Assessment Of Squamous Cell Carcinoma Research Articles

Assessment of squamous cell carcinoma of the floor of the mouth with magnetic resonance imaging

PurposeWe aimed to use magnetic resonance imaging (MRI) to determine the relationship between the pathological depth of invasion (DOI), undetectability, and tumor thickness of squamous cell carcinoma of the floor of the mouth.Materials and methodsWe retrospectively evaluated the relationship between pathological DOI and MRI detectability, as well as the relationship between pathological DOI and tumor thickness on coronal fat-suppressed contrast-enhanced T1-weighted imaging or coronal T2-weighted imaging.ResultsWe analyzed 30 patients with squamous cell carcinoma of the floor of the mouth; MRI revealed that the pathological DOI of the 11 undetectable lesions (median 2 mm) was smaller than that of the 19 detectable lesions (median 14 mm) (p < 0.001), and the cut-off value was 3 mm (sensitivity, 0.84; specificity, 0.91; area under the curve, 0.89). Tumor thickness on coronal fat-suppressed contrast-enhanced T1-weighted imaging was assessed in all 19 detectable lesions; however, tumor thickness on coronal T2-weighted imaging could not be assessed in eight cases. Tumor thickness on coronal fat-suppressed contrast-enhanced T1-weighted imaging was found to be significantly associated with the pathological DOI.ConclusionsUndetectability on MRI indicates superficial lesions with a pathological DOI value that is less than 3 mm. In detectable lesions, tumor thickness on coronal fat-suppressed contrast-enhanced T1-weighted imaging is associated with pathological DOI.

Differentiation Between Benign and Metastatic Cervical Lymph Nodes Using Ultrasound.

Purpose:The oral cavity is the most common site for squamous cell carcinoma, which has a distinct predilection for lymphatic spread before distant systemic metastasis. The cervical lymph node status is a very important consideration in the assessment of squamous cell carcinoma. Ultrasound is a noninvasive and inexpensive technique that can be used to differentiate between the benign and metastatic nodes. So the aim of this study was to evaluate reliability of ultrasound for such differentiation and to correlate them with histopathological finding.Materials and Methods:A total of 200 lymph nodes from 38 patients histopathologically proven for oral squamous cell carcinoma who underwent surgical neck dissection were considered. The patients underwent ultrasound examination of cervical lymph nodes prior to surgical neck dissection. The lymph nodes were differentiated into benign and metastatic based on the assessment of size, shape, shortest diameter/longest diameter (S/L ratio), margin, and internal architecture, and also the internal echo structure of the lymph nodes and histopathological findings were analyzed.Results:On correlation of ultrasonographic diagnosis with histopathological evaluation for metastatic lymph nodes, the overall accuracy of ultrasonographic analyses was 77.83%, and the sonographic criterion of irregular margin showed the highest predictability followed by the size. The correlation of internal echo structure with histopathological findings was highly variable.Conclusion:The ultrasound parameters such as size, shape, margin, S/L ratio, and internal echo structure might assist in differentiation between benign and metastatic lymph nodes. Combining these findings should raise the accuracy, as each sonographic parameter has some limitation as a sole criterion.

A Comparative Study of CT Scan and MRI in The Assessment of Squamous Cell Carcinoma of The Oral Cavity and Its Cervical Lymph Node Metastasis

Introduction: Squamous Cell Carcinoma (SCC) is the most common head and neck malignancy. To decrease the side effects of treatment and mortality from disease relapse, careful staging for the proper treatment plan is necessary. The main purpose of this prospective study is to compare the diagnostic value of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in oral SCC and its lymph node metastasis in order to represent the proper treatment plan. Materials and Methods: 30 patients (19 men and 11 women) with oral SCC underwent CT and MRI before surgery. Imaging modalities of each study were evaluated individually for tumor size, bone invasion, muscle infiltration. These evaluations were done by two radiologists and an oral-maxillofacial surgeon and verified with histopathology findings as gold standard. The results of the radiological assessment were correlated with the intraoperative and histopathological findings in all patients. Results: CT and MRI have equal potential for detecting the tumor size, perineural invasion and nodal metastasis. The sensitivity and specificity were 50%, 90% for CT in the detection of bone invasion and 90%, 85% for MRI. The sensitivity and specificity were 66.66%, 90.47% for CT in detection of muscle infiltration and 55.55%, 90.47% for MRI. Conclusion: The comparison of these modalities showed no statistically significant difference between CT and MRI. Regarding bone infiltration the sensitivity of CT scan was higher than of MRI, but regarding muscle invasion the spe

