Journal of Oral and Maxillofacial Surgery Medicine and Pathology最新文献_第9页

Identification of clinical, prognostic and immunological impact of replication factor C subunit 5 (RFC5) expression in head and neck squamous cell carcinoma 复制因子C亚单位5 （RFC5）在头颈部鳞状细胞癌中表达的临床、预后和免疫学影响的鉴定

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-27 DOI: 10.1016/j.ajoms.2025.04.014

Dakshitha Sankar , Anitha Pandi , Palati Sinduja , Vijayashree Priyadharsini Jayaseelan , Paramasivam Arumugam

Objectives

This study aimed to identify and validate replication factor C subunit 5 (RFC5) mRNA and protein expression in head and neck squamous cell carcinoma (HNSCC) patients, analyzing its association with clinicopathological features, prognosis, and immune signatures.

Methods

The study primarily relied on the cancer genome atlas (TCGA-HNSCC) dataset and additionally recruited 32 OSCC patients, a common type of cancer in HNSCC. RFC5 mRNA and protein expression were analyzed in oral squamous cell carcinoma (OSCC) and adjacent normal tissues using methods such as real time-qPCR and Western blot. The implications of RFC5 expression in clinicopathological features, survival, immune regulation, and functional enrichment analysis were analyzed using the TCGA-HNSCC dataset.

Results

RFC5 mRNA and protein are significantly altered in multiple cancers, particularly upregulated in HNSCC/OSCC. RFC5 mRNA expression is associated with cancer stage, grade, nodal metastasis, HPV status, and poor prognosis, suggesting its potential as a biomarker. Protein network analysis identified an interaction between RFC5 and various well-known oncoproteins involved in DNA replication and cancer pathways. Functional enrichment analysis showed a strong association between RFC5 and HNSCC development and progression.

Conclusions

RFC5 is a key player in HNSCC, and its overexpression is associated with aggressive clinical features and poor outcomes. Its role in oncogenic pathways and interaction with key proteins suggest its potential as a biomarker and therapeutic target.

目的鉴定和验证复制因子C亚基5 (RFC5) mRNA和蛋白在头颈部鳞状细胞癌（HNSCC）患者中的表达，分析其与临床病理特征、预后和免疫特征的关系。方法本研究主要依靠癌症基因组图谱（TCGA-HNSCC）数据集，另外招募了32例OSCC患者，OSCC是HNSCC中常见的一种癌症。采用real - time-qPCR和Western blot等方法分析口腔鳞癌（OSCC）及癌旁正常组织中RFC5 mRNA和蛋白的表达。使用TCGA-HNSCC数据集分析RFC5表达在临床病理特征、生存、免疫调节和功能富集分析中的意义。结果rfc5 mRNA和蛋白在多种肿瘤中表达显著改变，在HNSCC/OSCC中表达上调。RFC5 mRNA表达与癌症分期、分级、淋巴结转移、HPV状态和不良预后相关，提示其作为生物标志物的潜力。蛋白质网络分析确定了RFC5与参与DNA复制和癌症途径的各种已知癌蛋白之间的相互作用。功能富集分析显示，RFC5与HNSCC的发生发展密切相关。结论srfc5在HNSCC中起关键作用，其过表达与侵袭性临床特征和不良预后相关。它在致癌途径中的作用以及与关键蛋白的相互作用表明它具有作为生物标志物和治疗靶点的潜力。

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引用次数: 0

Malignant transformation of oral leukoplakia and associated risk factors: A retrospective clinical study from a single institution 口腔白斑恶性转化及相关危险因素：一项来自单一机构的回顾性临床研究

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-25 DOI: 10.1016/j.ajoms.2025.04.005

Sanako Nakaya , Kensuke Naganawa , Reika Hasegawa , Mai Tomimatsu , Fumitaka Terasawa , Satoru Miyabe , Satoshi Watanabe , Shogo Hasegawa , Hitoshi Miyachi , Mitsuo Goto

Objective

This study investigated the clinical features of oral leukoplakia (OL) and its rate of progression to oral squamous cell carcinoma (OSCC) in a Japanese population. We also investigated the impact of clinical risk factors on the rate of malignant transformation (MT).

