The epidemiology of mouth cancer: a review of global incidence

Mouth cancer (143-145 ICD-9) is a major health problem in many parts of the world. While its incidence is relatively low in most western countries there are some important exceptions to this trend: on the Indian subcontinent and in other parts of Asia it remains one of the most common forms of cancer. This review article summarises the global incidence of mouth cancer using cancer maps. Data have been compiled from the latest edition of Cancer Incidence in Five Continents and recent studies from various locations around the world. Significant geographic variation is noted in the incidence of mouth cancer, with high rates reported for the Indian subcontinent and parts of Asia (male incidence rates in excess of 10 per 100,000 per annum). It is also noted that as with other forms of oral cancer, the majority of population-based data for mouth cancer comes from the Western world with a paucity of reliable data from the so-called developing countries. Mouth cancer remains a serious health problem in many parts of the world with many regions reporting increasing incidence rates particularly in males. Ongoing research into the aetiologic risk factors associated with this disease must remain a very high priority if the causes of mouth cancer are to be established and disease control protocols introduced widely.     

The epidemiology of lip cancer: a review of global incidence and aetiology

Lip cancer (140 ICD-9) is a form of oral cancer that has a distinctive global epidemiology. This review summarises global incidence rates for male and female lip cancer with the aid of cancer atlases. High male lip cancer rates are reported for regions of North America (12.7 per 100 000 per annum), Europe (12.0 per 100 000 per annum) and Oceania (13.5 per 100 000 per annum), while it is virtually unknown in parts of Asia. Factors commonly cited as important in the aetiology of lip cancer include solar radiation, tobacco smoking and viruses. An attempt is made to summarise the evidence for factors that may be important in lip carcinogenesis. While incidence rates are generally stable or falling among males worldwide, they are rising in many female populations. The aetiology of the disease is far from established and much information regarding its pathogenesis is based on anecdotal rather than case-controlled epidemiological evidence. The epidemiology of lip cancer supports the proposal that the lip should be considered as a distinct cancer site, rather than being included with other forms of intraoral cancer.     

股前外侧皮瓣修复舌癌术后舌再造的护理

目的:探讨股前外侧皮瓣移植修复舌癌术后舌再造的护理。方法:2003年12月至2007年6月,共有13例舌癌患者接受了舌癌联合根治术同期股前外侧皮瓣血管化移植修复术,对该类手术的护理体会进行总结。结果:经积极治疗及护理,本组病人术后无呼吸道及肺部并发症,无血管危象,无院内感染,供受区切口均一期愈合,股前外侧皮瓣成活,康复出院。结论:充分的术前准备,术后对皮瓣的观察与护理,以及对舌再造的功能指导是护理的重点。     

Tongue coating and tongue brushing: a literature review

The present paper reviews the role of the tongue as a habitat for oral microorganisms and the potential need for tongue cleaning as part of daily oral hygiene. In addition tongue coating is described. Many microorganisms have been found colonizing the dorsum of the tongue. Some studies find a positive effect to tongue brushing on bacterial counts on the tongue. On the other hand there are also studies that do not find any differences in bacterial counts before or after tongue brushing. Bacteria colonizing the tongue and periodontal pockets play an important role in the production of volatile sulphur compounds in periodontal health and disease. These compounds can be the cause of oral malodour. The amount of tongue coating in patients complaining of halitosis was significantly greater than in patients without halitosis. Tongue brushing on a regular basis, particular aiming at removing the coating on the dorsum of the tongue, has been found to be fruitful in reducing oral malodour. Studies investigating the role of tongue brushing and plaque accumulation or gingival inflammation show conflicting results. It is clear that the tongue forms the largest niche for microorganims in the oral cavity. However, on the basis of literature, there appears to be no data to justify the necessity to clean the tongue on a regular basis. One exception would be oral malodour.     

