Ilmo Leivo

Turku University Hospital, Turku, Province of Western Finland, Finland

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Publications (124)361.39 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Mucoepidermoid carcinoma (MEC) is the most common salivary gland malignancy. Although several biomarkers have been evaluated, histological grade remains the most valuable prognostic marker. Toll-like receptor 9 (TLR9) is an immune receptor recognizing microbial DNA. Its expression associates with prognosis or cancer properties in several cancers. This study examined the role of TLR9 in MEC. Sixty patients with salivary gland MEC were collected from two Finnish university hospitals, and tumor samples were stained for TLR9. Salivary gland high-grade MEC cell line (UT-MUC-1) was cultured to assess TLR9 and MMP-13 expression. The function of TLR9 was studied in vitro using traditional Matrigel(®) invasion assay and novel human myoma organotypic model. Cancer-specific survival was related with tumor grade (P = 0.01), and there were no deaths in patients with low-grade MEC. TLR9 was expressed in 56 of 60 (93%) tumors. High TLR9 expression indicated better survival in the patient series (P = 0.002) and showed a trend for association with lower disease stage (P = 0.06) and higher differentiation grade (P = 0.068). In multivariate analysis, TLR9 expression was prognostically insignificant due to heavy correlation to disease stage and higher gradus. Treating UT-MUC-1 cells with TLR9 ligand CpG in vitro induced MMP-13 expression and invasion in Matrigel(®) invasion assay, whereas decreased invasion was seen in myoma organotypic model. Functional TLR9 is present in salivary MEC, and high level of expression may indicate good prognosis. However, more studies are needed to evaluate biological consequences of TLR9 interaction in tumor cells.
    Journal of Oral Pathology and Medicine 02/2014; · 2.06 Impact Factor
  • Katri Aro, Ilmo Leivo, Antti Mäkitie
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    ABSTRACT: The management of pediatric salivary gland cancer (SGC) remains a challenge, and long-term outcome data are lacking for these rare tumors. The heterogeneity of histopathological features in 24 different SGCs further complicates unequivocal treatment recommendations across different age groups. This review aims to outline the management guidelines for pediatric SGC. Compared with adults, pediatric SGC is more often localized to the primary site and of low-grade histology. Surgery remains the treatment of choice accompanied by oncological treatment in selected patients. Elective neck dissection seems unnecessary as the occurrence of occult metastases is rare. This review provides information for clinicians to manage pediatric SGC highlighting the need for individually based treatment decisions at multidisciplinary head and neck centers.
    Current opinion in otolaryngology & head and neck surgery 01/2014;
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    ABSTRACT: Due to their rarity most of the literature concerning head and neck extracranial schwannomas consists of case reports and small patient series. The aim of the study was to describe population-based incidence, presenting signs and symptoms, management and outcome of head and neck extracranial schwannomas in a larger patient group. All the head and neck extracranial schwannoma patients managed during 1987-2008 at the Helsinki University Central Hospital with a referral area of 1.5 million inhabitants were searched. Altogether 47 patients were identified and subjected to retrospective chart review. Population-based incidence of head and neck extracranial schwannomas was 0.14/100,000/year. Eighty-eight percent of the patients had symptoms, which had lasted on average for 11.5 months prior to diagnosis. Presenting signs and symptoms were diverse depending on the affected nerve. Ninety-four percent of the patients were treated surgically. Sixty-four percent of the operations were macroscopically radical. The tumor capsule was intentionally left in place in 9 %. Surgery-related complications were detected in only 7 % of the patients, but 1 month postoperatively 52 % of them had symptoms, majority relating to different nerve deficits. Treatment of extracranial head and neck schwannomas remains challenging. The tumor is benign, and it grows slowly in a vast majority of cases, but its symptoms are highly variable. Correct timing of surgery is essential, as also patients who are preoperatively asymptomatic may suffer severe postoperative morbidity. Preoperative patient counseling needs to address the risks of neurological sequelae.
