The Spectrum of Oral Pathology Specimens: a Retrospective Study of 442 Specimens and a Review of Literature

Background: Diseases of the oral cavity are heterogenous in etiology, pathogenesis, histogenesis and clinical outcome. Several epidemiologic studies exist in the literature with variable and conflicting results, based on small sized-samples and geographic factors. The aim of this study is to examine the frequency of oral diseases encountered in our experience from a tertiary hospital and to compare it with previous studies.Methods: The archives of pathology at Jordan University Hospital were retrospectively searched for specimens of oral cavity and related structures anatomic areas between 2013-2020. Fisher’s exact test was performed to examine the statistical difference between the pathologic diagnosis and clinical variables of age, gender and site of specimen. One-way ANOVA test was applied to analyzed the differences in the mean of age among different pathologic groups. P-value of less than 0.05 was considered significant.Results: A total of four-hundred forty-one cases were retrieved. There were 232 (52%) females and 210 (48%) males. The range of age was 3-87 years (mean 43), 46 (10%) of which were children younger than 16 years. Inflammatory and reactive diseases were the most common, constituting 147 (33%) of all specimens, followed by benign neoplasms: 139 (31%), cysts: 114 (26%) then malignant diseases: 42 (10%). Lichen planus was the most common inflammatory disease: 26/147 (18%) and prevailed in patients older than 40 years (P = 00039). Keratocyst predominated in children and adolescents more than in adults (P = 0.0015). Buccal mucosa represented the most frequent site for biopsy: 76 (17%), followed by tongue and maxillary bone: 70 (16%), each. Conclusion: Inflammatory and benign neoplasms are the most common lesions in oral diseases. Oral malignancy appears to show a low to intermediate frequency compared to previous reports. The study provides a general overview of the spectrum of oral pathology specimens and points to some novel epidemiologic findings that suggests further investigations.

Oral cavity squamous cell carcinoma presenting as a nasal mass in the setting of a dental implant

Primary oral cavity squamous cell carcinomas can rarely occur in anatomic vicinity of a dental implant in patients with no history of prior oral malignancy or premalignancy. This typically presents as a symptomatic oral gingival lesion. We report the unusual case of a 65-year-old former-smoker female with an implant-supported upper denture who developed an isolated nasal mass on exam, found to be a squamous cell carcinoma originating from the hard palate. Although very rare, an oral cavity cancer should be taken into consideration in the differential diagnosis of a nasal cavity mass in the setting of dental implants.

Role of exfoliative cytology in diagnosis of oral lesions: With special reference to rule out malignancy

Oral malignancy is very common in India because of the excessive use of tobacco chewing and smoking. Procedure of Cytology is inexpensive and unchallenging that can be carried out effortlessly at outdoor patient department to diagnose malignancy at early stage. The present study was carried out to detect cancer pre-invasive stage by use of exfoliative cytology and to probe the probability of using this technique in diagnosis of other oral lesions thought as premalignant ones. A total 102 patients referred from OPD and Surgery Department of a Private Hospital, Dispensary and Cancer Hospital, Delhi, between August 2019 to April 2020 , were included in this study. Two smears were taken by scrap method, from each patient and were prepared after air dried stained with RAPID PAP stain. According to the Papanicolaou classification the smear were assessed along with clinical, epidemiological data and classified in group I to IV. In our result 25 cases were normal, leukoplakia 47 cases with mean age 47.5 years, 85% male. Predominantly 53% Smear show anucleated squames. 06 cases were Oral submucous fibrosis ,66.7% were female with mean age 38.3 years and, the present smear revealed rarification of nuclei in 66% cases. 02 cases of mucosal hyperemia (Erythema), one-one case of traumatic ulcer and granular buccal mucosa were included. Out of 12 cases of malignancy, male were 75% with mean age of 46 year. Buccal mucosa and tongue were the common site with incidence of 60%. The smear showed inflammatory cells in 100%, malignant cells in 75% cases either in groups or in singles. The third type of cells 60%, 37% the undifferentiated cells, and 5% cases Tadpole cells. In this study 75% cases were positive for cancer, 10% were suspicious for cancer and remaining 15% were given as negative for cancer. For the diagnosis of presence or absence of malignancy in a lesion with high accuracy rate Cytology is reliable diagnostic tool. The oral cytologic technique is effortless to do and can provide the help of surgeon/physician, instead of performing an invasive procedure, like a biopsy, or desire more information regarding a lesion before referring the patient.

