European journal of cancer. Part B, Oral oncology最新文献

Transglutaminase C (TGase C), a family of Ca²⁺-dependent enzymes and an essential component in the cross-linking of peptide bonds, has been found to be a marker of epithelial differentiation with a possible role in cellular apoptosis, extracellular matrix stabilisation and Ca²⁺ binding, thereby having a potential role in tumour growth, differentiation and invasive behaviour. The expression of TGase C was evaluated in normal human salivary glands and their neoplastic lesions which included pleomorphic adenoma (n = 30), Warthin's tumour (n = 5), adenoid cystic carcinoma (n = 10), acinic cell carcinoma (n = 5), mucoepidermoid carcinoma (n = 5) and control tissue specimens of normal oral mucosa and squamous cell carcinoma, using polyclonal antibody, the specificity of which was determined by Western blotting, generated by immunising rabbits with purified transglutaminase. The TGase C was observed in the epithelial cells in the control tissue specimens examined. Pleiomorphic adenoma revealed reaction products in luminal tumour cells, the non-luminal or modified myoepithelial cells and their plasmacytoid variants, squamous metaplastic cells and chondroid cells. Adenoid cystic carcinomas had tumour cells in the luminal cells of tubular and cribriform structures and the acinic cell carcinoma had from low to moderate immunoreactivity in the tumour cell component and a diffuse immunoreactivity in the stroma for TGase C. Mucoepidermoid carcinoma showed no reaction products in the mucous-producing cells, while intermediate and epidermoid cells had immunoreactivity in the cell cytoplasm. As the presence of TGase C in salivary gland tumours was confined to those tumour cells which form the predominant histomorphology in each tumour subtype, it may be suggested that these enzymes may have a potential role in the regulation of cellular function in neoplastic salivary tissues affecting tumour growth, differentiation and neoplastic behaviour.

A rare case of desmoplastic melanoma arising from the maxillary gingiva of a 66-year-old woman is reported. This tumour metastasised to the submandibular lymph node 5 years after extirpation, and local recurrence was observed 2 years later. The gingival tumour showed the histopathological characteristics of desmoplastic melanoma and the metastasised tumour cells were immunohistochemically positive for S-100 protein, neuron specific enolase, HMB-45 highly specific for conventional melanoma, and Fontana—Masson staining. The gingival tumour, originally regarded as benign clinically, was actually a desmoplastic melanoma.

A series of 63 autopsied patients with a history of head and neck squamous cell cancer (HNSCC) is reported with emphasis on the importance of locoregional disease (LRD) versus distant metastasis (DM) in the terminal course of the disease. There were 49 males and 14 females; mean age 64.9 years (range 35–94 years). Locoregional disease was present in 39 patients (62%), in 25 (40%) without tumour at other body sites outside the head and neck region. Distant metastasis was observed in 15 patients (24%); in 12 (19%), it occurred with concomitant LRD. Second primary tumours (SPT) were observed in 20 patients (32%). They occurred in the head and neck region (n = 7; 11%), the lung (n = 9; 14%) and at miscellaneous other sites (n = 4; 6%). Of the 13 patients with SPT outside the head and neck region, 2 had concomitant LRD. 11 patients (17%) died due to other causes, no tumour being found at autopsy. These figures indicate that still a major part of HNSCC patients die with LRD as the single tumour manifestation, which means that improvement of local tumour control will result in a significant therapeutic gain.

In this survey, the experiences with and implications of a revised definition of oral leucoplakia are described. One of the new aspects of the revised definition is the distinction between a provisional, clinical diagnosis and a definitive one for which histopathological examination is required. A prevalence study of white lesions of the oral mucosa among a selected population of 1000 consecutive patients from the Netherlands showed a prevalence of a provisional and definitive diagnosis of oral leucoplakia of 0.6 and 0.2%, respectively. For uniform reporting, a recently proposed classification and staging system has been used to stage leucoplakias with a definitive diagnosis. The use of the revised definition of oral leucoplakia, as well as the classification and staging system, seem very suitable for epidemiological studies.

Orofacial complications are common after radiotherapy to the head and neck, and after chemo-therapy for malignant disease. Mucositis is the most frequent and often most distressing complication, but adverse reactions can affect all other orofacial tissues. This paper discusses the aetiopathogenesis and current means available for preventing, ameliorating and treating these complications, as well as indicating research directions.

