口腔粘膜下纤维性变中成纤维细胞的超微结构观察

为探讨口腔粘膜下纤维性变（ＯＳＦ）中胶原增生的机制,透射电镜下对成纤维细胞分类计数结果表明合成胶原功能最旺盛的成胶原细胞在病变早期,中期增多,降解胶原能力最强的破纤维细胞在病变中期,晚期减少,其差异均有显著性。提示ＯＳＦ中胶原纤维的堆积在早期主要为合成的增多,中期既有合成的增多,也有降解的减少,而晚期则主要为胶原降解不足所致。     

口腔粘膜下纤维变性中胶原纤维的超微结构研究

目的 探讨口腔粘膜下纤维变性（ＯＳＦ）中胶原堆积的原因。方法 电镜下对ＯＳＦ患者病变中胶原纤维进行研究,测量胶原原纤维的直径及周期性横纹。结果 ①胶原原纤维的直径：ＯＳＦ早期原纤维直径与正常无差别、中期、晚期直径逐渐增大;②周期性横纹：ＯＳＦ早期与正常无差别,中期、晚期逐渐增大。结论 ＯＳＦ的胶原纤维的形态表现异常,共程度随病变发展而加重。     

口腔粘膜下纤维性变中成纤维细胞形态学初步研究

为探讨口腔粘膜下纤维性变（ＯＳＦ）中胶原堆积的原因，电镜下对（ＯＳＦ）患者病变部位中的成纤维细胞（Ｆｂ）的形态学进行研究，并对各阶段的Ｐｂ进行计数。结果显示：幼稚的Ｆｂ（少分化Ｆｂ和幼Ｆｂ）在正常及病变各均无差别，肌成纤维细胞在ＯＳＦ中期增多，纤维细胞在ＯＳＦ早期减少，中期增加至正常水平，晚期则较其余各期增多，研究结果提示：ＯＳＦ中的Ｆｂ形态发生了改变。     

高压氧治疗口腔粘膜下纤维性变的临床观察

我们自1993～1998年应用高压氧(ｈｙｐｅｒｂａｒｉｃｏｘｙｇｅｎ,ＨＢＯ)治疗口腔粘膜下纤维性变(ｏｒａｌｓｕｂｍｕｃｏｕｓｆｉｂｒｏｓｉｓ,ＯＳＦ)患者34例,现报道如下。1材料和方法:(1)研究对象:均为门诊ＯＳＦ患者,高压氧组26例(34例中8例因不符合设计要求而被排除),其中男19例,女7例;治疗前张口度最小9ｍｍ,平均251ｍｍ。对照组17例,男13例,女4例,最小张口度12ｍｍ,平均266ｍｍ,均经临床及病理学诊断,无其他疾病。(2)治疗方法:均先戒嚼槟榔,高压氧组用ＨＢＯ治疗,10次为1个疗程,一般1～3个疗程;对照组服用茶色素胶囊250ｍｇ,2次/…     

口腔粘膜下纤维性变的超微结构研究

本文通过１６例口腔粘膜下纤维性变的电子显微镜观察研究，发现１５例上皮细胞增生肥大，伴有空泡变性，１６例上皮下组织中大量胶原原纤维增生，错杂排列并伴有显著退行性变，增生的胶原原纤维来源于纤维细胞。     

槟榔提取液诱发大鼠口腔粘膜下纤维性变的实验研究

采用粘腊上注射及表面涂布不溶性槟榔提取液（ＡＡＮＥ）相结合方法，诱发ＳＤ大鼠颊部口腔粘膜下纤维性变（ＯＳＦ）。在实验第１２，１６，２２及２８周分别进行粘膜显微及超微结构观察，结果发现：模型组埃各个时期出现了不同和蔼的ＯＳＦ样改变，即：上皮萎缩，钉突变平或消失；固有层大量炎症细胞浸润，胶原纤维堆积，旬紊乱并玻璃样变，病变进一步发展可波及深部肌层。停止使用ＡＡＮＥ６周后，病变未见明显逆转，对照组未见明     

肥大细胞与口腔粘膜下纤维性变关系的初步研究

肥大细胞与口腔粘膜下纤维性变关系的初步研究苏葵刘蜀凡沈子华彭隆详口腔粘膜下纤维性变（ｏｒａｌｓｕｂｍｕｃｏｕｓｆｉｂｒｏｓｉｓ，ＯＳＦ）发病机制尚未明确，目前多认为与嚼槟榔、遗传、免疫及全身、局部防御能力下降等因素有关。本实验观察了ＯＳＦ病变部位肥大...     

