Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

英文中文

Epithelioid Sarcoma of the Oral Cavity: A Retrospective Clinicopathologic Study of Three Rare Cases 口腔上皮样肉瘤：三例罕见病例的回顾性临床病理学研究

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-07-13 DOI: 10.1016/j.oooo.2024.04.063

Dr. Prokopios P. Argyris , Dr. Ashlie E. Rubrecht , Dr. Elizabeth Ann Bilodeau , Dr. Ioannis Koutlas

Introduction

Epithelioid sarcoma (ES) accounts for <1% of all sarcomas and is characterized by, partial or complete, epithelioid cytologic features and epithelial immunophenotypic properties. Involvement of the oral cavity is rare with only 7 well-documented examples reported to date.

Material and methods

Three archived cases of intraoral ES were retrieved from the files of the authors including information regarding demographics, tumor location, treatment and follow-up.

Results

Among the 3 intraoral ES cases, two were primary, proximal-type, and the third metastatic originating from ES of the right arm. Both primary tumors occurred in females, 17 and 68 years old, and affected the tongue. The clinical features ranged from an asymptomatic, well-demarcated, 0.4 cm, circular macule to a 3.8 cm submucosal mass which caused lingual enlargement. The metastatic ES affected a 39-year-old male presenting as poorly-demarcated, hemorrhagic, violaceous, multinodular growth of the mandibular gingiva/alveolar mucosa. Microscopically, all lesions were characterized by sheets of pleomorphic epithelioid cells with enlarged vesicular nuclei exhibiting coarse chromatin and 1-2 prominent eosinophilic nucleoli, abundant eosinophilic cytoplasm and distinct cytoplasmic borders. A rhabdoid and/or spindle cytomorphology was focally observed. Immunohistochemically, neoplastic cells revealed strong and diffuse positivity for keratins, weak-to-moderate ERG reactivity, and uniform loss of SMARCB1 (INI1). The 68-year-old female was treated with partial glossectomy and remains disease-free 23 months post-surgery. The adolescent female underwent resection of bilateral pulmonary metastases, received chemotherapy, and is currently alive with disease 10 months post-diagnosis. Lastly, the individual with metastatic intraoral ES is alive with disease with notable numerous cutaneous, pulmonary, and skeletal bone metastases.

Conclusions

Although infrequent, intraoral involvement occurs in ES. The epithelioid cytomorphology in conjunction with strong immunoexpression of epithelial markers in ES may cause a diagnostic pitfall. A battery of epithelial and non-epithelial immunohistochemical markers in conjunction to SMARCB1 (INI1), is necessary for the diagnosis.

简介上皮样肉瘤（ES）占所有肉瘤的<1%，具有部分或完全上皮样细胞学特征和上皮免疫分型特性。材料和方法从作者的档案中检索了三例口腔内 ES 的存档病例，包括人口统计学、肿瘤位置、治疗和随访等方面的信息。结果在这三例口腔内 ES 病例中，两例为原发性近端型，第三例为源自右臂 ES 的转移性肿瘤。两例原发性肿瘤患者均为女性，年龄分别为 17 岁和 68 岁，均累及舌头。临床特征从无症状、边界清楚、0.4 厘米的圆形斑丘疹到 3.8 厘米的粘膜下肿块，导致舌体肿大。转移性 ES 感染了一名 39 岁的男性，表现为下颌牙龈/牙槽粘膜分界不清、出血性、暴发性、多结节性生长。显微镜下，所有病变的特征都是成片的多形上皮样细胞，核增大呈水泡状，染色质粗糙，有1-2个突出的嗜酸性核小体，胞质大量嗜酸性，胞质边界清楚。局部可见横纹状和/或纺锤形细胞形态。免疫组化显示，肿瘤细胞的角蛋白呈弥漫性强阳性，ERG反应性弱至中等，SMARCB1（INI1）均匀缺失。这名 68 岁的女性接受了眼睑部分切除术，术后 23 个月仍未复发。这名青少年女性接受了双侧肺转移灶切除术，并接受了化疗，目前在确诊后 10 个月无病生存。最后，一名患有口腔内转移性 ES 的患者目前仍健在，并伴有明显的多处皮肤、肺部和骨骼骨转移。ES的上皮样细胞形态与上皮标记物的强免疫表达相结合，可能会造成诊断上的误区。上皮和非上皮免疫组化标记物与SMARCB1（INI1）的结合是诊断的必要条件。