Methods

This retrospective study included 308 patients diagnosed with OL between 1989 and 2020. Of these, 231 patients with 6 months follow-up were enrolled. The Kaplan−Meier method was employed to analyze 5- and 10-year risks of developing OSCC. Chi-square test and nominal logistic regression analysis were used to investigate predictors of progression to OSCC.

Results

The mean age of the patients was 62.6 years (range 20 −89), and 45.9 % were female. The most common site of OL was the tongue (36.4 %). Twenty patients (8.7 %) experienced MT to OSCC. The predominant clinical type was the homogenous type (66.7 %), with no patient developing OSCC. Univariate analyses showed that the risk of progression to OSCC was significantly higher in patients aged < 64 years, those with OL of the tongue, nonhomogeneous type, and biopsied cases. In the multivariate analyses, the statistically significant predictor was clinical type. The numbers of female nonsmokers and nondrinkers were significantly higher among the MT cases (p = 0.0016, p = 0.0373, respectively).

Conclusions

OL increases the risk of MT due to a combination of clinical risk factors. Therefore, high-risk cases require shorter follow-up intervals, and we suggest that multiple examiners share their findings. Performing biopsies to identify histopathological factors and make a definitive diagnosis should be considered.

目的研究日本人群口腔白斑（OL）的临床特征及其向口腔鳞状细胞癌（OSCC）的进展率。我们还调查了临床危险因素对恶性转化（MT）率的影响。方法回顾性分析1989年至2020年间诊断为OL的308例患者。其中，231名患者接受了为期6个月的随访。Kaplan - Meier方法用于分析5年和10年发生OSCC的风险。采用卡方检验和名义逻辑回归分析探讨进展为OSCC的预测因素。结果患者平均年龄为62.6岁（20 −89），女性占45.9% 。最常见的OL部位为舌部（36.4% %）。20例患者（8.7% %）行MT转OSCC。主要临床类型为同质型（66.7 %），无患者发生OSCC。单因素分析显示，年龄为 64岁的患者、舌部OL患者、非均质型患者和活检病例进展为OSCC的风险明显更高。在多变量分析中，临床类型是有统计学意义的预测因子。MT病例中不吸烟和不饮酒的女性人数显著高于女性（p = 0.0016,p = 0.0373）。结论sol是多种临床危险因素共同作用的结果。因此，高风险病例需要更短的随访时间间隔，我们建议多名检查人员分享他们的发现。应考虑进行活组织检查以确定组织病理因素并作出明确的诊断。

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引用次数: 0

Investigation of immune-related hub genes as prognostic biomarkers in HPV-positive oropharyngeal cancer hpv阳性口咽癌中免疫相关中枢基因作为预后生物标志物的研究

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-24 DOI: 10.1016/j.ajoms.2025.03.012

Chin-Hsuan Yeh , Tsung-Ming Chang , Chia-Yu Wu , Ju-Fang Liu

Human papillomavirus (HPV) infection is a significant risk factor for head and neck squamous cell carcinoma (HNSCC), with oropharyngeal cancer being predominantly attributed to HPV. Clinical studies have consistently demonstrated that patients with HPV-positive oropharyngeal cancer exhibit a markedly better prognosis compared to those with HPV-negative oropharyngeal cancer. Consequently, understanding the key genes that influence the prognosis of HPV-positive patients is critical. This study aimed to identify the essential genes contributing to the prognostic differences observed between HPV-positive and HPV-negative oropharyngeal cancer patients. Utilizing GSE72536 and GSE55544 datasets obtained from the Gene Expression Omnibus (GEO), we conducted a comprehensive analysis and identified ten hub genes (IFNG, CD19, CD27, CD2, CD247, PDCD1, KLRK1, LAG3, FASLG, and KLRB1) that are significantly overexpressed in HPV-positive oropharyngeal cancer tissues. These genes strongly correlate with improved prognosis and are closely associated with immune cell activation and infiltration, contributing to a potent antitumor immune response. The enhanced immune response observed in HPV-positive cancers, mediated by these hub genes, explains the better prognosis and longer overall survival (OS) associated with HPV-positive oropharyngeal cancer patients. These findings indicate that the identified hub genes could be valuable prognostic biomarkers and potential therapeutic targets. This underscores the importance of personalized treatment strategies in improving clinical outcomes for HPV-positive oropharyngeal cancer patients.

