important predictor of malignant transformation (MT). The majority of leukoplakias, however, do not show evidence of ED and yet MT of these lesions is well-recognized. These lesions have been referred to as “hyperkeratosis/hyperplasia, no dysplasia,” “keratosis of unknown significance” and “hyperkeratosis, not reactive (HkNR).” This study evaluates the MT rate of such leukoplakias. A literature review was performed to identify cohort studies on leukoplakias where (1) there was a recorded histopathologic diagnosis, (2) cases of “hyperkeratosis/hyperplasia, no dysplasia” comprised part of the cohort, and (3) follow-up information was available. There were 9,358 leukoplakias, of which 28.5% exhibited ED while 37.7% consisted of HkNR. Follow-up ranged from 15 to 73 months. The incidence of MT in leukoplakia exhibiting HkNR was 4.9%, compared to 15.3% for ED. Among oral squamous cell carcinomas (SCC) with previously biopsied, site-specific precursor lesions, 55.7% arose from ED/carcinoma in situ and 28.0% arose from HkNR. Leukoplakia exhibiting HkNR has a substantial MT rate, similar to that of mild ED, and must be recognized and managed appropriately to reduce oral SCC incidence.     

Oral Hairy Leukoplakia in Immunocompetent Patients Revisited with Literature Review

Oral hairy leukoplakia (OHL) is an Epstein-Barr virus (EBV) related lesion seen in severely immunocompromised patients especially, those with concomitant human immunodeficiency virus (HIV) infection. It has been rarely reported in immunocompetent patients. OHL most often presents on the lateral border of the tongue as an asymptomatic, white, and corrugated plaque that does not rub off. With Institutional Review Board (IRB) approval, the University of Florida Oral & Maxillofacial Pathology Biopsy Service archives spanning 1994–2020 were queried. All cases of OHL affecting immunocompetent patients were identified. Data related to age, gender, clinical presentation, results of Epstein-Barr virus in situ hybridization (EBER-ISH), and periodic acid–Schiff (PAS)-fungus stains were recorded. Medical history and histology of all cases were reviewed for confirmation of diagnosis. A total of 11 cases were identified, the majority of which were males (63.6%) with a mean age of 62 years. All patients were Caucasian. Lesions entirely were located on the lateral borders of the tongue. OHL should not be considered pathognomonic for HIV infection and should be included in the differential diagnoses of keratotic lesions affecting the lateral border of tongue even in immunocompetent elderly patients. The etiology of OHL in this group of patients is not clearly understood.     

Differential Expression of Potential Biomarkers of Oral Squamous Cell Carcinoma Development

To evaluate molecular epithelial changes, we investigated whether a profile of survivin, cyclin dependent kinase inhibitor 2A (CDKN2A), epidermal growth factor receptor (EGFR), polo like kinase 1 (PLK1), p63, p40 (Δnp63 isoform), cyclin D1 (CCND1) and BCL2 apoptosis regulator (BCL2) proteins could predict malignant transformation. Different tissue segments (tumor adjacent epithelium; dysplasia and tumor) from a total of 109 patients were analyzed by immunohistochemistry. An increased expression of survivin (p < 0.001), PLK1 (p = 0.001), and p63 (p < 0.001) in parallel to reduced immunostaining of p40 (p < 0.001) and BCL2 (p = 0.029) was observed among the tissue segments analyzed. Our study revealed that survivin, PLK1, p63, p40 and BCL2 play a role in oral tumorigenesis and represent promising biomarkers able to recognize mesenchymal phenotype induction in the transition from nonmalignant cells to tumor cells. These results reveals critical interaction between survivin, PLK1, p63, p40 promising proteins during invasive carcinoma development.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12105-021-01322-8.     

Oral Elastofibromatous Lesions: A Review and Case Series

Elastofibromas of the oral cavity are rare, with only 5 cases reported. In this paper, we present a series of five new cases of oral elastofibromatous lesions, occurring in 4 males and 1 female, with ages ranging from 33 to 76 years. The clinical differential diagnosis includes fibroepithelial polyp or fibroma, among other connective tissue tumours. Elastofibromas probably develop as reactive lesions, for which surgical treatment is definitive.     

Architectural Alterations in Oral Epithelial Dysplasia are Similar in Unifocal and Proliferative Leukoplakia

The current WHO histopathologic criteria for oral epithelial dysplasia (ED) are based on architectural and cytologic alterations, and do not address other histopathologic features of ED. Here we propose new diagnostic criteria including architectural, organizational, and cytologic features for oral ED. Cases of unifocal leukoplakia (UL) and proliferative leukoplakia (PL) with clinical photographs and follow-up information were identified. Only cases that showed minimal cytologic atypia or mild ED were used to demonstrate critical architectural changes as defined in this study. Eight biopsies from eight UL patients and 34 biopsies from four PL patients were included. The biopsies showed (a) corrugated, verrucous or papillary architecture, (b) hyperkeratosis with epithelial atrophy, (c) bulky squamous epithelial proliferation, and (d) demarcated hyperkeratosis and “skip” segments. The architectural alterations defined here are as important as the currently used criteria for the diagnosis of ED. Clinicopathologic correlation when diagnosing oral ED is also of the utmost importance in accurate diagnosis.     