Initial staging of squamous cell carcinoma of the oral cavity, larynx and pharynx (excluding nasopharynx). Part I: Locoregional extension assessment: 2012 SFORL guidelines

To set out good practice guidelines for locoregional extension assessment of squamous cell carcinoma of the head and neck (excluding nasopharynx, nasal cavities and sinuses). A critical multidisciplinary review of the literature on locoregional extension assessment of squamous cell carcinoma of the head and neck was conducted, applying levels of evidence in line with the French health authority's (HAS) literature analysis guide of January 2000. Based on the levels of evidence of the selected articles and on work-group consensus, graded guidelines are set out for clinical, endoscopic and imaging locoregional extension assessment of head and neck cancer.

Role of OGG1 Ser326Cys polymorphism and 8-oxoguanine DNA damage in risk assessment of squamous cell carcinoma of head and neck in north Indian population

Squamous cell carcinoma of head and neck (SCCHN), one of the leading cancers worldwide, is most prevalent in Indian sub-continent. The major risk factors involved are smoking and consumption of alcohol, since they provide high free radical generating environment.We studied 8-oxoguanine DNA-glycosylase (OGG1) Ser326Cys polymorphism in 278 SCCHN cases and 278 matched controls by PCR-RFLP and observed that the variant genotype Ser/Cys exhibited an enhanced risk of ∼1.7 folds (OR=1.71, 95% CI=1.20–2.93) and Cys/Cys ∼2.5 folds (OR=2.55, 95% CI=1.29–5.00). Furthermore, we found a significant increase in salivary cell 8-OHdG with respect to Ser/Cys and Cys/Cys genotypes of OGG1 in SCCHN cases, when compared to Ser/Ser and Ser/Cys genotypes of the control population. Our results demonstrate that Ser326Cys variant genotype is associated with an increased risk of SCCHN in north India. Ser326Cys variant genotype was found to accumulate more of 8-OHdG, which may serve as a biomarker for early diagnosis of SCCHN.

Basaloid squamous cell carcinoma of the head and neck: report of 18 cases

To evaluate the clinical course and pathological characteristics of basaloid head and neck squamous cell carcinoma. Retrospective study of 18 cases of basaloid head and neck squamous cell carcinoma. Epidemiological, clinical and histological data were analysed and the Kaplan-Meier test used to estimate survival rates. The majority of lesions were at an advanced stage. These lesions were primarily localised in the larynx, hypopharynx and oropharynx. Routine pre-therapeutic assessment of squamous cell carcinoma was performed. Pathological diagnosis was difficult, although immunostaining was extremely useful. Positive staining for KL1, MNF 116 and 34βE12 and negative immunostaining for chromogranin and synaptophysin were also important factors in obtaining a definitive diagnosis. In the majority of cases, treatment involved surgery and radiotherapy. The five-year survival rate was 5 per cent. Basaloid squamous cell carcinoma is an uncommon head and neck lesion, with a challenging histological diagnosis. These lesions must be carefully monitored due to their aggressive course, and require multimodality treatment.

Magnetic Resonance Imaging Assessment of Squamous Cell Carcinoma of the Anal Canal Before and After Chemoradiation: Can MRI Predict for Eventual Clinical Outcome?