    Archives of Oto-Rhino-Laryngology 01/2014; · 1.29 Impact Factor
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    ABSTRACT: Salivary gland cancer (SGC) accounts for 3-5% of head and neck malignancies, and register-based studies estimate the familial proportion to be 0.15%. We studied familial predisposition for SGC in the genetically distinct Finnish population. We sent a patient questionnaire to 161 Finnish SGC patients, 86 of whom responded. A total of 76% of the patients reported having one or more relatives with cancer, 30% two or more, and 9% three or more but only one patient reported having a relative with SGC. Tracing the birthplaces of the SGC patients' grandparents showed no regional clustering suggestive of a founder effect. Lack of familial SGC patients and the absence of a founder effect strongly suggest that familial predisposition for SGC is insignificant in the Finnish population. Various histological subtypes and the rarity of these neoplasms make it impossible to draw conclusions about site-specific association between SGC and other malignancies.
    Clinical medicine insights. Ear, nose and throat. 01/2014; 7:7-11.
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    ABSTRACT: Background. Oral (mobile) tongue squamous cell carcinoma (OTSCC) is characterized by a highly variable prognosis in early stage disease (T1/T2 N0M0). The ability to classify early OTSCCs into low- and high-risk categories would represent a major advancement in their management. Methods. Depth of invasion, tumor budding, histologic risk-assessment score (HRS) and cancer-associated fibroblasts (CAF) density were studied in 233 cases of T1/T2 N0M0 OTSCC managed in five university hospitals in Finland. Results. Tumor budding (≥5 clusters at the invasive front of the tumor) and depth of invasion (>4 mm) were associated with poor prognosis in patients with early OTSCC, hazard ratio (HR), 2.04 with 95% confidence interval, CI, (1.17-3.55) and HR, 2.55 (95% CI, 1.25-5.20), respectively after multivariate analysis. The HRS and CAF density did not predict survival. However, high-risk worst pattern of invasion (WPOI), a component of HRS, was also an independent prognostic factor: HR, 4.47 (95% CI, 1.59-12.51). Conclusion. Analyzing the depth of invasion, tumor budding and/or WPOI in prognostication and treatment planning of T1/T2 N0M0 OTSCC is recommended. Head Neck, 2013.
    Head & Neck 05/2013; · 2.83 Impact Factor
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    ABSTRACT: Mucoepidermoid carcinoma is the most common salivary gland malignancy, and includes a spectrum of lesions ranging from non-aggressive low-grade tumors to aggressive high-grade tumors. To further characterize this heterogeneous group of tumors we have performed a comprehensive analysis of copy number alterations and CRTC1-MAML2 fusion status in a series of 28 mucoepidermoid carcinomas. The CRTC1-MAML2 fusion was detected by RT-PCR or fluorescence in situ hybridization in 18 of 28 mucoepidermoid carcinomas (64%). All 15 low-grade tumors were fusion-positive whereas only 3 of 13 high-grade tumors were fusion-positive. High-resolution array-based comparative genomic hybridization revealed that fusion-positive tumors had significantly fewer copy number alterations/tumor compared with fusion-negative tumors (1.5 vs 9.5; P=0.002). Twelve of 18 fusion-positive tumors had normal genomic profiles whereas only 1 out of 10 fusion-negative tumors lacked copy number alterations. The profiles of fusion-positive and fusion-negative tumors were very similar to those of low- and high-grade tumors. Thus, low-grade mucoepidermoid carcinomas had significantly fewer copy number alterations/tumor compared with high-grade mucoepidermoid carcinomas (0.7 vs 8.6; P<0.0001). The most frequent copy number alterations detected were losses of 18q12.2-qter (including the tumor suppressor genes DCC, SMAD4, and GALR1), 9p21.3 (including the tumor suppressor genes CDKN2A/B), 6q22.1-q23.1, and 8pter-p12.1, and gains of 8q24.3 (including the oncogene MAFA), 11q12.3-q13.2, 3q26.1-q28, 19p13.2-p13.11, and 8q11.1-q12.2 (including the oncogenes LYN, MOS, and PLAG1). On the basis of these results we propose that mucoepidermoid carcinoma may be subdivided in (i) low-grade, fusion-positive mucoepidermoid carcinomas with no or few genomic imbalances and favorable prognosis, (ii) high-grade, fusion-positive mucoepidermoid carcinomas with multiple genomic imbalances and unfavorable prognosis, and (iii) a heterogeneous group of high-grade, fusion-negative adenocarcinomas with multiple genomic imbalances and unfavorable outcome. Taken together, our studies indicate that molecular genetic analysis can be a useful adjunct to histologic scoring of mucoepidermoid carcinoma and may lead to development of new clinical guidelines for management of these patients.Modern Pathology advance online publication, 28 September 2012; doi:10.1038/modpathol.2012.154.