Comparison of Androgen Receptor, VEGF, HIF-1, Ki67 and MMP9 Expression between Non-Metastatic and Metastatic Stages in Stromal and Tumor Cells of Oral Squamous Cell Carcinoma

Objectives: Oral squamous cell carcinoma (OSCC) is the most common oral malignancy with low survival as it is very often diagnosed at an advanced stage, which is why the accurate profiling of the tumor is essential. The aim of this study was to, for the first time, compare in OSCC the frequency of AR, VEGF, MMP9, HiF1beta and Ki67 between the non-metastatic and metastatic disease. Materials and Methods: In the study, 96 non-metastatic and 91 metastatic OSCC patients were analysed for AR, VEGF, MMP9, HiF1beta and Ki67 levels by immunohistochemistry. Results: All of the tested biomarkers significantly differed between non-metastatic and metastatic disease. A significant association was found between >/=20% AR positive epithelium cells in cytoplasm, Ki67 and VEGF in cancer stroma. Ki67, HiF1beta, VEGF and MMP9 were significantly associated with TNM stages. Conclusion: Our results show for the first time an interplay between AR, VEGF, MMP9, HiF1beta and Ki67 in OSCC which may contribute to better diagnostics and therapy selection.

Relationship between habits and precancerous lesions of the oral cavity – a clinicopathological study

Introduction: Oral cancers account for 3% of total malignancies. A research was conducted to findthe incidence, age, and sex distribution, clinical presentation, and the relationship between habitsand various premalignant lesions of the oral cavity. Methods: It was a hospital-based observationaland cross-sectional study, conducted in GSL Medical College, Rajamahendravaram from October2015 to April 2017. Individuals aged > 18 years, with leukoplakia, erythroplakia, blanched mucosawith or without fibrous bands and /or trismus suggestive of oral submucous fibrosis, bilateral whitishlesions with a reticular pattern suggestive of lichen planus, and ulcer against sharp tooth denturesuggestive of traumatic dental ulcers were taken. Individuals with frank oral malignancy, those withterminal diseases, those who did not submit informed consent were not considered. Results: Themajority of patients (33.33%) were aged between 51 – 60 years, belong (62.75%) to lowersocioeconomic status. Leukoplakia (64.7%) was a common clinical presentation. Most (49.02%) ofthe study patients presented with a burning sensation. When addictions were considered, 86.27% ofpatients were smokers, 23.53% were addicted to alcohol. Conclusion: Leukoplakia was thecommonest (64.71%) premalignant lesion, 51 – 60 years was the common age group. Premalignantlesions were most commonly seen among males, most of the study participants belong to low andmiddle socio-economic groups with a rural background. Diabetes mellitus was the most commoncomorbidity associated with premalignant lesions.

Analysis of the anticancer effect of endostatin on oral squamous cell carcinoma based on results of experimental studies

При плоскоклеточном раке полости рта основной причиной летальных исходов является метастазирование в регионарные лимфатические узлы. Злокачественный рост и формирование метастазов напрямую зависят от степени кровоснабжения первичного очага новообразования. Известно, что по мере прогрессирования опухолевый процесс сопровождается нарушением сбалансированной в норме системы регуляции ангиогенеза с превалированием уровня ангиогенных стимуляторов над ингибиторами. В связи с этим, использование антиангиогенных средств является патофизиологически обоснованным методом борьбы со злокачественным ростом. В обзоре обсуждаются данные доклинических исследований участия эндостатина, природного ингибитора ангиогенеза, в процессах подавления прогрессии и метастазирования плоскоклеточного рака челюстно-лицевой области. Проанализированы патогенетические механизмы ингибирования эндостатином опухолевого роста в экспериментальных моделях рака полости рта. Эндостатин можно рассматривать в качестве потенциального противоопухолевого средства для лечения данной нозологии. The main reason for cancer-associated mortality in patients with oral squamous cell carcinoma is metastatic spread to regional lymph nodes. It is known that the processes of malignant growth and metastasis are highly dependent on blood supply to the primary cancerous focus. The development of malignancy is accompanied by failure of the normally well-balanced system of angiogenesis regulation with prevalence of proangiogenic factors over inhibitors. Therefore, the use of angiogenic inhibitors is a pathophysiologically justified method aimed at suppression of cancer progression. This review presents reports of experimental studies on the role of endostatin, a natural inhibitor of angiogenesis, in processes of tumour shrinkage in squamous cell carcinoma of the maxillofacial region. The authors analysed pathogenic mechanisms of the anticancer effects exhibited by endostatin in preclinical models of oral malignancy. Endostatin can be regarded as a potential antitumor agent for the treatment of oral squamous cell carcinoma.

Oral Malignancy Detection Using Color Features from Digital True Color Images

<p class="0abstract"><span lang="EN-US">One of the most prevalent forms of cancer worldwide is oral cancer which has a high rate of mortality. Diagnosis and treatment of oral premalignant lesions at an early stage reduces the death rate. The objective of this work is to detect malignancies by analyzing color features of digital true color oral images. A dataset of around 433 oral lesion images has been created that includes benign, premalignant and malignant lesions. The proposed method was experimented on this dataset. Different classifiers have been trained using various color features. The neural network classifier detects abnormalities with an accuracy of 94.82%. Results indicate that the color features have better potential in identifying benign and malignant oral lesions. </span></p>