拔牙位点保存技术在口腔种植中的应用效果

目的 讨论在临床口腔种植中应用拔牙位点保存技术的价值。方法 选取我院2021年1月-2023年 12月收治的100例牙齿缺损患者为研究对象,采用随机数字表法分为对照组与观察组,每组50例。对照组 采用常规微创拔牙技术处理,观察组采用拔牙位点保存技术。比较两组修复效果、牙周指标、牙槽骨指 标、美学效果、满意度。结果 观察组修复优良率为98.00%,高于对照组的86.00%（P＜0.05）;观察组修 复后3个月mPLI、mBI、PD数值低于对照组（P ＜0.05）;观察组治疗后牙槽骨高度、牙槽骨宽度、骨密度 高于对照组（P＜0.05）;观察组各维度美学效果评分高于对照组（P＜0.05);观察组满意度为100.00%,高 于对照组的92.00%（P ＜0.05）。结论 在临床口腔种植中应用拔牙位点保存技术可有效改善患者牙槽骨与 种植体周围软组织情况,提高整体疗效及美观度,进而提高患者满意度,值得临床应用。     

拔牙位点保存技术融入口腔种植中的效果

探究在口腔种植中应用拔牙位点保存技术的有效性。方法 选取2022年12月-2023年6月于海 原县中医医院口腔科行口腔种植的98例患者为研究对象,以随机数字表法分为参照组和试验组,每组49 例。参照组于拔牙后采用常规处理,试验组于拔牙后采用拔牙位点保存技术,随后均植入种植体,比 较两组牙槽骨变化、美学效果、口腔修复效果及并发症发生情况。结果 试验组治疗后牙槽骨骨密度、 牙槽骨高度及牙槽骨宽度均优于参照组（P ＜0.05）;试验组治疗后WES评分、PES评分均高于参照组 （P＜0.05）;试验组口腔修复优良率为97.96%,高于参照组的83.67%（P＜0.05）;试验组并发症发生率为 4.08%,低于参照组的8.16%,差异无统计学意义（P ＞0.05）。结论 拔牙位点保存技术在口腔种植中的应 用效果确切,可保护牙槽骨,提高美学效果及口腔修复效果,还能有效降低并发症发生几率。     

Fluorescence in situ Hybridization and Immunohistochemical Analysis of p53 Expression in Endometrial Cancer: Prognostic Value and Relation to Ploidy

Background Endometrial carcinoma is the most common gynecological malignancy. Several molecular biological characteristics have been studied for their potential value in patient management. Objectives Our objectives were to compare p53 immunohistochemical expression with P53 gene status determined by fluorescence in situ hybridization (FISH) and to compare these characteristics with ploidy and with classical clinical and histological prognostic factors. Materials and Methods We reviewed stored specimens from 43 patients with endometrial cancer diagnosed in 1999–2004. P53 FISH and immunohistochemistry were performed, together with imaging cytometry to calculate DNA ploidy. Results Thirteen of the 43 endometrial carcinomas (30.2%) showed P53 loss of heterozygosity (LOH). P53 LOH correlated with the histological type (P = .03) and the histological grade (P = .004). Quantitative immunohistochemical expression of p53 protein correlated with the histological type (P = .0001). With a cutoff of 10% of p53-positive cells, p53 overexpression correlated with the histological type (P = .003) and grade (P = .0008). No relation was found between P53 LOH or immunohistochemical expression and the disease stage, the depth of myometrial invasion, lymph node status, lymphovascular space involvement, recurrence, or death from cancer. Nondiploid carcinomas showed deeper myometrial invasion than diploid carcinomas (P = .01). No relation was observed between ploidy and qualitative or semiquantitative p53 expression or P53 LOH. Conclusion In endometrial cancer, FISH analysis of P53 status adds no significant prognostic information compared with immunohistochemical p53 analysis.     

平阳霉素治疗口腔颌面部血管瘤及脉管畸形的副反应

目的探讨平阳霉素（PYM）联合地塞米松（DXM）治疗口腔颌面部血管瘤及脉管畸形的疗效及副反应。方法收集2003年2月～2009年6月用PYM联合DXM治疗口腔颌面部血管瘤及脉管畸形并获得完整随访的病例160例。患者在接受治疗前行胸片检查,治疗后6个月再行胸片检查,观察临床效果及副反应。结果经2个月-6年的随访观察,124例患者治愈,36例患者显效,总有效率为100％。所有患者均有不同程度的肿胀,其中34例患者注射后体温稍升高（21．3％）,1例患者末次治疗6h后全身疼痛,1例患者末次注射时出现呼吸困难及发音障碍,1例患儿出现过敏性休克,未发现肺纤维化现象、未发现溃烂出血及感染。结论PYM联合DXM治疗口腔颌面部血管瘤及脉管畸形简单易行、副反应少,是一种安全、有效的方法,但仍要做好过敏等副反应的急救准备。     