8例口腔粘膜下纤维性变喉镜检查结果报告

口腔粘膜下纤维性变OralSubmucousfibrosis,以下简称osf是一种慢性的隐匿性疾病.它可以侵犯口腔的任何部位,也可以侵犯咽喉部.由于其主要损害为上皮下的炎性反应导致固有层纤维弹性改变,上皮萎缩,最终出现口腔粘膜僵硬,张口受限和吞咽困难.WHO1978年就将osf列为了口腔癌前状态.对于病变侵犯口腔不同部位,国内外都有不少报道,而侵犯咽部的详细情况报道不多,国内还没有报道.现将我院1989年以来,会诊检查确诊的8例osf患者的喉检结果报告如下.一般资料本组8例osf患者均按Pindborg对osf流行病学检查诊断标准:在口腔粘膜下扪及纤维条索和/或粘…     

口腔粘膜下纤维性变临床病理的特殊表现

口腔粘膜下纤维性变(以下简称 OSF)自被发现以来,众多学者已对其临床病理表现、病因及发病机制等方面均做了较详尽的研究。1985年翦新春等首次报道两例患者,引起国内学者的广泛重视。继之在湖南省对该病进行了     

口腔粘膜下纤维性变组织中Ⅰ型和Ⅲ型胶原免疫组化及定量分析

目的：了解口腔粘膜下纤维性变（ＯＳＦ）组织中Ⅰ型及Ⅲ型胶原的分布及变化情况。方法：应用免疫组织学方法观察Ⅰ型及Ⅲ型胶原在ＯＳＦ中的分布,并应用图像分析仪对正常颊粘膜及ＯＳＦ各期中的Ⅰ、Ⅲ型胶原进行定量分析。结果：Ⅰ、Ⅲ型胶原在口腔颊粘膜中均有分布;Ⅰ、Ⅲ型胶原随ＯＳＦ病变程度加深逐渐增加,Ⅰ型原原在ＯＳＦ早、中、晚三期增多均有统计学意义,而Ⅲ型胶原仅在ＯＳＦ晚期增多有显著性差异。结论：随ＯＳＦ早、     

上皮间质转化相关蛋白在口腔黏膜下纤维化及其癌变组织中的表达

目的：探讨上皮间质转化相关标记蛋白E－cadherin和β－catenin在口腔黏膜下纤维化组织（oral submu－cous fibrosis,OSF）及其癌变组织中的表达特点及作用。方法：应用免疫组化SP法检测60例OSF患者,15例OSF癌变患者以及5例正常对照者的口腔黏膜组织中E－cadherin和β－catenin的表达并用IPP图像处理软件分析其平均光密度值。结果：①E－cadherin免疫组化阳性反应基本位于细胞膜,在正常黏膜和OSF早、中、晚期以及OSF癌变组织中其异常表达率分别为0、5％、20％、35％和53．3％;其平均光密度值分别为0．125±0．004,0．116±0．0006,0．109±0．008,0．103±0．009与0．095±0．008,各组之间表达均有显著性差异（P＜0．05）。②β－catenin免疫组化阳性反应在正常细胞基本位于细胞膜,而在OSF各组病变组织细胞中出现膜表达减少而质核表达增加的现象。在正常黏膜和OSF早、中、晚期以及OSF癌变组织中其异常表达率分别为0、60％、80％、90％和93．3％;其平均光密度值分别为0．105±0．007,0．098±0．009,0．106±0．012,0．114±0．007与0．119±0．003,β－catenin蛋白含量在早期组略有下降,但与正常组相比,表达无显著性差异（P＞0．05）;而OSF病变组间比较,表达均有显著性差异（P＜0．05）。结论：OSF及其癌变组织中E－cadherin的表达降低,β－catenin胞质核表达明显升高,EMT可能参与OSF及其癌变过程。     

Role of Collagen Impregnated with Dexamethasone and Placentrix in Patients with Oral Submucous Fibrosis

Purpose

To evaluate the versatility of the collagen membrane as both drug carrier and biologic dressing material to cover the raw wounds created after the surgical excision of fibrotic bands in oral submucous fibrosis.