Ameloblastoma is the most frequent odontogenic tumour. It occurs mainly in the mandible and grows expansively. The treatment of ameloblastoma, which influences the prognosis, is decided in consideration of many factors, especially the age and size of the tumour. Conservative treatment sometimes leads to the recurrence of tumours and poor prognosis, but the relationships between the prognosis and the cytological features of tumour cells are still unclear. In the present study, we examined the immunohistochemical detection of proliferating cell nuclear antigen (PCNA) in 23 cases of ameloblastoma and evaluated the correlation between the positive index of PCNA and the clinical and histological character. Our results revealed the higher the age of the patient the greater was the incidence of a positive index of PCNA. It was also shown that the mean positive PCNA index in the follicular type (34.56 ± 14.00 S.D.) was higher than that of the plexiform type (24.436 ± 15.74 S.D., P < 0.10). The cystic type showed a low positive PCNA index (14.75 ± 8.41 S.D.). In the follicular type, the localisation of PCNA-positive cells was different according to the histological patterns of tumours. Additionally, the positive indices of the same patient differed at different periods of treatment.

Cytokeratins (CK), the intermediate filament markers for epithelial cells were analysed in 23 squamous cell carcinomas (SCC) of the tongue and 11 SCC of the alveolar mucosa (AM) by SDS-PAGE, immunoblotting and two dimensional gel electrophoresis. Normal human adult ventral tongue expresses CK nos 4, 5, 6, 13, 14, 16 (17) while the dorsal tongue expresses CK nos 1, 5, 6, 10, 14, 16 (17). CK 5 and CK 14 were not detected in a majority of samples and CK 18, a marker of simple epithelia, was aberrantly expressed in 18 samples. Normal human adult AM expresses CK nos 4, 5, 6, 13, 14, 16 (17). Among 11 SCC of AM, CK 4 and CK 5 were detected in only two samples each. CK 1 and CK 10 were aberrantly expressed in nine and one samples, respectively. The basic CKs such as CK 4, 5 and 14 were not expressed in SCC at both these sites while others like CK 1 and 18 were aberrantly expressed. Thus, non-expression of basic keratin, CK 5, of the oral lining epithelia and aberrant expression of simple epithelial keratins seem to be the major events in malignant transformation in the oral epithelia.

Laryngeal cancer is the second most common respiratory cancer after lung cancer. Its incidence is increasing over time in much of the world and this increase is generally accepted to be related to changes in tobacco and alcohol consumption. It is a relatively common cancer in men, but rarer in women. Moreover, interesting new issues have been raised recently about the influence of other possible risk factors. Evidence from epidemiological studies which supports the involvement of new risk factors in the aetiology of larynx cancer, as well as new perspectives in therapy, must be taken into consideration in order to realise primary and tertiary prevention. However, it remains clear that, even as new evidence continues to amass about a wide range of risk factors, primary prevention of the great majority of laryngeal cancers could be achieved by elimination of tobacco smoking and reduction of consumption of alcoholic beverages. With an additional contribution from adoption of a diet rich in fruits and vegetables, the great majority of laryngeal cancer appears to be preventable within our current epidemiological knowledge.

In order to determine the incidence rate of oral lesions associated with chemotherapy, as well as its association with clinical and laboratory parameters and potential risk factors, 50 in-patients with non-Hodgkin's lymphoma or leukaemia under chemotherapy were followed from January 1993 to May 1994. Basal and weekly oral examinations were performed. Clinical and laboratory data were registered. Wilcoxon's rank sum test, chi square test, univariate and multivariate logistic regression analyses were used. 36 individuals with leukaemia and 14 with non-Hodgkin's lymphoma were followed for 158 weeks; mean age was 33 years (range 15–85). Oral lesion incidence rate was 45/100 patients-week. Exfoliative cheilitis and infections (herpes and candidosis) were the most common oral complications, followed by haemorrhagic lesions and mucositis. Haemorrhagic lesions correlated with thrombocytopenia (RR = 30.5). Etoposide administration (RR = 8.6), alkylating agents (RR= 15.6), a prior course of chemotherapy (RR = 23.2) and neutropenia (RR = 4.16) were predictors of mucositis. Oral lesions were a common complication in this study, and a possible association of mucositis with several factors is suggested.

Frequencies of proliferating and cytotoxic lymphocytes from the peripheral blood and tumour tissue of oral cancer patients and healthy individuals were monitored using limiting dilution analysis. Significantly lower precursor frequencies of proliferating lymphocytes were observed in the peripheral blood and tumour tissue of oral cancer patients. A high frequency of natural killer (NK) cells but low cytotoxic T lymphocytes (CTL) was observed in the peripheral blood compartment of oral cancer patients as compared to healthy individuals. A marked reduction in both NK and CTL frequencies in the tumour tissue compared to the peripheral blood was observed. In the tumour tissues, increased percentages of activated CD4⁺ lymphocytes as compared to CD8⁺ lymphocytes were observed. Our results suggest that impaired proliferative and cytotoxic potential of tumour infiltrating lymphocytes may play an important role in the escape of tumour cells from the immune system.