人乳头瘤病毒（HPV）感染是头颈部鳞状细胞癌（HNSCC）的重要危险因素，口咽癌主要归因于HPV。临床研究一致表明，hpv阳性口咽癌患者的预后明显优于hpv阴性口咽癌患者。因此，了解影响hpv阳性患者预后的关键基因至关重要。本研究旨在确定导致hpv阳性和hpv阴性口咽癌患者预后差异的必要基因。利用基因表达Omnibus （GEO）获得的GSE72536和GSE55544数据集，我们进行了综合分析，发现了10个在hpv阳性口咽癌组织中显著过表达的枢纽基因（IFNG、CD19、CD27、CD2、CD247、PDCD1、KLRK1、LAG3、FASLG和KLRB1）。这些基因与改善预后密切相关，并与免疫细胞活化和浸润密切相关，有助于产生有效的抗肿瘤免疫反应。在这些中心基因介导的hpv阳性癌症中观察到的增强的免疫反应，解释了hpv阳性口咽癌患者预后更好和总生存期（OS）更长。这些发现表明，这些中心基因可能是有价值的预后生物标志物和潜在的治疗靶点。这强调了个性化治疗策略在改善hpv阳性口咽癌患者临床结果中的重要性。

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引用次数: 0

Incidence of oral reactions of immune-related adverse events caused by immune checkpoint inhibitors 免疫检查点抑制剂引起的免疫相关不良事件的口服反应发生率

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-24 DOI: 10.1016/j.ajoms.2025.04.011

Akira Kurokawa , Kanae Niimi , Hiroko Kanemaru , Marie Soga , Moe Yamashita , Hidenobu Sakuma , Kei Tomihara , Kensuke Yoshida , Tadaharu Kobayashi , Akitugu Ohuchi

Objective

Immune-related adverse events (irAEs) are side effects caused by the persistence of autoantigen-specific T cells in normal cells and organs that are not eliminated after immune checkpoint inhibitors (ICI) administration. Oral irAEs include xerostomia, oral mucositis, and lichen planus-like lesions; however, only a few studies have reported oral irAEs during ICI therapy. This study aimed to examine the incidence of oral irAEs in our hospital and the effect of oral care.

Methods

The study enrolled 165 patients who underwent oral hygiene management during ICI administration, and did not undergo radiotherapy to the head and neck region, and 63 patients (38.2 %) presented with oral mucositis and/or xerostomia, which appears to be oral irAE. Although most of the patients who suffered from these oral reactions were using anti-Programmed cell Death-1 antibodies, severe oral mucositis was observed in patients who treated with multiple ICIs. Symptoms of patients with grade 1 and 2 mucositis were improved with oral care, and ICI were continued in most of them. However, all patients with grade 3 oral mucositis also showed improvement in symptoms, ICI therapy was discontinued in three patients, systemic steroids were administered in two patients, and ICI therapy was not restarted during the study period.

Conclusion

The incidence of oral irAEs is high in patients on ICI therapy, and continuous oral hygiene management by experts appears to be important for continuity of the treatment.

目的免疫相关不良事件（irAEs）是免疫检查点抑制剂（ICI）使用后，自身抗原特异性T细胞在正常细胞和器官中持续存在而未被清除所引起的副作用。口腔irae包括口干、口腔黏膜炎和扁平苔藓样病变；然而，只有少数研究报道了在ICI治疗期间口服irAEs。本研究旨在了解我院口腔irAEs的发生率及口腔护理的效果。方法本研究纳入了165例在使用ICI期间接受口腔卫生管理的患者，未进行头颈部放疗，63例（38.2 %）出现口腔黏膜炎和/或口干，这可能是口腔irAE。虽然大多数出现这些口腔反应的患者使用了抗程序性细胞死亡-1抗体，但在接受多次ICIs治疗的患者中观察到严重的口腔黏膜炎。1级和2级粘膜炎患者的症状在口腔护理后得到改善，大多数患者的ICI仍在继续。然而，所有3级口腔黏膜炎患者的症状也有所改善，3例患者停止了ICI治疗，2例患者接受了全身类固醇治疗，并且在研究期间没有重新开始ICI治疗。结论接受ICI治疗的患者口腔irAEs发生率较高，专家的持续口腔卫生管理对治疗的连续性至关重要。

