Cases Of Leukoplakia Research Articles

Analysis of serum zinc and copper levels in patients with oral potentially malignant disorders: A cross-sectional study

Aims and Objectives: Copper (Cu) and Zinc (Zn) are the important trace elements that play an important role in various functions of the human body at cellular and molecular level. The purpose of this study was to assess the alterations in serum Cu and Zn levels in oral potentially malignant disorders (OPMDs) and to correlate the variations with the severity and progression of the OPMDs. Materials and Methods: In this institution-based study, 20 of each clinically diagnosed and histopathologically proven cases of leukoplakia (Group 1), oral lichen planus (Group 2), clinically diagnosed cases of oral submucous fibrosis (OSMF) and 20 healthy age and sex matched controls were taken based on the clinical staging. Clinical examination of the selected subjects was carried out and an informed consent was obtained, following which blood samples were collected from the participants. After serum separation, Cu and Zn levels were analyzed using the colorimetric method. Data were sent for the statistical analysis using the Statistical Package for the Social Sciences (SPSS) software, version 21.0. Results: Serum copper levels were increased and zinc levels were decreased in patients with OPMDs when compared to that in the control group. However, gradual increase in the levels of serum Cu was found with the advancing stages of OSMF. No statistical significant relation was observed in the levels of serum Zn with the disease progression in OSMF. Conclusion: Serum Cu and Zn levels can have diagnostic significance in early evaluation of OPMDs. Increased serum Cu levels can be used as a marker of disease progression and severity in OSMF.

Nasalleukoplakia：update on diagnosis and management

Nasal leukoplakia, defined as nasal mucosal grayish white lesion accompanied by adjacent mucosa thickening and hyperemia, is a kind of precancerous lesion. Since a case of nasal septum mucosal leukoplakia reported by Edley in 1955 and 62 cases of nasal leukoplakia reported by Liu Chun-Lin in 1964, few cases were reported. In this review, the pathogenesis, diagnosis and treatment of nasal mucosal leukoplakia are systematically summarized. Attention should be paid to this disease to reduce the possibility of incidence of malignant tumors.

CD8+ and CD163+ infiltrating cells and PD-L1 immunoexpression in oral leukoplakia and oral carcinoma.

Overexpression of inhibitory checkpoint PD1/PD-L1 plays an important role in carcinogenesis and patients prognosis. 70 cases of oral squamous cell carcinoma (OSCC), 23 cases of oral leukoplakia (OLK), and 19 control cases were immunohistochemically stained with anti-PD-L1, -CD8, and -CD163 antibodies. PD-L1 was expressed on dysplastic and subepithelial infiltrating cells of OLK as well as on cancer and tumor-infiltrating cells of OSCC. In OSCC, PD-L1 immunoexpression was significantly increased in comparison to OLK, and control groups. The correlative study showed significant correlations between the immunoexpression of PD-L1 and the number of CD8+, CD163+ cells in both OLK and OSCC groups. We found also significant negative correlation between the number of PD-L1+ infiltrating cells and the number of CD8+ cells in OSCC, and positive correlation between the number of PD-L1+ infiltrating cells and CD163+ cells in OLK and OSCC groups. In conclusion, our study indicate that CD163+ and CD8+ infiltrating cells influence the early and subsequent stages of oral carcinogenesis. We demonstrated also that studied tumors may evade the host immune system by PD-L1 immunoexpression not only on epithelial cells but on infiltrating cells as well.

The expression characteristics and clinical significance of candidate molecular markers in vocal cord leukoplakia