Materials and Methods

The study comprises of ten patients. The patients of age group 20 to 50 years were selected. The collagen is reconstituted by injecting with dexamethasone and placentrix solution leaving a small overlap on to the remaining mucous membrane and the graft is sutured. Preoperative and post operative assessment was done regarding the improvement in mouth opening, decrease in burning sensation, change in colour of oral mucosa and clinically grading the extent of lesion.

Results

The results were found appreciable in seven patients while in the remaining three patients it showed relapse because of inadequate physiotherapy. All the ten patients were comfortable with intra oral collagen grafting. The collagen remained moist and supple intraorally, and remained in close contact with the underlying tissues, providing a strong mechanical barrier. The material was effective in attaining haemostasis, relieving pain and preventing extensive contracture.

Conclusion

In this study of short duration, the nature of collagen membrane was observed as both biological dressing material and drug carrier. It was found as a very suitable alternative to the other graft material mentioned for the repair of defects in the mucous membrane created by surgical excision of fibrous bands in oral submucous fibrosis.     

Therapeutic Interventions in Oral Submucous Fibrosis: An Experimental and Clinical Study

Introduction

Oral submucous fibrosis (OSF) is a chronic debilitating disease and premalignant condition of the oral cavity and is a serious public health issue in India and many parts of the world. The treatment is still elusive and empirical because of poorly understood etiopathogenesis, which is believed to be multifactorial including areca nut chewing, ingestion of chillies, genetic and immunologic processes, nutritional deficiencies, and many others. The present investigations was focused to understand the possible therapeutic interventions of anti-OSF agents in arecoline induced experimental in vitro model of OSF and clinical application of these anti-OSF agents in the restoration of various grade of the disease.

Materials and Methods

The 127 subjects were selected from patients who visited the OPD of Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, K.G. Medical University, Lucknow. Further the subjects were divided in two groups on the basis of clinical examination. Group-1 subjects showed presence of fibrosis bands in the labial and/or buccal mucosa, loss of elasticity, difficulty to open the mouth and had a habit chewing areca-nut in some form. Group-2 subjects had no habit of chewing areca-nut, were apparently healthy with no mucosal disorder. The samples were collected and were immediately transported to Indian Institute of Toxicology Research, Lucknow, for isolation and cultivation of primary cultures of mucosal fibroblast cells. Then isolation and cultivation of oral mucosal fibroblast, identification of non-cytotoxic doses of arecoline, real time PCR, immunocytochemistry, cytokine determination in culture cells, western blot analyses, functional activity of collagenase, lysyl oxidase enzyme activity, collagen beads assay, cyclooxygenase (COX-2) expression analysis was done.

Results and Conclusions

This study, shows that the reduction of phagocytic cells was strongly related to the arecoline levels in fibroblast culture when we exposed arecoline to normal oral mucosal cells (NOMC) and cells from OSF patient. An enhancement of phagocytic cells was observed following the pre exposure of cells to 1 μM dexamethasone, a glucocorticoids, In this study, histologic evidence is presented which supports the finding that COX-2 expression is upregulated in OSF specimens compared to normal oral submucosal cells. Strong immunostaining for COX-2 was detected in arecoline exposed NOMC and cells from OSF patient. Areca nut extract up-regulates prostaglandin production, cyclooxygenase-2 mRNA and protein expression of human oral keratinocytes. The number of phagocytic cells and phagocytic activity in cultured human oral fibroblasts from OSF site was lower than the fibroblasts from the normal regions of the same person.     

口腔粘膜下纤维性变临床分析

目的：总结口腔粘膜下纤维性变(OSF)临床特征，提高OSF临床检出率和诊断率。方法：对382例OSF患者临床资料进行总结，对其发病因素，临床特征进行分析。结果：1)382例OSF患者中男性370例(96．8％)，20～40岁以上的OSF患者328例(85％)；2)382例OSF患者均有咀嚼槟榔史，其发病与咀嚼槟榔的时间呈正相关关系，但与咀嚼槟榔的量无正相关关系；3)因热、辣食物有烧灼感、张口困难而就诊者分别为99．2％和50．2％，糜烂或起疱、张口受限者分别为85．8％和50．3％，颊、翼颌韧带受累者分别为96．3％和99．2％，患者常有多个部位受累。结论：1)OSF好发于青年男性；2)槟榔是OSF发病的关键因素；3)OSF临床症状和体征多样。     

Concomitant Association of Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma and Incidence of Malignant Transformation of Oral Submucous Fibrosis in a Population of Central India: A Retrospective Study

Aim

To evaluate the incidence of oral squamous cell carcinoma concomitant with oral sub mucous fibrosis in central India and to correlate precipitating factors associated with oral submucous fibrosis and oral squamous cell carcinoma. This paper also aims to study the incidence of oral squamous cell carcinoma arising secondary to untreated oral submucous fibrosis.