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引用次数: 0

Perioperative management of acquired von Willebrand syndrome associated with monoclonal gammopathy of undetermined significance: A case report and review of literature 意义不明的单克隆γ病合并获得性血管性血友病的围手术期治疗：1例报告及文献复习

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-20 DOI: 10.1016/j.ajoms.2025.04.010

Ryouji Tani , Tadayoshi Nobumoto , Kosei Okamoto , Taeko Fukutani , Sugru Hirota , Kento Okamoto , Koichi Koizumi , Souichi Yanamoto

Acquired von Willebrand syndrome (AvWS) is a bleeding disorder characterized by symptoms resulting from a decrease in the von Willebrand factor (vWF) due to an underlying disease or medication. We report our experience in managing tooth extraction in a patient with AvWS who had bleeding gums. A 90-year-old woman was admitted to a nearby hospital for gastrointestinal bleeding treatment, wherein bleeding gums were observed. Suspecting AvWS, she was referred to the hematology department for further evaluation and subsequently to our department for oral cavity treatment. Following a comprehensive evaluation by the hematology department, a diagnosis of AvWS with a background of monoclonal gammopathy was made. Upon initial presentation to our department, the residual root of the right maxillary first premolar was considered the bleeding source and thus indicated for extraction. Following Factor VIII/vWF concentrate administration during hospitalization, the tooth was extracted under local anesthesia. A local hemostatic agent was inserted into the extraction socket; a hemostatic splint was applied after suturing and closing the wound. Postoperative bleeding from the wound was absent; after Factor VIII/vWF concentrate administration, the patient was discharged the following day. However, upon sutures removal nine days after the procedure, rebleeding occurred, requiring reapplication of a hemostatic splint. Two weeks after surgery, the splint was removed and hemostasis was achieved. In such cases, collaborating with the hematology department is necessary to formulate a customized treatment plan for each case.

获得性血管性血友病综合征（AvWS）是一种出血性疾病，其特征是由于潜在疾病或药物导致血管性血友病因子（vWF）减少。我们报告我们的经验，管理拔牙的病人与AvWS谁有牙龈出血。一名90岁的妇女因胃肠道出血被送往附近医院治疗，其中观察到牙龈出血。怀疑为AvWS，转至血液科进一步评估，随后转至我科进行口腔治疗。经过血液科的全面评估，诊断为AvWS，背景为单克隆γ病。在首次就诊时，我们认为右上颌骨第一前磨牙残根是出血源，因此建议拔除。住院期间给予凝血因子VIII/vWF浓缩剂，在局部麻醉下拔牙。拔牙槽内置入局部止血剂；缝合并关闭伤口后使用止血夹板。术后无伤口出血；给予凝血因子VIII/vWF浓缩液后，患者于次日出院。然而，在手术后9天拆除缝线时，再次出血，需要重新使用止血夹板。术后两周，取下夹板并止血。在这种情况下，有必要与血液科合作，为每个病例制定定制的治疗方案。

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引用次数: 0

An in-silico comparison of success rate of different methods for inferior alveolar nerve blockade 下肺泡神经阻滞不同方法成功率的计算机比较

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-19 DOI: 10.1016/j.ajoms.2025.04.007

Ákos Bicsák , Leandra Esser , Stefan Hassfeld , Lars Bonitz

Objective

We present a comparison of five methods for inferior alveolar nerve blockade (Halsted’s, Fischer’s, Laguardia’s, Szokolóczy-Syllaba’s and Gow-Gates method -as control group) in our three-dimensional virtual model based on the radiological database of our Department.

Methods

The injection canula was modelled as a vector in a coordinate system applied to the skull, a spherical model projected to the mandibular foramen was defined as target zone. The parallelism of these vectors and the targeting accuracy around the mandibular foramen was compared by independent statistician with Fisher’s test with a significance level of α= 5 %.