Objective: To investigate the expression of marker proteins in vocal cord leukoplakia, and to find markers for the early stage of diagnosis and prognosis of precancerous lesions. Methods: The study included 119 cases, 68 cases of vocal cord leukoplakia (22 cases with epithelial simple hyperplasia, 46 cases with epithelial dysplasia), and 51 cases of vocal cords benign lesions(31 cases of vocal cord polyps, 20 cases of Reinke's edema). The expression of p53, Ki-67, p21, Survivin, p16, p27, PTEN, c-Myc and vascular endothelial growth factor (VEGF) in vocal cords leukoplakia were detected, vocal cord benign lesions (vocal cord polyps and Reinke's edema) acted as controls, comparing the expression differences of different pathological tissue. Data was analyzed by SPSS 22.0 software. Results: The expression of p53, p16, Ki-67, VEGF in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia did not show significant differences. There was a grading increase in the positive expression of p53, Ki-67 in the vocal cord leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia (p53: χ(2)=13.340, P=0.002, Ki-67: χ(2)=53.386, P=0.000). The expression of p27, PTEN, c-Myc in vocal cord benign lesions and vocal cords leukoplakia with epithelial dysplasia did not show significant differences. There was a grading increase in the positive expression of p21 Survivin in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions (P<0.05). Expression of Survivin in vocal cords leukoplakia with mild-moderate epithelial dysplasia showed a significant increase than those in vocal cord benign lesions (P<0.05). The positive expression grade of p21 showed a rising trend (P=0.073) between the different grades of dysplasia. Conclusion: The positive expression grade of p53, Ki-67, p21 Survivin showed an increase in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions, which might be an implication for evaluating the diagnosis and prognosis of precancerous lesions. Expression of p21 was correlated to the degrees of dysplasia and expression of Survivin showed a significant difference in early stage of epithelial dysplasia contrasting to benign lesions.

Leukoplakia of the Marginal Gingiva: A Report of Two Cases

IntroductionLeukoplakia of the marginal gingivae is uncommon and in most cases reported up to date represents a manifestation of proliferative verrucous leukoplakia. The clinical and pathologic features of two cases of leukoplakia confined to the marginal gingiva are described and their biologic significance is discussed.Case PresentationThe cases involved two female patients, non‐smokers, aged 82 and 57. The lesions clinically appeared as small, well‐demarcated white plaques on the marginal gingiva of posterior teeth. After being totally excised, microscopic examination showed keratosis of unknown significance in the first patient and verrucous hyperplasia in the latter, while immunohistochemistry for p16INK4A was negative for both. There was no recurrence in 7 months and 5 months after excision, respectively.ConclusionA white plaque on the marginal gingiva may be overlooked due to its small size or may be misdiagnosed as frictional keratosis. However, it may represent leukoplakia, a potentially malignant disorder. Therefore, diagnosis and management should follow the established guidelines for leukoplakia.

Expression of p53, epidermal growth factor receptor, c-erbB2 in oral leukoplakias and oral squamous cell carcinomas.

Oral cancer is a leading cause of cancer in India and contributes to 12% deaths worldwide. The identification of high-risk oral premalignant lesions such as leukoplakia and intervention at premalignant stages could result in significant loss of mortality and morbidity among these patients. The most frequently observed genetic aberrations in these lesions are of mutations in p53, c-erbB2, and epidermal growth factor receptor (EGFR). No specific tumor markers have been identified consistently in oral leukoplakias and the available studies show wide variations in their expression. A total of eighty cases were taken up for study which included forty cases of leukoplakia and forty cases of squamous cell carcinomas (SCCs). There was a significant correlation between the expression of markers p53 and EGFR in leukoplakia and SCC. The expression of p53 was correlated between leukoplakia, SCC, and control and was found to be significant (P ≤ 0.001). Similarly, EGFR expression was significant (P ≤ 0.001) between cases of leukoplakia, SCCs, and controls. c-erbB2 was found to be negative though cytoplasmic positivity was observed in a few cases. Similarly, in SCCs, it was observed that lesser the differentiation, more is the expression of both p53 and EGFR. Similarly, a definite correlation was observed between p53 and EGFR (P ≤ 0.001) but not with c-erbB2 (P ≤ 1.000). Thus, the author concludes that p53 and EGFR are useful biomarkers for the diagnosis of leukoplakia and their risk of malignant transformation.

Evaluation of Collagen in Leukoplakia, Oral Submucous Fibrosis and Oral Squamous Cell Carcinomas Using Polarizing Microscopy and Immunohistochemistry

Objectives:Picrosirius red and MMP are capable of degrading extracellular matrix proteins, expressed in lesions such as squamous cell carcinomas. The present study was undertaken with an aim to analyze and compare changes in collagen using Picrosirius red staining under polarizing microscopy and immunohistochemical staining using anti MMP-13 in samples of oral leukoplakia, oral submucous fibrosis and oral squamous cell carcinoma.Materials and Methods:A total of 70 slides were prepared and divided into 3 groups. Group I comprised 10 slides of normal gingival tissue, Group II 40 slides of potentially malignant disorders and Group III 20 slides of well differentiated oral squamous cell carcinoma. Half the slides for each group were stained with Picrosirius red stain and the remainder with antibodies to MMP-13.Rerults:In Group II, MMP-13 connective tissue expression was greater in OSMF as compared to leukoplakia. Group III showed elevated expression among 70% of cases. Picrosirius red staining in Group II cases, showed higher staining Yellow-Orange andGreen-Yellow mature fibers in OSMF than leukoplakia cases while in Group III, 50% OSCC cases showed Green-yellow stained immature thin fibers.Conclusion:In future, therapeutic measures targeted against MMP-13 may inhibit collagenolysis to some extent and delay spread of tumors. An easy and reliable method to determine the state of the stroma in such cases may be Picrosirius red staining with polarizing microscopy.