    Modern Pathology 09/2012; · 5.25 Impact Factor
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    ABSTRACT: Worldwide, only 5% of all salivary gland tumours are reported in children and 35-50% of these are malignant. According to the Finnish Cancer Registry, 15 children were diagnosed with salivary gland cancer (SGC) during 1990-2009 in Finland. There are no previous studies available on the histopathology, treatment, and survival of patients with these rare malignancies in Finland. Retrospective patient and tumour data covering the past 20 years were retrieved from the five University Hospitals in Finland. Ten paediatric SGC patients with a median age of 14 years (range, 9-19 years) and with available adequate patient data were included. The series comprised four boys and six girls. Follow-up time varied from five months to 14 years. Two patients had a history of a previous malignancy. The majority of cases had a parotid gland cancer (7/10), and mucoepidermoid carcinoma was the most common histological subtype (5/10). All patients presented with Stage I-II disease and were treated surgically with curative intent. One patient with a Stage I mucoepidermoid carcinoma of the parotid gland received postoperative radiotherapy. No recurrences were encountered and all patients were free of disease at the last follow up. The individual treatment design for paediatric SGC should follow consistent treatment strategies. All patients in the present study had low-grade tumours with a favourable prognosis. Since paediatric SGC is infrequent worldwide, the diagnostics, treatment, and follow up should be centralized in multidisciplinary Head and Neck Centres.
    International journal of pediatric otorhinolaryngology 06/2012; 76(9):1304-7. · 0.85 Impact Factor
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    ABSTRACT: Transforming growth factor β1 gene (TGFβ1) genotype is a potential p16 independent prognostic factor predicting response to chemoradiotherapy in head and neck squamous cell carcinoma (HNSCC). Expression of p16 and epidermal growth factor receptor (EGFR) has been reported to be associated with survival in HNSCC. We have previously reported that genetic polymorphism of TGFβ1 is linked with survival in HNSCC patients who have undergone chemoradiotherapy. We evaluate here whether TGFB1 genotype can serve as a prognostic factor independent of tumor p16 and EGFR expression. Expression of p16 and EGFR was studied by immunohistochemistry in tumors from 130 HNSCC patients. Peripheral blood DNA was used to genotype 95 patients for single nucleotide polymorphism rs1800470 within the TGFβ1 gene. The minimum follow-up time was 31 months. p16 overexpression was associated with an improved disease-free survival (hazard ratio (HR) = 0.39, 95% CI 0.19-0.78), whereas no evident association was observed between EGFR expression and disease-free survival (HR = 0.90, 95% CI 0.68-1.19). Among the 37 patients who had received chemoradiotherapy, TGFβ1 genotype was associated with disease-free (HR = 0.44, 95% CI 0.19-1.02) and overall survival (HR = 0.31, 95% CI 0.12-0.80) independent of tumor p16 expression.