Results

100 mandibular sides (50 left and 50 right mandibles) were measured in virtual model. There were no significant gender or age differences. In case of the Laguardia method the administration lines deviated in average 10°, in case of the other methods 5° in average. The hit rate at different target radius was worst with the Laguardia’s method than with the others, the results were statistically significant (p < 0.001).

Conclusions

This in-silico model reproduced the literature results of the clinical accuracy (70 %-100 %) of inferior alveolar nerve blockade. Further anatomical studies of the pterygomandibular space are necessary to improve clinical accuracy.

目的以我科放射学数据库为基础，在三维虚拟模型中比较Halsted、Fischer、Laguardia、Szokolóczy-Syllaba和Gow-Gates五种下牙槽神经阻滞方法（作为对照组）。方法将注射管在颅骨坐标系中建模为矢量，将投影到下颌孔的球形模型定义为靶区。通过独立统计学家Fisher检验比较这些载体的平行度和下颌孔周围的瞄准精度，显著性水平为α= 5 %。结果在虚拟模型中测量了100个下颌骨侧面（50个左右下颌骨）。没有明显的性别和年龄差异。在拉瓜迪亚方法的情况下，给药线平均偏差为10°，在其他方法的情况下，平均偏差为5°。在不同目标半径下，拉瓜迪亚方法的命中率比其他方法最差，结果具有统计学意义（p <； 0.001）。结论该计算机模型与文献结果吻合，下肺泡神经阻滞的临床准确率为70 % ~ 100 %。进一步的翼下颌间隙解剖研究是提高临床准确性的必要条件。

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引用次数: 0

Pyostomatitis vegetans associated with ulcerative colitis: A case report 植物性化脓性口炎合并溃疡性结肠炎1例报告

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-18 DOI: 10.1016/j.ajoms.2025.04.009

Hiroyuki Kano , Yusuke Kato , Naoyuki Sato , Mai Nozawa‑Kobayashi , Tadaharu Kobayashi

Pyostomatitis vegetans (PV) is a rare, benign, and chronic disorder of the oral mucosa characterized by the presence of multiple pustules with an erythematous base and is an unusual oral expression of inflammatory bowel disease, such as ulcerative colitis (UC) or Crohn’s disease. Herein, a case of successful treatment for PV associated with UC is described. A 62-year-old male exhibited numerous tiny pustules and shallow erosions fusing to form characteristic “snail track” appearances were noted extensively on the gingiva. He had been diagnosed with UC five years previously and had been treated with steroid suppositories and other medications. Histological examination of a biopsy specimen of the upper left gingiva revealed a diagnosis of PV. Treatment for PV and UC was initiated with ATM therapy in which three antibiotics (amoxicillin, tetracycline and metronidazole) should be co-administered simultaneously three times a day, for two weeks. Then, the patient administered prednisolone at 30 mg/day. Two weeks later, significant improvement of oral mucosal lesions was observed. Although prednisolone was reduced gradually to 5 mg⁄ day after that, the erosions and ulcers of the rectalmucosa were not found endoscopically four months after the administration of systemic corticosteroids. Thereafter, treatment and management of UC was continued by his attending gastroenterologist, and no recurrence of PV has been observed for more than five years after the PV was cured.PV may accompany or precede active UC despite the absence of intestinal symptoms and can be used as a good mucocutaneous sign to determine the occurrence of active UC at an early stage.

植物性化脓性口炎（PV）是一种罕见的、良性的口腔黏膜慢性疾病，其特征是存在多个红斑性脓疱，是炎症性肠病（如溃疡性结肠炎（UC）或克罗恩病）的一种不寻常的口腔表达。本文描述了一个成功治疗PV合并UC的病例。一名62岁男性患者表现出大量细小的脓疱和浅层糜烂，在牙龈上广泛发现并融合形成典型的“蜗牛轨迹”外观。他五年前被诊断为UC，并接受类固醇栓剂和其他药物治疗。左上牙龈活检标本的组织学检查显示PV的诊断。PV和UC的治疗开始于ATM治疗，其中三种抗生素（阿莫西林、四环素和甲硝唑）应同时服用，每天三次，持续两周。然后，患者给予强的松龙30 mg/天。两周后，口腔黏膜病变明显改善。尽管此后泼尼松龙逐渐减少至5 mg / d，但在全身性皮质类固醇治疗4个月后，内窥镜未发现直肠粘膜糜烂和溃疡。此后，他的主治胃肠科医生继续治疗和管理UC， PV治愈后5年多没有复发。尽管没有肠道症状，PV可能伴随或先于活动性UC，可作为早期判断活动性UC发生的良好粘膜皮肤征象。