Effectiveness of mechanical tongue cleaning on breath odour and tongue coating: a systematic review

To cite this article:
Int J Dent Hygiene  8 , 2010; 258–268
DOI: 10.1111/j.1601‐5037.2010.00479.x
Van der Sleen MI, Slot DE, Van Trijffel E, Winkel EG, Van der Weijden GA. Effectiveness of mechanical tongue cleaning on breath odour and tongue coating: a systematic review. Abstract: Background: The objective of this review was to summarize the available evidence regarding the effects of mechanical tongue cleaning compared with no mechanical tongue cleaning on breath odour and tongue coating (TC). Methods: PubMed‐MEDLINE, EMBASE and Cochrane‐CENTRAL were searched to identify potentially relevant studies. The inclusion criteria included the following: randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs) conducted in humans in good general health (no systemic disorders) and a patient age of ≥17 years. For the intervention, we considered tongue cleaning [the use of a tongue scraper (TS) or tongue brush (TB)] and for the control, brushing only (B) groups. Clinical parameters such as volatile sulphur compound concentration, organoleptic scores and TC were the outcome variables of interest. Study selection, quality assessment and data extraction were carried out by two independent reviewers. Results: After screening of the titles and abstracts and subsequent full text reading of the potential papers, we identified five publications that met the eligibility criteria and provided seven experiments. The five studies consisted of three RCTs and two CCTs. All experiments show a positive effect of mechanical tongue cleaning in addition to toothbrushing on various parameters of oral malodour. Conclusions: This review demonstrated that mechanical approaches, such as tongue brushing or tongue scraping to clean the dorsum of the tongue, have the potential to successfully reduce breath odour and TC. However, data concerning the effect of mechanical tongue cleaning on chronic oral malodour (halitosis) are insufficient.     

Trends in palatine tonsillar cancer incidence and mortality rates in the United States

OBJECTIVE: The purpose of this paper is to describe the extent of the public health problem presented by palatine tonsillar cancer in the United States by analyzing recent incidence and mortality rate trends. METHODS: Using the National Cancer Institutes' Surveillance, Epidemiology and End Results (SEER) Program database, age-adjusted incidence rates (1973-2001) for five histological types of palatine tonsillar cancer by race and sex were calculated. For total palatine tonsillar cancer age-specific incidence (1973-2001) and mortality (1969-2001) rates by race and sex were calculated. Mortality and population data were obtained from the National Center for Health Statistics (NCHS) and the U.S. Census Bureau. The Joinpoint Regression Model was employed to establish the statistical significance of incidence and mortality rate trends. RESULTS: The majority of palatine tonsillar cases diagnosed in SEER-9 registries from 1973 to 2001 occurred among white males, age 40-64 years, with squamous cell carcinoma (SCC). The highest incidence of palatine tonsillar cancer occurred in black males, followed by white males with SCC. For age 40-64 years, palatine tonsillar incidence rates significantly declined for white females and black females, rose and then declined for black males, but increased from 1988 for white males. For age 65+ years, incidence significantly declined among white males. Palatine tonsillar cancer mortality rates for age 40-64 years significantly declined for white females. Rates also declined for black females (1981-2001) and black males (1985-2001) in this age group while rates for white males declined significantly from 1969 to 1987, but stabilized at nearly 0.4 through 2001. Mortality for the age group, 65+, significantly rose and fell for white females and declined for white males. CONCLUSIONS: Beginning in the late 1980s, and continuing through 2001, the risk for white males, age 40-64 years, of developing palatine tonsillar cancer increased. In contrast, the risk for white males, age 65 years and older, of developing palatine tonsillar cancer and of dying from this disease decreased during the study period.     

Sublingual lymph node metastasis of early tongue cancer: report of two cases and review of the literature

Sublingual lymph node metastasis of early stage squamous cell carcinoma of the tongue (SCCT) is seldom reported. Lymphatic tissue in the floor of mouth, which intervenes between the tongue and neck, will be left behind by a primary tumour resection with discontinuous neck dissection. The authors present two cases of early stage SCCT with sublingual lymph node metastasis, review the literature, and discuss the management of the floor of mouth for early stage SCCT. The authors suggest that more attention should be paid to possible sublingual lymph node metastasis for T1/T2 SCC of the ventral tongue with deeply endophytic infiltration.     

Oncological outcomes of total glossectomy procedure for advanced tongue cancer: a single-centre experience

Surgeons treating advanced carcinoma of the tongue with total glossectomy face many conflicts in view of the morbidity and poor functional and survival outcomes following surgery. It is pertinent to study the patients undergoing total tongue compartment resection as a separate cohort to analyse their outcomes. This study investigated the oncological outcomes of 150 patients with advanced tongue squamous cell carcinoma who underwent total glossectomy. The results suggest that compartment resection significantly improved local control, irrespective of margin status. The presence of multiple positive nodes was found to be an independent poor prognostic factor, and adjuvant radiation significantly improved survival. Total glossectomy is feasible and safe in both the primary and salvage setting and should be considered as the surgical option for advanced tongue cancer.     