    Acta oto-laryngologica 06/2012; 132(9):1006-12. · 0.98 Impact Factor
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    ABSTRACT: Salivary duct carcinoma (SDC) is a rare and aggressive malignancy with poor prognosis. Its histomorphology is distinctly reminiscent of the ductal carcinoma of the breast. We reviewed the treatment and outcome of SDCs at a single tertiary care centre. Twenty-five cases of SDC of major salivary gland origin, diagnosed and treated at the Department of Otolaryngology, Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland, during a 14-year period from 1997 to 2011, were reviewed retrospectively. Survival outcome was analyzed for 18 patients with a minimum follow-up of 24 months. There were 16 male (64 %) and 9 female (36 %) patients with a median age of 61 years (range 36-82 years). The majority of the cases occurred in the parotid gland (n = 21, 84 %) followed by the submandibular gland (n = 4, 16 %). The primary treatment consisted of surgical resection in all cases and 17 (68 %) patients also underwent neck dissection. Most of the patients (n = 18, 72 %) were treated with postoperative radiotherapy. Seven patients (28 %) had a disease recurrence within a median follow-up time of 15 months (range 3-27 months). In the group (n = 18) with a minimum follow-up time of 24 months, the 2- and 5-year overall and disease-specific survival rates were 66, 41 % and 75, 55 %, respectively. These results confirm the aggressive nature of SDCs in major salivary glands. Diagnostics and management of these tumours need to be centralized in experienced surgical Head and Neck Oncology Centres, and new treatment strategies should be investigated.
    Archives of Oto-Rhino-Laryngology 03/2012; · 1.29 Impact Factor
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    ABSTRACT: Salivary gland tumors (SGTs) of epithelial origin are relatively rare, and worldwide reports show considerable variations in their epidemiology. The aim of this study was to examine, for the first time, the records of SGTs from two very distant geographical locations, Finland (two medical centers) and Israel (one medical center) between 1999 and 2008, based exclusively on the 2005 WHO classification of head and neck tumors, and to compare those data to the other available (single-center) studies that used the same classification. A total of 2,218 benign and malignant tumors diagnosed in the three centers were analyzed. Differences in classification of the tumors were found between the two geographical locations as well as between the two centers from Finland. There was a higher ratio of benign-to-malignant SGTs in the Finnish centers (5.4:1 and 7:1) compared to the Israeli center (2:1), a higher frequency of tumors of minor salivary glands in the Israeli center (34%) than in the Finnish centers (4 and 11%), and a higher frequency of malignant SGTs in the minor salivary glands in Israel (64.5%) than in Finland (10.9 and 27%). The diversity of these multicenter data are compatible with reports from different parts of the world. We conclude that conducting epidemiologic surveys based on the latest WHO classification provides clinicopathologic correlations on SGTs that seem to be characteristic even in small geographical regions.
    Head and Neck Pathology 01/2012; 6(2):224-31.
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    ABSTRACT: Oral tongue squamous cell carcinoma (OTSCC) often metastasizes to cervical lymph nodes. Mechanisms of this disease progression are not fully known. We aimed at finding new predictive markers for diagnosis and disease monitoring. Seventy-three consecutive T1N0M0 and T2N0M0 OTSCC patients treated at Helsinki University Central Hospital, Helsinki, Finland, in 1992-2002 were included. Tissue array blocks were prepared from primary tumors and immunostained. Immunoexpression of matrix metalloproteinase (MMP)-2, -8, -9, and -13 was compared with patient characteristics and outcome. Nuclear expression of MMP-13, but not cytoplasmic expression of MMP-2, -8, and -9, was associated with invasion depth (P = 0.017) and tumor size (P = 0.008). Furthermore, high nuclear MMP-13 expression was predictive of poor outcome (P = 0.042). Our results suggest that especially MMP-13 may be regarded as a prognostic biomarker in OTSCC.