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引用次数: 0

A unique presentation of spongiotic hyperplasia at the mucogingival junction 牙龈粘膜交界处海绵状增生的独特表现

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-16 DOI: 10.1016/j.ajoms.2025.04.008

Karanbir Sidhu , Kale Wudrich , Matheus de Castro Costa , Amanda Gruza , Marina Lara de Carli , Felipe Fornias Sperandio

Introduction

Spongiotic Gingival Hyperplasia (SGH), previously known as Localized Juvenile Spongiotic Gingival Hyperplasia (LJSGH), has been a subject of nomenclature debate due to its presentation in patients of all ages. SGH is characterized by erythematous, slightly raised plaques or nodules, often localized in the marginal gingiva. This case report presents a unique clinical presentation of Spongiotic Hyperplasia of the Mucogingival Junction (SHMJ), further elucidating SGH's clinical variability, with a particular focus on its differential diagnosis and management, followed by long-term clinical monitoring.

Case Report

A 67-year-old female presented with an asymptomatic, erythematous patch at the mucogingival junction between teeth #21 and #22. Clinical and radiographic examination revealed no signs of periodontal or pulpal infection/necrosis. An excisional biopsy of the lesion revealed marked spongiosis and exocytosis of a diffusely CK19-positive overlying mucosal epithelium. Histological findings were consistent with spongiotic hyperplasia. The lesion showed complete healing at a 9-month follow-up without recurrence.

Conclusion

This case represents a peculiar instance of SHMJ, highlighting the need for heightened clinical awareness of SGH’s atypical presentations. Surgical excision remains the treatment of choice, as conservative periodontal treatments are ineffective. Histological and immunohistochemical analysis aid in definitive diagnosis; long-term follow-up is essential to exclude recurrence.

海绵状牙龈增生症（SGH），以前被称为局限性青少年海绵状牙龈增生症（LJSGH），由于其在所有年龄段的患者中表现出来，一直是命名争议的主题。SGH的特征是红斑，轻微凸起的斑块或结节，通常局限于边缘牙龈。本病例报告提出了粘膜牙龈交界处海绵状增生症（SHMJ）的独特临床表现，进一步阐明了SGH的临床变异性，特别关注其鉴别诊断和治疗，随后进行长期临床监测。病例报告：一名67岁女性，在21号和22号牙齿之间的粘膜交界处出现无症状的红斑斑块。临床及影像学检查未见牙周或牙髓感染/坏死征象。病变的切除活检显示明显的海绵状病变和弥漫性ck19阳性粘膜上皮的胞吐。组织学表现与海绵状增生一致。在9个月的随访中，病变完全愈合，无复发。结论：该病例是SHMJ的一个特殊病例，强调了提高临床对SGH非典型表现认识的必要性。手术切除仍然是治疗的选择，因为保守的牙周治疗是无效的。组织学和免疫组织化学分析有助于明确诊断；长期随访是排除复发的必要条件。

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引用次数: 0

A case of primary squamous cell carcinoma of the submandibular gland responding to chemoradiotherapy 原发性颌下腺鳞状细胞癌放化疗的疗效分析

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-16 DOI: 10.1016/j.ajoms.2025.04.006

Akihiko Nakamura , Tomohiro Hamada , Mizuki Yanagida , Toshiaki Tanaka , Masashi Oe , Tsuguo Sano

