[Show abstract][Hide abstract]ABSTRACT: The use of tobacco/betel quid can alone lead to death. India is the fourth largest consumer of tobacco/betel quid in the world and the third-largest producer of tobacco/betel quid after China and Brazil.
A case-control study was carried out to assess the prevalence and various risk factors among potentially malignant disorders (PMD) and oral cancer patients of central India.
A total of 100 clinically and histopathologically diagnosed PMD and oral cancer patients were selected for the study.
A histopathologically confirmed 100 patients who were suffering from PMD and oral cancers were selected and an equal number 100 healthy controls who were age- and sex-matched at par with the cases were also examined and interviewed. Chi-square (χ2 ) test and adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated to estimate the suspected risk factors for PMD and oral cancers by using multivariate logistic regression analysis. Significance level was set at P < 0.05.
Statistically significant difference was observed in the age group, socioeconomic status (SES), duration, frequency, exposure time and synergistic effect of tobacco/betel quid chewing, smoking, and alcohol drinking in our study population.
Chewing tobacco/betel quid is a strong risk factor in the development of PMD and oral cancer. Also age, gender, SES, education, and occupation influence the development of PMD and oral cancer.
No preview · Article · Apr 2015 · Journal of cancer research and therapeutics
[Show abstract][Hide abstract]ABSTRACT: Impaired balance between cell proliferation and apoptosis is crucial to the development of malignant neoplasm. The purpose of this study was to evaluate and compare the expression of X-Linked inhibitor of apoptotic protein (XIAP) (antiapoptotic marker) and Ki-67 (proliferative marker) expression in benign and malignant salivary gland (SG) tumours.
The study consisted of 40 cases of benign SG tumours and 50 cases of malignant SG tumours. The immunohistochemistry was carried out by using Ki-67 antibody (clone MIB-1) and XIAP antibody in all the groups.
XIAP expression was significantly higher in malignant SG tumours than benign SG tumours (p = 0.016). Ki-67 LI was significantly higher in malignant SG tumours than benign SG tumours (p = 0.0002). Statistically significant positive correlation between Ki-67 count and XIAP expression was noted in benign and malignant SG tumours (p = 0.000).
As the expression of an antiapoptotic marker (XIAP) increases, the expression of a proliferative marker (Ki-67) also increases from benign to malignant SG tumours. Thus, targeted therapy of XIAP may play a future role in the management of SG malignancy.
[Show abstract][Hide abstract]ABSTRACT: Chondrosarcoma (CHS) is a rare malignant neoplasm of the jaws. Based on the morphologic features alone, a correct diagnosis of CHS may be difficult. Therefore, correlation of radiological and clinicopathological features are mandatory for the diagnosis of CHS. A case of CHS of the maxilla is reported. A brief discussion on the etiopathogenesis, radiologic and histologic presentation of the tumor and the treatment modalities of this unusual tumor is discussed.
No preview · Article · Sep 2014 · Journal of Oral and Maxillofacial Pathology
[Show abstract][Hide abstract]ABSTRACT: The annual mortality rate from head and neck squamous cell carcinoma (HNSCC) is over 11,000 worldwide. Squamous cell carcinoma of the head and neck (SCCHN) frequently metastasizes to the regional lymph nodes which are the first site of arrest of tumor cells that have invaded the peritumoral lymphatics, hence the strongest predictor of disease prognosis and outcome.
The present study aims to compare the efficacy of frozen sections (cryosection), step-serial sectioning conventional H and E staining, immunohistochemistry (IHC) and RT-PCR analysis in detection of lymph node micrometastasis.
A prospective series of 30 patients who were diagnosed with primary squamous cell carcinoma of the oral cavity and underwent surgical treatment including unilateral or bilateral selective neck dissection were considered for the study.
Metastatic carcinomatous cells were observed in H and E staining of frozen section in 18 lymph nodes (54%) and in 19 lymph nodes (57%) in step-serial sectioned H and E-stained sections of the 78 lymph nodes from 30 patients. Carcinomatous cells were immunolabeled with pancytokeratin in 18 lymphnodes (54%). CK19 mRNA was detected in 33 lymph nodes of 16 patients. RT-PCR gave positive signals for 24% and 23% of lymph nodes positive by histopathology and immunohistochemistry.