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引用次数: 0

Benign Myoepithelial Neoplasms of Salivary Glands, Clinicopathologic Features and Review of the Literature 唾液腺良性肌上皮肿瘤、临床病理特征和文献综述

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-07-13 DOI: 10.1016/j.oooo.2024.04.020

Mr. Christopher Hollingsworth, Dr. Rafik Abdelsayed, Dr. Mohammed Bindakhil

Introduction

Myoepitheliomas (ME) are rare, benign neoplasms composed of myoepithelial cells with a highly variable histologic presentation profile; recognized subtypes include spindle, plasmacytoid/hyaline, epithelioid, and clear. This article presents the largest single-center case series with regards to this neoplasm class. Cases were analyzed with emphasis placed on relevant histological presentation, clinical appearance, and demographics. A 15-year literature review is included as a point of comparison.

Materials and Methods

Institutional case series with accompanying 15-year, retrospective literature review.

Results

Institutional Case Series:</em> </strong>The retrospective search revealed 13 cases of myoepithelial salivary gland tumors—9 benign myoepitheliomas & 4 malignant myoepithelial tumors (included for comparison). Tumor morphology was analyzed—epithelioid pattern, 6 cases (4 benign, 2 malignant); spindle cell pattern, 6 cases (4 benign, 2 malignant); plasmacytoid pattern, 7 cases (6 benign, 1 malignant). The characteristics of connective tissue stroma were also analyzed. The stroma was myxoid in 2 cases (1 benign, 1 malignant), fibrous in 5 cases (4 benign, 1 malignant), and necrotic in 2 cases (2 malignant). The difference in reported clinicopathologic characteristics was not statistically significant, except for the presence of mitosis (p=0.001).

Literature Review

The search revealed 139 records. 32 articles including 34 cases were included. Cell morphology and stromal features were analyzed. The pattern of tumor cells included—epithelioid, 9 cases (29%); spindle cell, 13 cases (41%); plasmacytoid, 14 cases (45%). The stroma was myxoid in 11 cases (40%), fibrinous in 9 cases (33.3%), and necrotic in 2 (7.4%) cases.

Conclusions

Rare salivary gland tumors, especially those arising in atypical locations with ambiguous morphological patterns, present a unique diagnostic challenge. Due to myoepithelioma's ability to manifest in the various glandular structures of the head and neck, dental professionals and physicians who encounter head and neck pathology must recognize this entity as part of their differential diagnosis when clinically appropriate

导言肌上皮瘤（ME）是一种罕见的良性肿瘤，由肌上皮细胞组成，组织学表现千变万化；公认的亚型包括纺锤型、浆液性/透明型、上皮样型和透明型。本文介绍了该类肿瘤最大的单中心病例系列。病例分析的重点是相关的组织学表现、临床表现和人口统计学特征。材料与方法机构病例系列，并附有 15 年的回顾性文献综述。结果机构病例系列：</em> </strong>回顾性检索发现了 13 例唾液腺肌上皮肿瘤--9 例良性肌上皮瘤& 4 例恶性肌上皮肿瘤（纳入比较）。对肿瘤形态进行了分析--上皮样型，6 例（4 例良性，2 例恶性）；纺锤形细胞型，6 例（4 例良性，2 例恶性）；浆细胞型，7 例（6 例良性，1 例恶性）。此外，还分析了结缔组织基质的特征。基质呈肌样的有 2 例（1 例良性，1 例恶性），纤维状的有 5 例（4 例良性，1 例恶性），坏死的有 2 例（2 例恶性）。除了有丝分裂（P=0.001）外，临床病理特征的报告差异无统计学意义。共纳入 32 篇文章，包括 34 个病例。对细胞形态和基质特征进行了分析。肿瘤细胞的形态包括：上皮样细胞，9 例（29%）；纺锤形细胞，13 例（41%）；浆细胞，14 例（45%）。结论罕见的唾液腺肿瘤，尤其是那些发生在不典型部位、形态模式模糊的肿瘤，给诊断带来了独特的挑战。由于肌上皮细胞瘤能在头颈部的各种腺体结构中表现出来，牙科专业人员和头颈部病理医生在临床上遇到这种肿瘤时必须将其作为鉴别诊断的一部分。

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引用次数: 0

Histiocytic sarcoma affecting the oral cavity: a clinical, pathologic and molecular study 影响口腔的组织细胞肉瘤：临床、病理和分子研究。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-06-26 DOI: 10.1016/j.oooo.2024.06.014

Objective

To investigate the clinicopathological, immunohistochemical and molecular features of histiocytic sarcomas affecting the oral cavity.