Primary squamous cell carcinoma of the submandibular gland is extremely rare. Although surgical resection is recommended for the initial treatment of primary squamous cell carcinoma of the submandibular gland, postoperative loss of oral and maxillofacial function with tumor growth represents a significant concern. We report the case of a patient with primary squamous cell carcinoma of the submandibular gland that responded to chemoradiotherapy. A 72-year-old man was referred to our department with swelling in the right submandibular region. Tissue biopsy resulted in a histopathological diagnosis of squamous cell carcinoma. The patient declined surgery and selected chemoradiotherapy, which proved effective. However, salvage surgery was performed for residual tumor at the primary site. Negative results were obtained for CRTC1/MAML2 fusion, so the diagnosis was primary squamous cell carcinoma of the submandibular gland. Careful follow-up is important because patients with primary squamous cell carcinoma of the submandibular gland has a poor prognosis.

原发性颌下腺鳞状细胞癌极为罕见。虽然手术切除被推荐用于原发性颌下腺鳞状细胞癌的初始治疗，但术后肿瘤生长导致的口腔颌面功能丧失是一个值得关注的问题。我们报告的情况下，病人原发性鳞状细胞癌的下颌骨腺，响应放化疗。一名72岁男性因右下颌下区肿胀而转介至我科。组织活检导致组织病理学诊断为鳞状细胞癌。病人拒绝手术，选择放化疗，证明是有效的。然而，对原发部位的残余肿瘤进行了挽救性手术。CRTC1/MAML2融合阴性，诊断为原发性颌下腺鳞状细胞癌。仔细的随访是很重要的，因为原发性颌下腺鳞状细胞癌患者预后不良。

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引用次数: 0

Metachronous occurrence of Epstein-Barr virus-positive mucocutaneous ulcers suspected to be related to periodontitis: A case report 怀疑与牙周炎有关的eb病毒阳性皮肤粘膜溃疡同时发生1例

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology

Pub Date : 2025-04-11 DOI: 10.1016/j.ajoms.2025.04.001

Yukiko Kusuyama , Rie Irie , Atsuko Niki-Yonekawa , Yoshio Ueno , Nobuo Morita , Yoshihiro Morita , Shinya Takahashi , Kenshin Ohara , Yumi Ito

Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is an Epstein-Barr virus-associated B-cell lymphoproliferative disorder that usually occurs in immunosuppressed patients. In this report, we describe the case of a 75-year-old man who repeatedly developed EBVMCUs at different gingival sites. He had a history of B-cell lymphoma and had achieved remission with chemotherapy 2 years before visiting our hospital. In all three EBVMCUs, radiographic examination revealed alveolar bone resorption beneath the EBVMCUs, and the ulcers regressed after spontaneous loss or extraction of adjacent teeth. Four years after the third appearance, no new lesions emerged, and the periodontal disease was controlled. Histopathological features showed that ulcers in the first and third instances were classical Hodgkin lymphoma-like and that in the second instance was a diffuse large B-cell lymphoma-like EBVMCU. Programmed death-ligand 1 (PD-L1) expression was examined using a PD-L1 antibody (SP142); only the ulcer in the third instance was positive. This case suggests a possible association between EBVMCU and periodontitis and that the past history of chemotherapy can be a risk factor for systemic immunosuppression causing EBVMCU.

eb病毒阳性粘膜皮肤溃疡（EBVMCU）是一种与eb病毒相关的b细胞淋巴增殖性疾病，通常发生在免疫抑制患者中。在这个报告中，我们描述了一个75岁的男性在不同的牙龈部位反复发展ebvmcu的病例。患者既往有b细胞淋巴瘤病史，在来我院就诊前2年通过化疗获得缓解。在所有三个ebvmcu中，x线检查显示ebvmcu下的牙槽骨吸收，溃疡在自发脱落或拔出邻近牙齿后消退。第三次出现后4年未出现新的病变，牙周病得到控制。组织病理学特征显示，第一例和第三例溃疡为典型的霍奇金淋巴瘤样溃疡，第二例为弥漫性大b细胞淋巴瘤样EBVMCU。应用程序性死亡配体1 （PD-L1）抗体（SP142）检测PD-L1表达；只有第三例的溃疡是阳性的。该病例提示EBVMCU与牙周炎之间可能存在关联，并且既往化疗史可能是导致EBVMCU的全身免疫抑制的危险因素。

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