Our study demonstrated that RT-PCR is far more sensitive in detection of micrometastasis than any other technique used in routine procedures and immunohistochemistry. Fifty-three percent patients with micrometastasis detected by RT-PCR had large T3/T4 tumors. Prognosis was poor for patients who were positive for micrometastasis detected only by RT-PCR, among which two patients died within a period of 6 months.
No preview · Article · Sep 2013 · Journal of Oral and Maxillofacial Pathology
[Show abstract][Hide abstract]ABSTRACT: The purpose of this study was to assess and compare angiogenesis in ameloblastoma, keratocystic odontogenic tumors, dentigerous cysts, and normal oral mucosa.
Angiogenesis was assessed in 28 ameloblastoma–36 keratocystic odontogenic tumors, 28 dentigerous cysts, and 19 normal oral mucosa by measuring the mean vascular density (MVD), total vascular area (TVA) and mean vascular area (MVA). Immunohistochemistry was carried out by using CD105.
The nonsignificant difference of MVD was noted between ameloblastoma and keratocystic odontogenic tumors (p = .174). TVA and MVA were significantly higher in ameloblastoma than keratocystic odontogenic tumors, normal oral mucosa, and dentigerous cysts (p < .001). MVD, TVA, and MVA were significantly higher in keratocystic odontogenic tumors than normal oral mucosa and dentigerous cysts (p < .001).
The results suggest that tumor angiogenesis may play an important role in locally invasive aggressive biologic behavior of ameloblastoma and keratocystic odontogenic tumor. The angiogenesis could be a potent target for developing antiangiogenic therapeutic strategies, particularly in recurrent cases of odontogenic tumors. Head Neck, 2013
[Show abstract][Hide abstract]ABSTRACT: Objectives. Compare the total salivary Streptococci and Lactobacilli counts in cleft and noncleft children with differing caries experiences, correlate the bacterial counts with dmft/DMFT status and identify the different biotypes of Mutans Streptococci (MS). Patients. Group I included thirty subjects with dental caries (DC) and cleft lip and palate (CL/P); Group II had thirty subjects with DC but without CL/P. Group III comprised a control of thirty subjects with neither DC nor CL/P. Methodology. Enumeration of total salivary Streptococci and Lactobacilli was done by the plate count method and correlation of counts with dmft/ DMFT status examined. Differences in biochemical reactions were used to identify the biotypes. Results. Streptococci colonies in CL/P children with caries (64.30 ± 24.52) was significantly higher than in children with no CL/P or caries (45.57 ± 16.73). No significant differences in the Lactobacilli count were observed. dmft/DMFT status and Streptococci counts showed a strong positive correlation whereas Lactobacilli counts showed a moderate correlation. S. mutans was the predominant biotype. Conclusions. Higher total salivary Streptococci and Lactobacilli counts exist in cleft subjects with caries than in the non-cleft subjects. Positive correlation between dmft/DMFT scores and salivary Streptococci reinforces its role in DC. S. mutans and S. sobrinus are the biotypes more frequently associated with dental caries in children.
[Show abstract][Hide abstract]ABSTRACT: The aim of the study was to analyze the eruption pattern of permanent and deciduous teeth along with radiographic findings in sickle cell disease patients. Materials and methods: The study consisted of 63 patients of sickle cell haemoglobinopathy and 63 normal children matched for same age and sex as a control group. Orthopantamogram was made for those diseased children in whom delayed eruption of teeth was found clinically. Overier, overbite and mucosal pallor was also examined in the diseased children. Results: There was a significant delay in the eruption of teeth in patients with sickle cell haemoglobinopathy as compared to normal group. An increase in overjet and overbite and mucosal pallor was seen in diseased patients. Radiographic finding like step ladder pattern and coarse trabaculae pattern were also seen inpatients with delayed eruption of teeth. Conclusion: The study supports a delayed eruption pattern in sickle cell anemia patients
[Show abstract][Hide abstract]ABSTRACT: Candida is the most common fungal pathogen of oral cavity in humans. It exists as a commensal inhabitant of mucosal surfaces in most healthy individuals. Periodontitis is an inflammatory disease of the periodontium with multifactorial etiology. There is a positive relationship between periodontal inflammation and type 2 diabetes. Diabetes is a metabolic disease characterized by hyperglycemia due to defects in insulin production, insulin action, or both. Diabetes mellitus can impair the function of polymorphonuclear leukocytes which may predispose diabetic patients to greater risk of diseases including periodontal disease and oral candidal infections . The objective of this study is to evaluate the oral candidal carriage in the subgingival sites and also to evaluate the predominant candidal subtypes in non-diabetic individuals with periodontitis, diabetic individuals with periodontitis and healthy individuals without periodontitis.