Materials and Methods

Two hundred and twenty five cases of oral squamous cell carcinoma and one hundred and nineteen cases of oral submucous fibrosis of various regions in oral cavity were included in the study. All the included cases were clinically and histopathologically diagnosed and retrospective data was retrieved.

Result

In the present study of 119 patients of oral submucous fibrosis, 97.4 % were found to have betel nut chewing habit. Incidence of malignant transformation to oral squamous cell carcinoma in patients of untreated oral submucous fibrosis was found to be 4.2 % in the present study. The incidence of oral cancer concomitant with oral submucous fibrosis was found to be 25.77 %, which is statistically significant.

Conclusion

From the present study, it is evident that the malignant potential of OSF is underestimated. However, considering the small sample size and the fact that the study was carried out in a small geographical area, further study with a larger sample size and longer duration of follow up on a multicentric basis may be required to reveal the actual malignant potential of the disease.     

Custom Made Protective Appliance for Oral Submucous Fibrosis

Oral submucous fibrosis is a chronic, debilitating disease characterized by gradually increasing fibrosis of oral cavity and pharynx, mainly the buccal mucosa, resulting in trismus. Various flaps have been used to reconstruct the surgical defects following excision of fibrous bands. It is inevitable to prevent these flaps from trauma by occlusion. The main objective of the authors is to introduce a technical innovation used to protect the flaps in the post-operative period. Here, we propose an easy and economical method to protect the flaps.     

bFGF在口腔黏膜下纤维性变组织中的表达研究

目的:检测碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)在正常颊黏膜(normal buccalmucosa,NBM)、口腔黏膜下纤维性变(oral submucous fibrosis,OSF)上皮组织中的表达,探讨bFGF在OSF发生发展中可能发生的作用。方法:收集10例NBM、30例颊部OSF上皮组织,利用免疫组化(immunohistochemistry,IHC)、聚合酶链式反应(PCR)和Western Blotting(WB)的方法研究bFGF在其中的分布和表达情况。结果:IHC提示:bFGF在NBM和OSF上皮组织中均有表达。在正常黏膜中,bFGF主要表达在黏膜下层的成纤维细胞胞浆中。在OSF早期,bFGF主要表达在上皮细胞间隙,基底膜和细胞浆中,发展到中晚期后则逐渐扩大表达,广范分布在细胞核中。bFGF的阳性表达率与其病理级别呈正相关。PCR提示正常黏膜组织中有bFGF mRNA的表达。在OSF组织中,bFGF mRNA随病变的加重而表达增加。WB提示:NBM上皮组织中未探及bFGF蛋白的表达,在OSF标本中bFGF随病变的加重而表达增强。结论:bFGF在OSF的发生发展中起着一定的作用。     

内皮素-1(ET-1)在口腔粘膜下纤维性变中的表达水平

为探讨ＥＴ－１与口腔粘膜下纤维性变（ＯＳＦ）的关系,应用免疫组化染色和图像分析技术,检测了ＯＳＦ３０例、正常口腔粘膜（ＮＯＲ）１０例组织中ＥＴ－１的定位分布和含量。结果显示：①ＯＳＦ组织中ＥＴ－１有异常表达,其免疫阳性物质主要分布于上皮棘细胞、基底细胞,间质成纤维细胞、血管内皮细胞及平滑肌细胞的胞浆胞膜上;②ＥＴ－１在ＯＳＦ组织表达的阳性率及相对含量均显著高于ＮＯＲ（Ｐ＜０．０１）;③ＯＳＦ各期ＥＴ－１相对含量存在差别,其中早、中期上皮细胞ＥＴ－１相对含量显著高于晚期（Ｐ＜０．０５）。由此提示,ＥＴ－１可能参与了ＯＳＦ的纤维化过程