    Journal of Oral Pathology and Medicine 11/2011; 41(5):394-9. · 2.06 Impact Factor
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    ABSTRACT: We present a series of 23 cases of a distinctive, hitherto poorly recognized low-grade adenocarcinoma, with several histologic features reminiscent of papillary carcinoma of the thyroid, and which mostly but not exclusively occurs in the tongue. All the tumors were unencapsulated and were divided into lobules that were composed mainly of cribriform and solid growth patterns. Therefore, we propose the name "cribriform adenocarcinoma of minor salivary gland origin (CAMSG)." All the patients were adults with a mean age at diagnosis of 55.8 years (range, 25 to 85 y). Fourteen of the 23 tumors were localized in the tongue, 3 in the soft palate, 2 in the retromolar buccal mucosa, 3 in the lingual tonsils, and 1 in the upper lip. Fifteen patients of 23 had synchronous metastases in the cervical lymph nodes at the time of diagnosis, bilateral in 3 cases. In 3 patients, the nodal metastasis was the first evidence of disease, later investigation revealing primary neoplasms in the base of tongue and tonsil, respectively. In addition, 1 patient developed a cervical lymph node metastasis 8 years after excision of a primary tumor of the tongue. Data on treatment and follow-up were available in 14 cases. The patients were treated by radical excision with clear margins (12 cases) or by simple excision (2 cases). Neck dissection was performed in 10 patients; 9 received radiotherapy, but none were treated by chemotherapy. Clinical follow-up ranged from 2 months to 13 years (mean, 6 y and 5 mo). Twelve patients are alive with no evidence of recurrent or metastatic disease after treatment, 1 patient died 2 years after surgery without evidence of tumor, and 1 patient is alive with recurrent tumor of the palate.
    The American journal of surgical pathology 06/2011; 35(8):1168-76. · 4.06 Impact Factor
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    ABSTRACT: The incidence of oropharyngeal squamous cell cancer (OPSCC) in Finland has increased during the past decades. A similar change has been seen in the relative frequency of p16-positive head and neck squamous cell carcinoma (HNSCC). As p16 is a surrogate marker for human papilloma virus (HPV) infection, and as most p16-positive HNSCCs are OPSCC, HPV infection may have had a role in the observed increased incidence of OPSCC. Numerous studies have shown that HPV is an independent risk factor for OPSCC. We aimed to use p16 as a surrogate marker of HPV infection to study its role as a possible risk factor in OPSCC. Furthermore, the change in the incidence of OPSCC in Finland was studied. HPV status was determined by p16 immunohistochemistry of 135 HNSCC tumour specimens retrieved from patients treated at the Helsinki University Central Hospital. Incidence data on OPSCC were obtained from the Finnish Cancer Registry. The incidence of OPSCC in Finland increased from 0.66/100 000 person-years during 1989-1993 to 1.36 during 2004-2008. During the same period a significant increase in the relative frequency of p16 positive HNSCC tumours from 22% during 1990-1999 to 41% during 2000-2007 could be seen at our institution. In all, 85% of the p16-positive specimens were OPSCC.
    Acta oto-laryngologica 05/2011; 131(9):1008-11. · 0.98 Impact Factor
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    ABSTRACT: The management of juvenile nasopharyngeal angiofibroma (JNA) has changed during the last decades but it still continues to be a challenge for the multidisciplinary head and neck surgical team. The aim of this study was to review the used treatment approach and outcome of JNA in a single institution series of 27 patients diagnosed and treated during the years 1970-2009. All patients were male, with the median age of 17 years (range 11-33 years). Surgery was used as the primary treatment in every case. Surgical approaches varied, transpalatal approach (N = 14) being the most common approach used in this series. During the last decade various other techniques were applied, including endoscopic (N = 3) resection. Two patients were additionally treated with antiangiogenic agents and one patient with stereotactic radiotherapy. The primary recurrence rate was 37% and it seemed to correlate with vascular density of tumour and the surgical approach used. We suggest that the management of JNA should be planned by an experienced head and neck surgeon, as part of a multidisciplinary team, preferably in a tertiary referral setting, and the recent development of the available therapies should be taken into account to minimise the risk of recurrence.