No preview · Article · Jan 2013 · Journal of International Dental and Medical Research
[Show abstract][Hide abstract]ABSTRACT: Dental pulp is enclosed in hard tissue and hence it is well protected and preserved for long time. Preservation of dental pulp is seen long after damage to other tissues is evident. Thus it is an ideal tissue for analysis of post-mortem changes. In this study we have made an attempt to quantify the amount of degenerative changes in pulp at increasing time interval. We have analyzed the changes in staining characteristics and structural details, in Haematoxylin and Eosin stained pulp tissue harvested at varying time intervals.
[Show abstract][Hide abstract]ABSTRACT: The aim was to evaluate and compare the presence of myofibroblasts in oral squamous cell carcinoma (OSCC), verrucous carcinoma (VC), high-risk epithelial dysplasia (HRED), low-risk epithelial dysplasia (LRED), and normal oral mucosa (NOM). The study consisted of 37 OSCC, 15 VC, 15 HRED, 15 LRED and 15 NOM. α-smooth muscle actin (α-SMA) antibody was used to identify myofibroblasts. The α-SMA expression was not observed in NOM and LRED. The α-SMA was expressed in 97.29% of OSCC, 86.66% of VC, 46.66 % of HRED. The α-SMA expression was significantly higher in OSCC than VC (p = 0.023) and HRED (p < 0.000). The α-SMA expression was significantly higher in VC than HRED (p = 0.043). Myofibroblastic expression, as highlighted by α-SMA, is undetectable in NOM and LRED but increases as the disease progresses from potentially malignant disorders, as HRED to VC to invasive OSCC. Thus, proliferation of myofibroblasts may be used as a stromal marker of oral premalignancy and malignancy.
Full-text · Article · Mar 2012 · Head and Neck Pathology
[Show abstract][Hide abstract]ABSTRACT: This study aimed to assess the serum levels of vascular endothelial growth factor in oral squamous cell carcinoma patients before and after surgical therapy, to compare these values with those of healthy individuals using ELISA, and to evaluate if any correlation existed between vascular endothelial growth factor levels and TNM stage or histolopathologic grade of the tumor.
The study included three groups: group A1 consisted of 31 oral squamous cell carcinoma patients who had not received any prior treatment; group A2 consisted of the same 31 oral squamous cell carcinoma patients who had undergone radical surgical excision 1 month prior but no adjuvant therapy; and group B (control group) consisted of 16 healthy individuals. The serum vascular endothelial growth factor levels were assessed using the ELISA kit.
The vascular endothelial growth factor levels of preoperative oral squamous cell carcinoma patients were found to be three times higher than those of controls, and this difference was found to be statistically significant. The postoperative vascular endothelial growth factor levels had decreased 1 month after surgery but did not decrease to baseline levels. The vascular endothelial growth factor levels increased progressively with the TNM stage and histologic grade of tumor, but no definite correlation between the two could be found.
Vascular endothelial growth factor is an important marker of angiogenesis, as the vascular endothelial growth factor levels of the oral squamous cell carcinoma groups remained significantly elevated compared to that of controls. Though no significant difference was found between the pre- and postoperative oral squamous cell carcinoma groups, it can be suggested that successful treatment may reduce serum vascular endothelial growth factor levels if the time period of postoperative sample collection is increased. Only then can the utility of vascular endothelial growth factor as marker for assessing the effectiveness of surgical therapy or as a prognostic indicator be commented upon.
Full-text · Article · Oct 2011 · Quintessence international (Berlin, Germany: 1985)
[Show abstract][Hide abstract]ABSTRACT: The purpose of this study was to assess and compare angiogenesis with proliferative activity in Keratocystic odontogenic tumors (KCOT) and dentigerous cysts (DC) by using monoclonal mouse anti-human antibody against CD105 (endoglin).
Angiogenesis was assessed in 38 KCOT, 27 DCs and 19 Normal Oral Mucosa (NOM) by measuring the Mean Vascular Density (MVD), Total Vascular Area (TVA) and Mean Vascular Area (MVA). Cell proliferation was assessed by obtaining Ki-67 Labeling Index (Ki-67LI) in all the groups.