Detection of salivary heat shock protein 27 by enzyme-linked immunosorbent assay and its correlation with histopathology of oral leukoplakia.

Context:Salivary analytes may be used as biomarkers for translational and clinical applications. Heat shock proteins (Hsps) are ubiquitous, highly conserved proteins found in all prokaryotic and eukaryotic species. Hsp27, a low molecular weight protein, may act as a salivary biomarker. Leukoplakia is the most common oral potentially malignant disorder and various salivary biomarkers such as interleukin-6, 8, tumor necrosis factor-α and MMPs have been detected in it. Oral leukoplakia presents clinically as homogenous and nonhomogenous forms; the microscopic pattern ranges from simple epithelial hyperplasia to carcinoma in situ.Aims:This study aims to detect salivary Hsp27 in oral leukoplakia by enzyme-linked immunosorbent assay (ELISA) and to correlate its expression pattern with histopathology.Materials and Methods:A total of 45 cases had constituted the study group. Salivary Hsp27 levels were assessed by ELISA in histopathologically confirmed cases of oral leukoplakia and were compared with that of healthy volunteers.Statistical Analysis:Mann–Whitney U-test and Spearman's correlation coefficient were used for the detection of Hsp27 and its correlation with mean absorbance levels.Results:The mean absorbance values had shown elevated expression of Hsp27 in oral leukoplakia when compared to that in healthy volunteers.Conclusions:The present study had shown elevated expression of salivary Hsp27 in oral leukoplakia which could be attributed to altered redox potential.

Overexpression of ADAM10 in oral squamous cell carcinoma with metastases

ADAMs (a disintegrin and metalloproteinase) are important mediators of cell signalling events, which play a role in the pathogenesis and progression of cancers. Immunohistochemical method was used to examine the immunoexpression of ADAM10 and microvessel density in 80 cases of oral squamous cell carcinoma (OSCC): without metastases - OSCC M(-) (n = 38), and with metastases - OSCC M(+) (n = 42), in 24 cases of oral leukoplakia (OLK), (15 cases with low-grade dysplasia - OLK-LG, and 9 cases with high-grade dysplasia - OLK-HG), and 19 controls. The immunoexpression of ADAM10 and the mean number of vessels were significantly increased in both groups of OSCC in comparison to both groups of OLK and controls. Moreover, the immunoexpression of ADAM10 and microvessel density were significantly increased in the OSCC M(+) group in comparison to the OSCC M(-) group. No statistically significant differences were found between immunoexpression of ADAM10 and microvessels density in the OLK-LG, OLK-HG, and control cases. In conclusion, the present study revealed overexpression of ADAM10 in OSCCs, especially in OSCC with metastasis. These findings suggest that ADAM10 could potentially contribute to metastases of oral cancer. Although, our findings suggest that ADAM10 may be involved in angiogenesis of OSCC, further studies are required to determine the role of ADAM10 in this process.

Immunohistochemical Study of TGF-β1 in Oral Leukoplakia and Oral Squamous Cell Carcinoma: Correlations Between Clinicopathologic Factors and Overall Survival.

The aim of the present study was to analyze transforming growth factor β1 (TGF-β1) expression in cases of leukoplakia and oral squamous cell carcinoma (OSCC) and to correlate these expression profiles with proliferative labeling index, clinicopathologic factors, and clinical outcome. Clinical data for 24 cases of leukoplakia and 87 cases of OSCC were retrieved from medical records. OSCC tissues were included into tissue microarray blocks and sections of normal mucosa, leukoplakia, and OSCC tissue microarray's were prepared on slides. Immunohistochemistry was used to detect expression of TGF-β1 and Ki67. The expression of TGF-β1 and Ki67 were significantly increased from normal mucosa, through leukoplakia to OSCC. High expression of TGF-β1 correlated with an increase in proliferative labeling index. No association between TGF-β1 expression and the clinicopathologic factors examined was observed. Expression of TGF-β1 also did not associate with clinical outcome in either of groups. Our results suggest that changes in TGF-β1 are associated with the progression of oral carcinogenesis.