Patterns of oral and pharyngeal cancer incidence in New South Wales, Australia

Incidence and mortality rates for oral and pharyngeal cancers have been reported to be increasing in Europe and the United States, with particularly large increases in mortality in central and eastern Europe. Such increases have been noted to be birth cohort-based, primarily affecting young and middle-aged men. In this report oral and pharyngeal cancer incidence data from New South Wales, Australia has been analysed for the period 1972–90. Although an increase in the incidence of oral and pharyngeal cancer occurred during the mid-1970s and early 1980s, it did not continue. This pattern is consistent with Australian trends in per capita consumption of tobacco, alcohol, fruit and vegetables. Individual regions within metropolitan Sydney showed substantial geographical variation with age-specific rates of oral and pharyngeal cancers (combined) in middle-aged men being at least three times higher in the city of Sydney than in New South Wales as a whole. Given the preventable nature of the disease, such high rates need not occur.     

50例老年舌癌患者围手术期护理

目的：探讨老年舌癌患者围手术期的护理方法。方法：对50例老年舌癌患者做好心理护理，严格术前准备，术后严密观察病情变化，做好呼吸系统、口腔及饮食护理，对实施皮瓣移植修复的患者做好并发症观察。结果：50例老年舌癌患者通过实施肿瘤切除和颈部淋巴结清扫术，加游离皮瓣移植修复及围手术期的护理，全部成功。结论：对老年舌癌患者在围手术期实施有效的护理方法至关重要，是促进患者尽早康复提升生命质量的重要措施。     

Lip cancer in Northern Finland: changing incidence and clinical characteristics

A population-based survey was conducted in 35 municipalities in Northern Finland to assess the incidence of lip cancer as well as the patient and tumour characteristics in cases diagnosed between 1983 and 1997. A total of 96 new patients emerged. The age-standardised incidence (per 100,000 years) of lip cancer in men decreased from 4.8 in 1983-1987 to 1.4 in 1993-1997. The incidences in women were 0.30 to 0.36, respectively. The median age of the patients increased from 66 to 73 years through the years. Overall, 90% of the patients had at least one of the known risk factors, namely rural domicile, outdoor occupation or smoking. The median duration of symptoms also remained the same, as did the median size and location of the tumour at diagnosis. In contrast, spread to regional lymph nodes became rare during the period.     

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舌癌是口腔癌中发病率最高的恶性肿瘤,早期特异性生物学标志物的缺乏、肿瘤转移和复发导致了舌癌患者的5年生存率几十年来都停滞在50%左右的较低水平。动物模型在人类疾病的研究中起着十分重要的作用,建立舌癌动物模型将推动舌癌发病机制和防治措施的研究进展。本文将对舌癌动物模型的建立方法、原理和主要应用领域进行综述,并对各种建模方法的优缺点进行分析和评价。     

The incidence of oropharyngeal cancer in Taiwan: an endemic betel quid chewing area

BACKGROUND: Oropharyngeal cancer is the one of the most common cancers in the world. The purpose of this study was to examine the trends in oropharyngeal cancer from 1979 to 1996 in Taiwan. METHODS: Traditional cohort analysis was employed to show the birth-cohort effect of oropharyngeal cancer incidence. Age-period-cohort model analysis was used to examine the age, period and cohort effect between intraoral and pharyngeal cancer. RESULT: A significant increasing trend in oropharyngeal cancer has been seen in males. The principal increases have been seen in tongue and mouth in males, and tongue in females. In males, an increasing trend was found in successive cohorts born after 1929. The increase in incidence of intraoral cancer of males was greater than the increase in incidence of pharyngeal cancer in the younger age group, more recent time periods and the younger cohorts. CONCLUSION: The increasing incidence in oropharyngeal cancer in Taiwan is probably heavily influenced by the rising consumption of alcohol and use of betel quid. The effect of these etiologies on intraoral cancer was more significant in recent time periods, later cohorts and the younger group.     