Statistically significant difference was observed in MVD, TVA, MVA and Ki-67 LI between the KCOT, DC and NOM (P=0.000). The MVD, TVA, MVA and Ki-67 LI were significantly higher in KCOT than in DC and NOM (P=0.000). The Ki-67 LI was significantly higher in NOM than in DC (P=0.000). MVD (P=0.032) and TVA (P=0.038) were significantly higher in NOM than in DC. There was significant positive correlation between Ki-67 LI and MVD, Ki-67 and TVA and Ki-67 and MVA.
The result suggests that CD105 (endoglin) is strongly expressed in microvessels of KCOT compared with that in Dentigerous cyst and Normal oral mucosa. Thus, it suggests that angiogenesis may be associated with locally aggressive biological behavior of KCOT. These findings further stress on the hypothesis that the stroma of KCOT could be regarded not just as a structural support of the cyst wall, but as playing a part in the neoplastic behavior of cyst.
Full-text · Article · Oct 2010 · Journal of Oral Pathology and Medicine
[Show abstract][Hide abstract]ABSTRACT: Mucoepidermoid carcinoma (MEC) is a malignant glandular epithelial neoplasm having an unpredictable behavior and a tendency to recur. Numerous parameters have been assessed to predict the outcome of this lesion, but have been deemed inadequate, with the exception of tumor stage and grade. In the present study, we attempted to correlate the proliferative activity of MEC with its histopathological grade, using argyrophillic nuclear organizer region (AgNOR) count. Thirty cases of MEC were included in the study. All the slides were stained using hematoxylin and eosin and silver nitrate techniques. Counting was performed at a magnification of x1,000 with an oil-immersion lens. Positive correlations were seen between AgNOR count and MEC grade (P < 0.05), with AgNOR count increasing in proportion with tumor grade. The AgNOR count in various grades of MEC indicates a relative progression in the proliferative activity of this tumor. This index is positively correlated with tumor grade, although there are some exceptions. The utility of AgNOR count in predicting the prognosis of MEC can be considered of importance; however, further assessment, such as survival studies, is necessary.
Full-text · Article · Jun 2010 · Journal of Oral Science
[Show abstract][Hide abstract]ABSTRACT: Fibrosarcoma has been defined as a malignant tumor of the fibroblasts that shows no other evidence of cellular differentiation and is capable of recurrence and metastasis. Fibrosarcomas are rare but may occur anywhere in the body, most commonly in the retroperitoneum, thigh, knee and distal extremities. Fibrosarcoma is uncommon in the head and neck region and constitutes about 1% of all the malignancies affecting the human race. Of all the fibrosarcomas occurring in humans, only 0.05% occurs in the head and neck region. Of this, almost 23% is seen in the oral cavity. Fibosarcomas generally have a poor prognosis and the overall survival rate is 20-35% over a period of 5 years.
No preview · Article · Apr 2010 · Indian journal of dental research: official publication of Indian Society for Dental Research
[Show abstract][Hide abstract]ABSTRACT: The purpose of this study was to evaluate the biological aggressiveness of odontogenic keratocyst/keratocystic odontogenic tumour (KCOT), radicular cyst (RC) and dentigerous cyst (DC) by observing the actual proliferative activity of epithelium, and p53 protein expression.
The actual proliferative activity was measured by Ki-67 Labelling Index and argyrophilic nucleolar organizing regions (AgNOR) count per nucleus. The p53 protein expression was also evaluated.
Ki-67 positive cells were observed higher in suprabasal cell layers of KCOT with uniform distribution, a few of them were predominantly observed in basal cell layer in RC and DC. The AgNOR count was significantly higher in suprabasal cell layers of KCOT. The actual proliferative activity was noted to be higher in suprabasal cell layers of KCOT. The p53 immunolabelling was dense and scattered in basal and suprabasal cell layers in KCOT. The weakly stained p53 positive cells were observed diffusely distributed in KCOT, whereas they were mainly seen in basal cell layer of RC and DC.
The quantitative and qualitative differences of the proliferative activity and the p53 protein expression in sporadic KCOT may be associated with intrinsic growth potential that could play a role in its development and explain locally aggressive biological behaviour. AgNOR count and p53 protein detection in odontogenic lesions can be of great consequence to predict the biological behaviour and prognosis.