To describe the MRI appearances of squamous cell carcinoma of the anal canal before and after chemoradiation and to assess whether MRI features predict for clinical outcome. Thirty-five patients (15 male, 20 female; mean age 60.8 years) with histologically proven squamous cell cancer of the anal canal underwent MRI before and 6-8 weeks after definitive chemoradiation. Images were reviewed retrospectively by two radiologists in consensus blinded to clinical outcome: tumor size, signal intensity, extent, and TNM stage were recorded. Following treatment, patients were defined as responders by T and N downstaging and Response Evaluation Criteria in Solid Tumors (RECIST). Final clinical outcome was determined by imaging and case note review: patients were divided into (1) disease-free and (2) with relapse and compared using appropriate univariate methods to identify imaging predictors; statistical significance was at 5%. The majority of tumors were ≤T2 (23/35; 65.7%) and N0 (21/35; 60%), mean size 3.75 cm, and hyperintense (++ to +++, 24/35 patients; 68%). Following chemoradiation, there was a size reduction in all cases (mean 73.3%) and a reduction in signal intensity in 26/35 patients (74.2%). The majority of patients were classified as responders (26/35 (74.2%) patients by T and N downstaging; and 30/35 (85.7%) patients by RECIST). At a median follow-up of 33.5 months, 25 patients (71.4%) remained disease-free; 10 patients (28.6%) had locoregional or metastatic disease. Univariate analysis showed that no individual MRI features were predictive of eventual outcome. Early assessment of response by MRI at 6-8 weeks is unhelpful in predicting future clinical outcome.

Accuracy of endoanal ultrasound in the follow-up assessment for squamous cell carcinoma of the anal canal treated with radiochemotherapy

Radiochemotherapy has largely replaced surgery in the treatment for squamous cell cancer of the anal canal. Transanal ultrasonography is well documented as an important investigation method in the management of anal carcinoma. This study aimed to evaluate the accuracy of endoanal ultrasound in the study of the postradiation findings and to distinguish between postradiation fibrosis, residual tumor, and local recurrence. The study enrolled 16 consecutive patients with biopsy-proven squamous carcinoma of the anal canal between 2003 and 2006. All the patients underwent a pretreatment and at least four posttreatment endosonographies, according to the follow-up period. All the patients were treated with the same radiochemotherapy protocol. Nine patients had stage uT2 disease; none had uT3 disease; and seven had uT4 disease. There was no evidence of residual tumor in the T2 group after treatment. In the T4 patients after treatment, ultrasound demonstrated tumor regression or abnormalities considered to be radiation-induced changes rather than residual diseases. Only for three patients was a posttreatment biopsy performed to evaluate recurrence (two uT2 and one uT4). Surgical treatment of recurrence was performed for two uT4 patients. Endoanal ultrasound is a safe and effective method for evaluating and following anal cancer before and after treatment. Experience and evaluation during the period of the ultrasonographic abnormalities could give a clear idea concerning the evolution of the anal tumors treated with radiochemotherapy.

Comparison of 16-slice MSCT and MRI in the assessment of squamous cell carcinoma of the oral cavity

The goal of this retrospective study was to assess the accuracy of 16-slice multislice CT (MSCT) and MRI in staging of patients with primary squamous cell carcinoma (SCC) of the oral cavity. Fifty-two patients with histologically proven primary SCC were examined with contrast enhanced MSCT and MRI at 1.5 T with a combined head and surface neck coil. Image modalities were evaluated in a blinded fashion by two radiologists and an oral-maxillofacial surgeon in consensus concerning tumour depiction, local tumour infiltration and cervical lymph node metastases. Results of the radiological assessment were correlated with the intraoperative and histopathological findings in all patients. 36 of 52 primary tumours (69.2%) were depicted by MSCT while 44 were localized by MRI (84.6%). Regarding muscle infiltration MRI versus MSCT had a sensitivity of 81.8% versus 72.7%, but a low specificity and an accuracy of 63.4% versus 61% and 67.3% versus 63.5%, respectively, were found. There was a trend towards a better detection of bony infiltration by MRI than MSCT with a sensitivity of 100% versus 71.4%, a specificity of 93.3% versus 95.5% and an accuracy 94.2% versus 92.3%, respectively. Detection of cervical lymph node involvement was similar for MRI and MSCT with a sensitivity of 84.2% and 78.9%, a specificity of 63.6% and 75.7% and an accuracy of 71.1% and 76.9%, respectively. For N-staging both methods failed to detect small metastasis. For T-staging MRI was superior to MSCT, because there was a tendency to underestimate the tumour size by MSCT more often (19.4% versus 6.8% by MRI). Therefore, pre-operative MRI is recommended as the basic imaging modality of choice for treatment planning of oral SCC. MSCT is a valid alternative imaging method especially in cases with low patient compliance.

