Journal of Oral Pathology & Medicine最新文献

Background: Oral potentially malignant disorders may precede the development of oral cancer, and biomarkers are being investigated for their risk assessment. We aim to provide updated information on tissue biomarkers related to the risk of malignant transformation (MT) in patients with oral leukoplakia (OL) published during the last four years.

Methods: A search strategy was developed using the electronic databases PubMed, EBSCO, and Cochrane Library to search for articles related to this topic (published from 2020 to 2024) (CRD42024527395).

Results: Of the 1385 articles identified, 14 were included, with a combined sample of 1479 patients of whom 216 suffered MT. There were 30 different biomarkers evaluated of which Bmi-1, CD3/CD8, Ki-67, p16, and DNA ploidy were evaluated in more than one study. Of the 9 studies with multivariate analysis, Bmi-1, Tipe-2, copy number alteration, DcR2, and Ki-67, PTHrP, podoplanin (PDPN), and BubR1/Mad2 biomarkers presented independent significant value on MT. In one study, adding DNA ploidy status to the grade of dysplasia increased the model's predictive power.

Conclusion: Although heterogeneity continues to exist, this systematic review reconfirms the role of biomarkers previously described such as PDPN and DNA ploidy and some new additional biomarkers.

Introduction: Oral squamous cell carcinoma (OSCC) is a common cancer, with a high propensity for regional lymph node metastasis (LnM), resulting in 5-year survival rates of only 40%-50%. The premetastatic niche (PMN), a modified lymph node microenvironment preparing for future metastasis, is poorly understood. This study analyzes the histomorphological features of nonmetastatic lymph nodes from OSCC patients, stratified by the presence or absence of regional cervical LnM.

Methods: This cohort study examined 424 nonmetastatic lymph nodes, preserved in paraffin blocks, from 45 OSCC patients. Histological analysis was performed using hematoxylin and eosin staining to evaluate architectural features, specifically capsule and trabeculae thickness, subcapsular and medullary sinus ectasia, fibrosis, follicular organization, and hyperplasia. Logistic regression models were used to assess the relationships between these features and LnM, recurrence, and survival.

Results: Our analysis revealed that intense medullary ectasia was associated with an increased risk of lymph node metastasis (LnM) (OR = 1.63; 95% CI: 0.99-2.67; p = 0.051), whereas follicular hyperplasia appeared protective (OR = 0.27; 95% CI: 0.15-0.5; p < 0.001). Nonvisible sinusoidal trabeculae suggested a higher risk of recurrence (OR = 2.18; 95% CI: 0.99-4.81; p = 0.05). Disorganized lymphoid follicles (OR = 1.91; 95% CI: 0.97-3.77; p = 0.059), focal subcapsular ectasia (OR = 4.4; 95% CI: 1.34-14.37; p = 0.014) and marked subcapsular ectasia (OR = 3.2; 95% CI: 1.06-9.63; p = 0.038) correlated with decreased survival. Conversely, follicular hyperplasia (OR = 0.38; 95% CI: 0.19-0.74; p = 0.005) and medullary fibrosis (OR = 0.13; 95% CI: 0.02-0.67; p = 0.015) were associated with improved survival.

Conclusion: These results highlight the potential clinical significance of follicular hyperplasia in lymph nodes. Patients exhibiting this feature may have a more favorable prognosis, characterized by increased survival and decreased risk of lymph node metastasis, regardless of concurrent alterations in other lymph node architecture.

Background: Updated and comprehensive epidemiological data on odontogenic tumors are not available for the Nordic countries. The aim of the study was to retrospectively examine the prevalence and clinical and radiological characteristics of primary odontogenic tumors over a 10-year period in Sweden, Norway, Finland, and Denmark.

Methods: Primary odontogenic tumors diagnosed by oral pathologists from 2010 to 2020 at nine different diagnostic laboratories in Sweden, Norway, Finland, and Denmark were identified. Using histopathology referrals and their corresponding histopathological reports, age and sex, anatomic site, clinical and radiological findings, tentative diagnosis, histopathological diagnosis, and recurrence of the tumors were recorded. Range, mean, and median for continuous variables and frequency tabulation for discrete variables were used.