Carcinoma of the oral tongue in Northern Finland: trends in overall incidence and patient and tumour characteristics

A population-based survey was conducted in the two northernmost provinces of Finland to describe the incidence of tongue cancer as well as patient and tumour characteristics in cases diagnosed between 1974 and 1994. A total of 105 new-patients with cancer of the oral tongue were included in the 21-year study period. The age-standardised incidence (per 100,000 years) of the carcinoma in men increased from 0.6 in the first 7-year period (1974–1980) to 1.0 in the last period (1988–1994). The incidences in women were 0.7 to 1.4, respectively. The average patient profile remained much the same through the years. The median duration of symptoms also remained the same over the 2 decades, as did the median size and location of the tumour at diagnosis. In conclusion, the incidence of carcinoma of the tongue about doubled in both the male and the female population from 1974 to 1994. However, the patient and tumour characteristics remained about the same, the tumours being relatively large at the time of diagnosis in spite of well-developed community health and dental care.     

PTTG和bFGF在舌癌细胞株Tca8113中表达相关性研究

目的：探讨垂体肿瘤转化基因（Pituitary Tumor Transforming Gene,PTrG）蛋白在舌癌细胞株Tca8113中的表达及其与碱性成纤维细胞生长因子（basic Fibroblast Growth Factor,bFGF）间的关系.方法：应用免疫细胞化学方法,检测加入bFGF抗体后孵育的癌细胞中PTTG蛋白表达的变化.结果：Tca8113中PTTG蛋白呈阳性表达,并受bFGF影响,加入bFGF抗体的培养液中的癌细胞PTTG蛋白荧光明显减弱,随着时间延长和bFGF抗体滴度增加,减弱趋势明显.结论：舌癌细胞株中PTTG蛋白的表达受bFGF制约,对二者的联合治疗可能是一种治疗舌癌的有效方法.     

免疫功能正常小鼠肾囊膜下移植舌癌模型的建立

目的：建立免疫功能正常小鼠肾囊膜下移植舌癌模型。材料和方法：利用ＳＲＣＡ 技术,建立移植舌癌模型,观察移植前后瘤体大小的变化,并对移植瘤进行病理切片观察。结果：舌癌移植后第６ 天瘤体增长率为８７．８％ （７／８）（Ｐ＜ ０．０５）,病理切片证实其为高分化性鳞癌。结论：小鼠肾囊膜下移植舌癌模型的建立具有可行性,它可为舌癌的基础与临床研究提供一个经济、快速、高效的动物模型。     

血管化黏膜瓣在早-中期舌癌及口底癌缺损修复中的早期应用研究

目的 探究以面动脉为蒂的黏膜肌(FAMM)瓣在修复临床早-中期舌癌及口底癌缺损中的临床效果及安全性.方法 通过回顾性队列研究的方式纳入使用FAMM瓣(FAMM组)或者皮瓣(皮瓣组)修复早-中期舌癌、口底癌切除后中小型舌、口底缺损的患者,收集患者一般资料及相关手术资料,术后3个月和6个月评估患者满意度、张口度、外形满意度...     

沉默RohA基因对舌鳞状细胞癌细胞增殖的影响

目的 通过RNA干扰技术沉默RhoA基因从而探讨RhoA对舌癌细胞增殖和生长的影响及其作用机制。方法体外培养舌鳞状细胞癌SCC-4细胞,以小分子干扰RNA转染沉默RhoA基因的表达。实验分为3组：实验组（又分为实验1组和实验2组,脂质体分别转染对应序列1的RhoA-siRNA和序列2的RhoA-siRNA）、阴性对照组（脂质体转染NC-siRNA）和空白对照组（不转染siRNA）。采用实时定量聚合酶链反应技术检测SCC-4细胞转染后RhoA mRNA的表达,Western blot检测RhoA、Cyclin D1、p21和p27蛋白的表达,四唑盐比色法检测舌癌细胞生长水平和倍增时间。结果 与阴性对照组和空白对照组相比,实验组舌癌细胞的RhoA基因及蛋白表达降低,p21、p27蛋白表达升高,Cyclin D1蛋白表达降低,细胞倍增时间延长,增殖能力降低（P<0.05）。结论 沉默RhoA基因可以抑制舌癌细胞的增殖和生长,RhoA基因通过调控细胞周期信号转导途径影响舌癌细胞的增殖,RhoA基因可以成为舌癌基因治疗的靶点。