    Archives of Oto-Rhino-Laryngology 04/2011; 268(4):599-607. · 1.29 Impact Factor
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    ABSTRACT: Esthesioneuroblastoma remains a challenging disease because of its rarity, the complexity of surrounding structures, missing opinions of optimal treatment protocol, and complications associated with necessary surgery. Our objective was to analyse the management and outcome of a cohort of patients with esthesioneuroblastoma from 1990 to 2009 in a tertiary medical centre. There were 17 eligible patients (8 males and 9 females) with the median age of 53 years (range 20-75 years). An obvious inconsistency was noted in the management of the various tumours of the present series during the two decades due to a lack of a uniform treatment protocol. The median follow-up time was 57.5 months (range 3-158 months). Nine patients (seven with curative treatment intent) died of the disease with the median time from diagnosis to death of 60 months (range 3-161 months). Eight patients had no evidence of the disease at last follow-up visit (median 76 months, range 24-119 months). Recurrences were documented in seven of the patients. The median time from end of primary treatment to a recurrence was 57 months (range 6-110 months). The 5-year overall survival and disease-free survival was 68 and 62%, respectively. The management of ENB should be planned by an experienced head and neck surgeon as part of a multidisciplinary team in a tertiary referral setting. Multimodality therapy with long-term follow-up is preferable and should be set based on the available disease-specific classifications for clinical staging and histopathological grading.
    Archives of Oto-Rhino-Laryngology 03/2011; 269(1):213-21. · 1.29 Impact Factor
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    ABSTRACT: Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular tumour, occurring almost exclusively in adolescent males. Histogenesis of JNA remains unclear, two optional theories proposing either fibrous or vascular tissue as the tissue of origin. Stem cell-related proteins have been discussed to possibly participate in the growth of these tumours. In our study, we reviewed retrospective clinicopathological data of 26 JNA patients. By immunohistochemistry, we investigated the cellular distribution and expression levels of stem cell-related proteins C-KIT, C-MYC and BMI-1 and their correlation with cell and vessel density of the tumour. Contrary to earlier reports, we detected C-KIT expression in addition to stromal cells also in endothelial cells. The C-KIT expression was more dominant in slit vessels than large vessels. A significant correlation was found between endothelial immunoexpression of C-KIT and cellular density of the tumour. C-MYC and BMI-1 expression was detected in stromal cells only. Due to our finding of C-KIT expression in both stromal and endothelial cells and the strong correlation between the endothelial C-KIT expression and cellular density, we suggest that, besides the stromal tissue, the vascular component might take part in the neoplastic growth of JNA.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 02/2011; 458(2):189-95. · 2.68 Impact Factor
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    ABSTRACT: In Finland over the past few years approximately 100 new cases of oro- and hypopharyngeal cancer have been diagnosed annually. Most of these are squamous cell carcinomas. The incidence of these diseases increases after age 45. Minor and nonspecific local symptoms caused by the primary tumor are common to pharyngeal cancers at the initial stage of the disease. Often the diagnosis is delayed and the search for the primary tumor is begun only after detection of neck metastases. They occur in 60 to 80% at the time of diagnosis. Among the risk factors, smoking and heavy drinking are most important.
    Duodecim; lääketieteellinen aikakauskirja 01/2011; 127(18):1971-7.
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    ABSTRACT: Vascularization and angiogenicity of human nonvascularized nerve grafts in the second stage of facial reanimation were studied. Immunohistochemistry for endothelial markers (CD-31) and vascular endothelial growth factor (VEGF) and its receptors Flt-1 and Flk-1 was performed on distal end biopsies from 35 cross-facial nerve grafts. In grafted nonvascularized nerve, density of vascular structures (also clearly immunopositive for VEGF and both receptors) showed a mean of 166 vessels (range 78 to 267) per unit area, corresponding to control values. In addition, VEGF was expressed in axons and perineural structures. In control samples, VEGF expression was low and occurred in the myelin sheath. In nerve grafts, expression of Flt-1 and Flk-1 (less intense) was seen in axons and perineural structures. A higher density of vessels was associated with lower VEGF expression (not significant). In short, expression of VEGF and its receptors is described in human nerve grafts and compared with basic histology and p75 nerve growth factor receptor expression of the nerve graft and functional outcome of patients.