Methods

Pathology files of two institutions were searched for cases of histiocytic sarcoma, and new H&E-stained slides and immunohistochemistry reactions evaluated for diagnosis confirmation. Molecular screening for KRAS and PIK3CA mutations was performed through polymerase chain reaction (PCR) followed by Sanger sequencing. BRAFp.V600E mutation was assessed by pyrosequencing. Clinical data regarding sex, age, tumor location, systemic manifestations, clinical presentation, follow-up time, treatment applied and status at last follow-up were collected from patients' pathology and medical files.

Results

Three cases were retrieved during the period investigated (2000-2023). Two females and one male were affected, with a wide age range, involving the tongue, palate and gingiva. Histopathologically, the neoplasms presented as highly pleomorphic atypical cells distributed diffusely with infiltration of normal structures. All cases demonstrated histiocytic differentiation expressing CD68 and CD163, and a high Ki67 expression. Genetic mutations were evaluated in two cases. One case harboured BRAF-V600E mutation, but not in KRAS and PIK3CA, while the second case did not show mutation in BRAF-V600E, KRAS and PI3KCA. One patient was lost, and two patients died after eight and four months of follow-up.

Conclusion

Histiocytic sarcomas involving the oral cavity are extremely rare, and may represent dissemination of a systemic condition. It has an aggressive biological behaviour with a poor overall prognosis.

目的：研究口腔组织细胞肉瘤的临床病理学、免疫组织化学和分子特征：研究口腔组织细胞肉瘤的临床病理、免疫组化和分子特征：方法：检索两家机构的病理档案，寻找组织细胞肉瘤病例，并对新的 H&E 染色切片和免疫组化反应进行评估以确诊。通过聚合酶链反应（PCR）和桑格测序对 KRAS 和 PIK3CA 基因突变进行分子筛查。BRAFp.V600E突变通过热释光测序进行评估。从患者的病理和医疗档案中收集了有关性别、年龄、肿瘤位置、全身表现、临床表现、随访时间、应用的治疗方法和最后一次随访时的状况等临床数据：在调查期间（2000-2023 年），共检索到 3 个病例。其中两女一男，患者年龄跨度较大，涉及舌、腭和牙龈。从组织病理学角度看，肿瘤表现为高度多形性非典型细胞，呈弥漫性分布，并浸润正常结构。所有病例均表现为组织细胞分化，表达 CD68 和 CD163，Ki67 高表达。对两个病例进行了基因突变评估。其中一个病例存在 BRAF-V600E 突变，但 KRAS 和 PIK3KCA 没有突变，而第二个病例则没有出现 BRAF-V600E、KRAS 和 PI3KCA 突变。一名患者死亡，两名患者分别在随访八个月和四个月后死亡：结论：累及口腔的组织细胞肉瘤极为罕见，可能是全身性疾病的扩散。结论：累及口腔的组织细胞肉瘤极为罕见，可能是全身性疾病的扩散，具有侵袭性生物学行为，总体预后较差。

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引用次数: 0

Multiple expansile radiolucencies with focal radiopacities in both maxilla and mandible 上颌骨和下颌骨均有多发性扩张性放射斑，伴有局灶性放射灶

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-06-25 DOI: 10.1016/j.oooo.2024.06.012

引用次数: 0

The efficacy of CBCT-based radiomics techniques in differentiating between conventional and unicystic ameloblastoma. 基于 CBCT 的放射组学技术在区分传统釉母细胞瘤和单囊釉母细胞瘤方面的功效。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-06-24 DOI: 10.1016/j.oooo.2024.06.010

Xiaoyan Sha, Chao Wang, Senrong Qi, Xiaohong Yuan, Hui Zhang, Jigang Yang

Objective: The aim of this study was to develop a cone beam computed tomography (CBCT) radiomics-based model that differentiates between conventional and unicystic ameloblastoma (AB).