Results: In total, 1139 primary odontogenic tumors (598 in males and 540 in females) were identified during the study period, giving an annual incidence rate of 4.2/million. The mean age of all patients was 29 years. Ninety-nine percent of the tumors were benign, and the mandible was the predominant location. Odontoma, ameloblastoma, and odontogenic fibroma were the three most common tumors. The mixed epithelial and mesenchymal benign odontogenic tumors were more common at a younger age compared with the epithelial tumors and the mesenchymal tumors (mean age 22, 44, and 35 years, respectively). Information on variables other than sex, age, and tumor site was missing in most referrals.

Conclusion: The annual incidence of 4.2 cases per million indicates that odontogenic tumors are uncommon in Nordic countries. Better practices to improve the quantity and quality of clinical information in the pathology referrals are needed.

Background: Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor that inflicts the population even with the development of treatments.

Methods: In this letter, we used SEER to investigate the prevalence of MEC in the oral cavity, lip, and pharynx within the U.S. population to contribute to this movement.

Results: We found that MEC is prevalent among various ethnic groups (e.g., Black and American-Indian/Alaska Natives) and is higher in more specifically White and Asian/Pacific Islanders. Prevalence increases with age, with the highest in the 70-74 age group.

Conclusion: By showing the demographic characteristics of the inflicted population, we are contributing to the future of precision medicine and expanding the relaitonship between disease and population factors.

Rare cancers are a diverse group of malignancies with low incidence, posing significant challenges for research due to the scarcity of cases and the lack of well-established in vitro and in vivo models. In this letter, we describe how 3D bioprinting can address these challenges by enabling the construction of more accurate tumor models that capture the essential characteristics and heterogeneity of rare cancers. The technology allows for the creation of multicellular microenvironments, the incorporation of diverse extracellular matrix substrates, and the deployment of additional components like growth factors, nanoparticles, and genetic modulators. This versatility facilitates the study of complex tumor behaviors, such as perineural invasion, and enables high-throughput drug screening for personalized therapies. We emphasize the transformative potential of 3D bioprinting in advancing rare cancer research and overcoming the longstanding challenges associated with these malignancies, with a particular focus on salivary gland cancers.

Introduction: Hematopoietic stem cell transplantation (HSCT) is an important and potentially curative treatment for some hematological disorders. Chemotherapeutic preconditioning can result in complications due to the direct or indirect toxicities of the administered drugs. Among the adverse effects, various complications may arise within the oral environment.

Objective: We investigated the occurrence of oral alterations in hematologic patients during their hospitalization for HSCT.

Methods: This study involved 30 patients undergoing HSCT at a reference hospital in Brazil. Data on oral physical examination, hematological disorder diagnosis, transplant type, comorbidities, chemotherapy protocols, and oral risk factors were collected. Survival analysis was conducted to estimate the onset time of oral alterations and investigate potential associations with risk factors.

Results: Oral alterations were observed in 93.3% of patients, with the most common being edema of the buccal mucosa (83.3%) and oral mucositis (80%). FluBuMel was the most frequently used conditioning protocol (46.7%). The mean follow-up time was 23 days, and the probability of the patient remaining free of oral alterations decreased as time progressed. The Mel200 protocol (HR 2.89; IC 0.04-1.02; p = 0.020) and autologous transplant (HR 3.41; CI 1.28-9.07; p = 0.004) were associated with an earlier occurrence of oral alterations, while allogenic related transplant was a protective factor (HR 0.48; CI 0.22-1.07; p = 0.040).

Conclusion: The time of onset of oral alterations is affected by transplant type and conditioning protocol, and suggests that the severity of the alterations is positively influenced by the presence of dentists in the HSCT team.

Background: This study explored the expression patterns of epithelial-mesenchymal transition markers E-cadherin and beta-catenin in mild and moderate oral epithelial dysplasia (OED) to determine whether their expression predicts malignant progression in oral tissue.

Methods: Formalin-fixed paraffin-embedded tissue specimens with mild or moderate dysplasia were retrieved from 87 patients. Immunohistochemistry was performed to compare E-cadherin and beta-catenin expression in tissue sections that progressed to severe dysplasia, carcinoma in situ, or squamous cell carcinoma (n = 29) with those that did not progress (n = 58). Expression patterns were observed in the basal, parabasal, lower spinous, and upper spinous epithelial layers. Expression was assessed in the cell membrane for E-cadherin and beta-catenin (low expression = absent/weak staining, high = moderate/strong) and in the cytoplasm and nucleus for beta-catenin (low = absence, high = presence). Logistic regression was used to predict progression based on the expression pattern.