    Journal of Reconstructive Microsurgery 12/2010; 27(3):173-8. · 1.00 Impact Factor
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    ABSTRACT: Claudins (CLDNs) are a family of membrane proteins important for permeability of tight junctions. They have also been implicated in carcinogenesis and tumor progression. We analyzed patterns of distribution and intensity of expression of CLDNs 1, 3, 4, and 7 in mucoepidermoid carcinoma (MEC) of salivary gland in 39 patients. Correlations between the expression of CLDNs, tumor grade, and survival were explored. In immunohistochemical analysis, high expression of CLDN 1 was seen in low-grade MEC, and it appeared to be a suitable auxiliary marker of good prognosis. It classified MEC similarly to histological grading in 89.7% of cases (p = 0.001). High CLDN 3 expression was seen in intermediate- and high-grade MEC, while it was low in low-grade MEC. CLDN 3 intensity correctly categorized tumors into grades in 71.8% of cases (p = 0.017). However, in multivariate analysis CLDN 1 and CLDN 3 did not achieve significance over tumor grade in predicting patient behavior. We conclude that analysis of staining intensities of CLDN 1 and 3 is useful as an auxiliary diagnostic and prognostic tool in patients with salivary gland MEC.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 12/2010; 458(3):341-8. · 2.68 Impact Factor
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    ABSTRACT: To examine a series of head and neck squamous cell cancer (HNSCC) patients treated with combined gefitinib and chemoradiotherapy (CRT) regarding treatment efficacy and tolerability and correlation with epidermal growth factor receptor (EGFR) factors. Fifteen patients with locally advanced HNSCC were included in the study. The patients were scheduled to take gefitinib 250 mg in combination with concurrent radiotherapy (RT) +/- concomitant cisplatin. EGFR expression, activation and amplification; serum vascular endothelial growth factor (S-VEGF); and microvessel density were determined. Locoregional tumour control at 3 months was achieved in 79% of the patients. The treatment was reasonably well tolerated. A tendency toward a correlation between complete tumour response and EGFR amplification was observed (p = .057). Patients with activated EGFR did not have significantly more complete responses than patients with no EGFR activation (p = .10). The baseline S-VEGF levels seemed to be higher in patients with HNSCC than in 40 healthy controls (p = .076). The combination of gefitinib and RT with concurrent cisplatin was feasible. EGFR amplification status may correlate with the treatment response in HNSCC patients treated by gefitinib and CRT. S-VEGF level does not seem to correlate with treatment outcome.
    Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 06/2010; 39(3):269-76. · 0.71 Impact Factor

Publication Stats

2k Citations
361.39 Total Impact Points


  • 2014
    • Turku University Hospital
      Turku, Province of Western Finland, Finland
  • 1989–2014
    • University of Helsinki
      • • Department of Pathology
      • • Institute of Dentistry
      • • Department of Virology
      • • Institute of Biomedicine
      • • Department of Anatomy
      • • IV Department of Surgery
      Helsinki, Southern Finland Province, Finland
  • 2005–2013
    • University of Turku
      • Institute of Dentistry
      Turku, Province of Western Finland, Finland
    • University of Surrey
      Guilford, England, United Kingdom
  • 1998–2012
    • Helsinki University Central Hospital
      • Department of Pathology
      Helsinki, Southern Finland Province, Finland
  • 1992–2011
    • Charles University in Prague
      • • Ústav patologie (3. LF)
      • • Lékařská fakulta v Plzni
      Praha, Hlavni mesto Praha, Czech Republic
  • 2001
    • Slovak Medical University in Bratislava
      Presburg, Bratislavský, Slovakia
  • 1996
    • Faculty of Medicine in Pilsen
      Pilsen, Plzeňský, Czech Republic
    • Harvard Medical School
      Boston, Massachusetts, United States