Methods: In this retrospective study, CBCT images were collected from 100 patients who had ABs that were diagnosed histopathologically as conventional or unicystic AB after surgical treatment. The patients were randomly divided into training (70) and validation (30) cohorts. Radiomics features were extracted from the images, and the optimal features were incorporated into 5 models: Logistic Regression, Support Vector Machine, Linear Discriminant Analysis, Random Forest, and XGBoost for prediction of tumor type. Model performance was evaluated using the area under the curve (AUC) from receiver operating characteristic analysis, sensitivity, specificity, accuracy, calibration curves, and decision curve analysis (DCA).

Results: The 20 optimal radiomics features were incorporated into the Logistic Regression (LR) model, which exhibited the best overall performance with AUC = 0.936 (95% confidence interval [CI] = 0.877-0.996) for the training cohort and AUC = 0.929 (95% CI = 0.832-1.000) for the validation cohort. The nomogram combined the clinical features and the radiomics signature and resulted in the best predictive performance.

Conclusions: The LR model demonstrated the ability of radiomics and the nomogram to distinguish between the 2 types of AB and may have the potential to replace biopsies under noninvasive conditions.

目的：本研究旨在开发一种基于锥形束计算机断层扫描（CBCT）的放射组学模型，以区分常规和单囊釉母细胞瘤（AB）：本研究旨在开发一种基于锥形束计算机断层扫描（CBCT）放射组学的模型，以区分传统型和单囊型母细胞瘤（AB）：在这项回顾性研究中，研究人员收集了100名AB患者的CBCT图像，这些患者在手术治疗后经组织病理学诊断为传统型或单囊型AB。这些患者被随机分为训练组（70 人）和验证组（30 人）。从图像中提取放射组学特征，并将最佳特征纳入 5 个模型：逻辑回归模型、支持向量机模型、线性判别分析模型、随机森林模型和 XGBoost 模型用于预测肿瘤类型。使用接收者操作特征分析的曲线下面积（AUC）、灵敏度、特异性、准确性、校准曲线和决策曲线分析（DCA）对模型性能进行评估：训练队列的 AUC = 0.936（95% 置信区间 [CI] = 0.877-0.996），验证队列的 AUC = 0.929（95% 置信区间 [CI] = 0.832-1.000）。提名图结合了临床特征和放射组学特征，具有最佳预测效果：LR模型证明了放射组学和提名图区分2种类型AB的能力，并有可能在无创条件下取代活检。

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引用次数: 0

Relationship of microvascular density and tumor-associated macrophages with orofacial squamous cell carcinoma progression 微血管密度和肿瘤相关巨噬细胞与口面部鳞状细胞癌进展的关系

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-06-24 DOI: 10.1016/j.oooo.2024.06.013

Objective

The current study aimed to investigate the characteristics of tumor-associated macrophages (TAMs) and their association with microvascular density (MVD) in tumor progression in different grades of orofacial squamous cell carcinoma (OSCC) in the Pakistani population.

Study Design

This prospective study included 234 patients with oral cancer reported at different hospitals in Pakistan diagnosed with OSCC. Tumors were graded on the Anneroth grading system and the association between the frequency of TAMs and MVD was examined in vivo. The macrophages visible through immunohistochemistry for CD68 and the microvessels observed through immunohistochemistry for CD34 were manually counted in 3 high-power fields.

Results

The CD68 and CD34 counts were significantly lower in well-differentiated squamous cell carcinoma compared to poorly differentiated squamous cell carcinoma. Linear regression analysis revealed a positive correlation between the area percentage of CD68 immunoreactivity and the grade of the tumor (r = 0.776). Vice versa, a positive correlation also existed between the area percentage of CD34 immunoreactivity and the grade of the tumor (r = 0.690). Pearson correlation revealed a positive association between the TAMs and MVD (r = 0.680; P < .001).