Results: There were no significant differences in the progression and expression patterns of E-cadherin and beta-catenin (p > 0.05).

Conclusion: This study found that the expression of E-cadherin and beta-catenin was not a predictor of early malignant progression, highlighting the importance of longitudinal studies in studying progression.

Background: The diagnosis of oral squamous cell carcinoma (OSqCC) is sometimes delayed. In this study, we attempted to comprehensively analyze the surface and cross section of OSqCC using whole-mount sections.

Methods: Representative cross sections of 41 pT2 and pT3 OSqCC were digitally assembled, and whole-mount sections were reconstructed. In the cross section of the tumor, the degree of differentiation was classified as well/moderately differentiated (WDMD) and poorly differentiated (PD); and the surface of the specimen was divided into four types: benign-looking epithelium, dysplasia, carcinoma, and ulceration.

Results: In the cross-sectional analysis, 17 cases (41.5%) consisted of only WDMD, and the PD component was predominant in seven cases (17.1%). In the remaining 17 patients, the PD component was partial (< 50%). When grouping noncancerous lesions (benign-looking epithelium and dysplasia, BnDy) and cancerous lesions (carcinoma and ulceration, CaUl) in the surface analysis, the proportion of CaUl was significantly lower in the tongue than in other oral sites (p = 0.009) In the survival analysis, although not statistically significant, the overall survival of partial PD patients was more similar to that of the predominant PD group compared to that of the WDMD-only group.

Introduction: Several biomarkers in peri-implant crevicular fluid have been studied to diagnose peri-implant diseases with inconclusive results. This systematic review and meta-analysis aimed to comprehensively compare data on the levels of biological components in peri-implant crevicular fluid collected from healthy and diseased implants to identify reliable biomarkers for diagnosing and monitoring peri-implant disease.

Materials and methods: The search strategy included studies comparing biomarker levels in peri-implant crevicular fluid between healthy and diseased implants through electronic databases (MEDLINE/PubMed, Embase, Cochrane Library), grey literature, and hand-searching relevant journals and reference lists of pertinent papers. A two-stage screening was performed in duplicate and independently. In the first stage, titles and abstracts that fulfilled eligibility criteria were screened. In the second stage, a full-text analysis was conducted to verify eligibility. All articles meeting the inclusion criteria underwent data extraction and quality assessment. Meta-analyses were conducted on studies with similar comparisons and outcome measures.

Results: After screening the titles and abstracts, out of 100 potentially relevant papers identified for full-text evaluation, 49 were excluded, 51 were included in the qualitative analysis, and 18 were included in the quantitative synthesis. Among 96 biomarkers assessed, the most studied were pro-inflammatory cytokines (IL-1ß, IL-6, TNF-α, and IL-17), osteoclastogenic-related factors (RANK, RANKL, and OPG), anti-inflammatory cytokines (IL-10), chemokines (IL-8, MIP-1α/CCL3, and MIP-3α/CCL-20), and enzymes (MMP-8, Cat-K, AST, and ALT).

Conclusions: Meta-analyses comparing data from healthy patients and those with peri-implantitis or mucositis and between patients with mucositis and those with peri-implantitis showed a moderate predictive value of IL-1ß, VEGF, cortisol, and sRANKL/OPG for peri-implantitis.

Objectives: Topical capsaicin is widely used for managing peripheral neuropathies; however, its impact on gustatory perception following prolonged oral use remains unclear. This pilot study aimed to evaluate changes in gustatory sensitivity and food preferences induced by capsaicin topical gel therapy in healthy individuals.

Materials and methods: Ten healthy female subjects applied capsaicin gel (0.025%) to the gingival mucosa twice daily for 14 days. Evaluations were conducted at baseline (T0), after 2 weeks (T1), after 4 weeks (T2), and after 4 weeks following discontinuation (T3). A matched control group underwent identical assessment without capsaicin application. Gustatory changes were measured using a modified taste strip method and a food preferences questionnaire.

Results: While subjective alterations in food perception, liking, and preferences were reported in the capsaicin group, no significant objective changes in gustatory perception (intensity and recognition of salty, sweet, sour, and bitter flavors) were observed. Subjective changes were reversible upon cessation of capsaicin use.

Conclusions: Topical capsaicin gel influences subjective food perception and preferences without objectively altering gustatory function. These findings highlight the importance of considering such effects when prescribing capsaicin for oral somatosensory disorders, such as burning mouth syndrome or dysgeusia.