Mutagen sensitivity: Enhanced risk assessment of squamous cell carcinoma

Mutagen sensitivity: Enhanced risk assessment of squamous cell carcinoma

Tumor vascularization, mitotic index, histopathologic grade, and DNA ploidy in the assessment of 114 head and neck squamous cell carcinomas.

Quantification of tumor vascularization recently has been shown to a parameter of potential clinical significance. Several basic and clinical studies have demonstrated that tumor growth correlates significantly with angiogenesis. To determine the utility of quantification of tumor vascularization and mitotic index for the pathobiologic assessment of head and neck squamous cell carcinoma, a prospective study of 114 consecutively recruited primary neoplasms was performed. Tumors were also studied for differentiation, keratinization, nuclear atypia, growth pattern, inflammation, desmoplasia, vascular tumor emboli, and DNA content. In this cohort, tumor vascularization was correlated with mitotic index (P < 0.001), nuclear grade (P = 0.03), presence of tumor emboli in the peripheral microvessels (P = 0.05), and lymph nodal status (P = 0.03). A strong relationship between poor differentiation and high N classification (P < 0.001), differentiation and keratinization (P < 0.001) and tumor cell emboli and clinically involved lymph nodes (P = 0.01) was also observed. Emboli were more rare in laryngeal and oropharynx/oral cavity tumors than in hypopharynx/epilarynx (P = 0.02). This study indicates that tumor vascularization, differentiation, and tumor emboli in peripheral microvessel network are important histologic parameters in the assessment of squamous cell carcinoma of the head and neck.

Clinical assessment of squamous cell carcinoma of the nasal cavity proper.

The subjects were 14 patients with squamous cell carcinoma or undifferentiated carcinoma of the nasal cavity treated at Nihon University Hospital between October 1984 and November 1991, who were followed for at least 3 years. The site of the tumor origin within the nasal cavity was the lateral wall in 8 patients, the nasal septum in three patients, and unknown in three patients. Histologically, there were 13 squamous cell carcinomas in (3 well differentiated, 7 moderately differentiated, and 3 poorly differentiated) and 1 undifferentiated carcinoma. Treatment was by a combination of radiotherapy, chemotherapy, and surgery in 8 cases, a combination of radiotherapy and surgery in 5 cases, and surgery alone in 1 case. The 3-year and 5-year Kaplan-Meier survival rates were 86 and 69%, respectively. A total of 6 patients suffered a recurrence, with local recurrence occurring in 4 patients and pulmonary metastasis in 2 patients. Tumor control was achieved in 3 of the 4 cases of local recurrence by reoperation, and by surgery in 1 of the 2 cases of pulmonary metastasis. The duration of the recurrence-free interval in the patients who developed local recurrences, 18 to 46 months after the completion of the initial course of therapy, was of considerable interest.

Computed tomographic assessment of squamous cell carcinoma of oral and pharyngeal cavities.

Computed tomographic (CT) scans were prospectively obtained on 68 patients with previously untreated stages III and IV squamous cell carcinoma of the oral and pharyngeal cavity. We report herein the results of CT evaluation of primary disease arising in these sites, improvements in contrast-enhancement techniques, and CT assessment of the patient's condition after radiation or chemotherapy treatment.