Conclusions

There was an increased population of tumor-associated macrophages and tumor angiogenesis with the increasing grade of orofacial squamous cell carcinoma. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)

本研究旨在调查巴基斯坦人群中肿瘤相关巨噬细胞（TAMs）的特征及其与不同等级口腔鳞状细胞癌（OSCC）肿瘤进展过程中微血管密度（MVD）的关系。这项前瞻性研究纳入了巴基斯坦不同医院报告的 234 名被诊断为 OSCC 的口腔癌患者。根据 Anneroth 分级系统对肿瘤进行了分级，并在体内检测了 TAMs 的频率与 MVD 之间的关联。在 3 个高倍视野中人工计数通过 CD68 免疫组化可见的巨噬细胞和通过 CD34 免疫组化观察到的微血管。与分化不良的鳞状细胞癌相比，分化良好的鳞状细胞癌的 CD68 和 CD34 数量明显较低。线性回归分析显示，CD68 免疫反应的面积百分比与肿瘤的分级呈正相关（r = 0.776）。反之亦然，CD34 免疫反应的面积百分比与肿瘤分级之间也存在正相关（r = 0.690）。皮尔逊相关性显示，TAMs 与 MVD 呈正相关（r = 0.680；< .001）。随着口腔鳞状细胞癌等级的升高，肿瘤相关巨噬细胞的数量和肿瘤血管生成也随之增加。(Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)

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引用次数: 0

Information for Readers 读者信息

IF 2 3区医学 Q1 Dentistry

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-06-20 DOI: 10.1016/S2212-4403(24)00299-2

引用次数: 0

Society Page 社会网页

IF 2 3区医学 Q1 Dentistry

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-06-20 DOI: 10.1016/S2212-4403(24)00298-0

引用次数: 0

Risk factors for temporomandibular disorders: a systematic review of cohort studies 颞下颌关节紊乱症的风险因素：队列研究系统回顾

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-06-19 DOI: 10.1016/j.oooo.2024.06.007

Objective

A systematic review was performed to synthesize and identify risk factors involved in TMD onset.

Study Design

Electronic searches were conducted in PubMed, Web of Science, Scopus, Embase, PsyInfo and Lilacs databases, as well as in three gray literature databases (Google Scholar, ProQuest and Open grey). The studies were blindly assessed by two reviewers and selected by a pre-defined eligibility criterion. Risk of bias of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Cohort Studies. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was evaluated for most related factors.

Results

Twenty-one cohort studies were included. Significant factors were female gender, symptoms of depression and anxiety, perceived stress, sleep quality, symptoms of obstructive sleep apnea and presence of any comorbidity, such as Irritable Bowel Syndrome, lower back pain, headache frequency, tension-type headache, migraine and mixed headache. Moreover, high estrogen and low testosterone levels in utero, greater pain perception, jaw mobility pain, pain during palpation, orofacial anomalies, as well as extrinsic and intrinsic injuries were also significant.

Conclusions

Several factors seems to be involved in TMD onset, however, more studies with standardized methodology are necessary to confirm these findings.

为了综合并确定与 TMD 发病有关的风险因素，我们开展了一项系统性研究。我们在 PubMed、Web of Science、Scopus、Embase、PsyInfo 和 Lilacs 数据库以及三个灰色文献数据库（Google Scholar、ProQuest 和 Open grey）中进行了电子检索。这些研究由两名审稿人进行盲评，并按照预先设定的资格标准进行筛选。纳入研究的偏倚风险采用乔安娜-布里格斯研究所的队列研究批判性评估核对表进行评估。对最相关的因素进行了建议评估、发展和评价分级（GRADE）评估。共纳入 21 项队列研究。其中一些重要因素包括女性性别、抑郁和焦虑症状、感知到的压力、睡眠质量、阻塞性睡眠呼吸暂停症状以及任何合并症，如肠易激综合征、下背痛、头痛频率、紧张型头痛、偏头痛和混合型头痛。此外，子宫内高雌激素和低睾酮水平、更强的疼痛感、下颌活动性疼痛、触诊时疼痛、口面部异常以及外在和内在损伤也有重要影响。TMD 的发病似乎与多种因素有关，但还需要更多采用标准化方法的研究来逐一确认。

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引用次数: 0

Evolving patient privacy standards in publishing and social media 出版和社交媒体中不断演变的患者隐私标准

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology

Pub Date : 2024-06-12 DOI: 10.1016/j.oooo.2024.06.004

引用次数: 0

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