深圳技术大学新生口腔健康状况调查与分析

目的 调查深圳技术大学2022级新生的口腔健康状况。方法 选取我校2022届新入学大学生为研 究对象，根据世界卫生组织《口腔卫生健康调查基本方法》，借助2022年9月新生入学体检，对新入学的 大学生进行口腔健康状况调查，观察龋病、牙龈炎和阻生牙的患病情况。结果 4140名新入学大学生中龋病 总患病率最高，为11.50%（476/4140）；男生龋病、牙龈炎、阻生齿患病率均高于女生，差异有统计学意 义（P＜0.05）。结论 我校2022届新生的口腔卫生状况不容乐观，口腔疾病种类繁多，其中龋病、牙龈炎、 阻生牙是大学生的常见病、多发病，校医院需加强口腔疾病的防治工作、宣教口腔卫生健康知识和定期组 织口腔检查，对口腔疾病做到早发现、早诊断、早治疗，帮助学生养成良好的口腔卫生习惯，以提高口腔 健康水平。     

The Challenges of Defining Oral Cancer: Analysis of an Ontological Approach

An important inconsistency currently exists in the literature on oral cancer. Reviewing this literature, one finds that the term oral cancer is defined and described with great variation. In a search in PubMed, at least 17 different terms were found for titles of papers reporting data on oral cancer. The variability of the terms used for designating anatomic regions and type of malignant neoplasms for reporting oral cancer has hampered the ability of researchers to effectively retrieve information concerning oral cancer. Therefore, it is sometimes extremely difficult to provide meaningful comparisons among various studies of oral cancer. Recently, a new ontological strategy that is rooted in consensus-based controlled vocabularies has been proposed to improve the consistency of data in dental research (Smith et al. in J Am Dent Assoc 141:1173–1175, 2010). In this paper, we analyzed the terminology dilemma on oral cancer and explained the current situation. We proposed a possible solution to the dilemma using an ontology-based approach. The advantages for applying this strategy are also discussed.     

The Analysis of Treatment of Aggressive Fibromatosis Using Oral Methotrexate Chemotherapy

Background

Aggressive fibromatosis is a rare but invasive tumor infiltrating widely between fascia and muscle fibers. It has a high tendency to be locally recurrent despite complete resection. Effectiveness of adjuvant treatment for aggressive fibromatosis including radiotherapy, pharmacological agents, hormonal treatments, and chemotherapy have been previously reported. The purpose of this article was to collect and analyze all information regarding the effectiveness and side effects of oral methotrexate in aggressive fibromatosis.

Methods

From 2005 to 2011, eleven patients with aggressive fibromatosis treated with oral methotrexate at our institution were analyzed in this study. Oral methotrexate was administered once per week at 10 mg per week. Authors collected information about effectiveness concerning cases of local recurrence and metastasis.

Results

Eleven patients had remission, two patients had local recurrence. Fatal complications or toxicity were not observed.

Conclusions

Oral methotrexate given at this dose and schedule was considered as a useful treatment in primary inoperable fibromatosis and recurrent fibromatosis.     

针对性口腔修复治疗在老年口腔疾病中的应用效果

目的 探讨针对性口轻修复治疗在老年口腔疾病中的应用效果。方法 选取2020年5月-2023年1月于我院口腔科就诊患的46例老年口腔疾病患者作为研究对象,采用随机数字表法分为对照组及观察组,各23例。对照组采用保守治疗,观察组采用针对性治疗。比较两组临床疗效、生活质量评分以及治疗满意度。结果 观察组治疗总有效率为91.30%,高于对照组的73.91%,差异有统计学意义（P ＜0.05）;观察组生活质量各项评分均高于对照组,差异有统计学意义（P＜0.05）;观察组治疗满意度为86.96%,高于对照组的69.57%,差异有统计学意义（P＜0.05）。结论 对于罹患多种口腔疾病的老年患者,在患者自身基础病情允许的情况下,结合患者口腔疾病的种类、部位、性质以及治疗目标需要制定针对性口腔修复计划,可提高患者口腔疾病的治疗有效率,改善其生活质量,患者满意度较高。     

儿童口腔溃疡治疗及分析

目的 探讨儿童口腔溃疡实施综合治疗的临床效果。方法 选择2022年1月-10月我院儿科收治的92例儿童口腔溃疡患者为研究对象,随机分为对照组和观察组,各46例。对照组给予对症支持治疗,观察组在此基础上联合儿内科进行综合治疗,比较两组临床疗效、疼痛程度、进食时间、创面愈合时间及不良反应发生情况。结果 观察组治疗总有效率为97.83%,高于对照组的84.78%（P＜0.05）;观察组VAS评分低于对照组,进食时间及创面愈合时间均短于对照组（P＜0.05）;观察组不良反应发生率为0,低于对照组的10.87%（P＜0.05）。结论 对溃疡患儿采取综合治疗可有效控制感染,加速创面愈合,减轻疼痛程度,促进肉芽组织形成,提早进食,增加机体免疫力,降低不良反应发生几率,值得临床应用。