Impacts of survivin and caspase-3 on apoptosis and angiogenesis in oral cancer.

The present study aimed to investigate the impact of survivin and caspase-3 on apoptosis and angiogenesis in oral cancer. A total of 16 oral leukoplakia cases accompanied by low-moderate epithelial dysplasia, 12 cases of oral leukoplakia accompanied by severe epithelial dysplasia, 17 cases of high-moderate differentiated oral squamous cell carcinoma and 10 cases of normal oral mucosa were selected. Immunohistochemistry was used to detect the expression levels of survivin, caspase-3, and caspase inhibitor factor VIII in lesions from each group. Terminal deoxynucleotidyl transferase 2'-deoxyuridine, 5'-triphosphate nick end labeling was performed to detect the apoptotic index of oral leukoplakia and cancer tissue. Immunohistochemistry revealed increased expression levels of survivin in oral cancer tissues, as compared with the normal mucosa, whereas the expression of Caspase-3 was decreased during malignant transformation. Microvascular density (MVD) was increased from 28.49±11.87 strips/mm2 (mean ± standard deviation, normal control group) to 91.98±40.20 strips/mm2 (oral cancer group). Therefore, survivin may serve an important role in oral cancer, as its expression was increased in association with a downward trend in caspase-3 expression and apoptotic index, whereas MVD was significantly increased.

Aberrant expression of CK8 in leukoplakia and oral squamous cell carcinoma: an immunohistochemistry study

Introduction: In India, oral cavity cancer contributes to significant morbidity and mortality. Since only few of premalignant lesions turn into cancer and routine histopathology has limited prognostic value, therefore we need to devise methods to ascertain premalignant lesions with high potential for conversion to malignancy, appropriate management and early diagnosis of cancers. Cytokeratin K8 (CK8) may be used as surrogate markers in oral premalignant lesion and cancers, so we conducted the present study with an aim to evaluate & compare expression of CK8 in normal oral mucosa, leukoplakia as well as Oral squamous cell carcinoma (OSCC). Material and Methods: The present study included 107 pathological specimens of histologically proven cases of OSCC (n=19), leukoplakia (n=77) and benign lesions (n=10). All the cases were subjected to immunohistochemistry to check the expression of CK8 antibodies. Correlation was evaluated statistically by Chi-square test. Result: Increased expression of CK8 was seen in OSCC and leukoplakia with dysplasia. No immunoreactivity was seen in benign oral mucosa. Expression of CK8 was significantly correlated with dysplasia and cancer. Conclusion: CK8 can be used as marker of sequential premalignant changes in oral cancers.

Clinicopathological parameters associated with histological background and recurrence after surgical intervention of vocal cord leukoplakia.

Histological examination of biopsy shows usefulness in the diagnosis of vocal cord leukoplakia; however, in considerable amount of cases, the examination cannot provide definitive diagnosis of malignancy from benign conditions such as hyperplasia and dysplasia. The present work therefore was aimed to identify clinicopathological factors and molecular markers predictive of recurrence and malignant transformation of vocal cord leukoplakia.Clinical data of 555 cases of vocal cord leukoplakia enrolled from July 1999 to June 2014 were analyzed. The cohort consisted of keratosis (n = 137), hyperplasia (n = 139), dysplasia (n = 177), and primary (n = 10) and invasive (n = 46) carcinoma. Correlations between patients’ backgrounds, clinicopathological factors, molecular markers (p53, p16, Ki67, cytokeratin, and proliferating cell nuclear antigen), and histology backgrounds were examined using by Pearson Chi-squared or Fisher exact test. Reflux symptom index (RSI) and reflux finding score (RFS) before and after treatment were compared using Wilcoxon signed-rank test. Risk factors for disease recurrence were identified using Cox proportional hazards models of multivariate analysis. Time to recurrence was analyzed using log-rank test of Kaplan–Meier method.In the present cohort, alcohol drinking was found associated with GRBAS grade (P = .0258) and the site (P = .0298) of leukoplakia. For the different disease types, chief complaint (P = .0179), GRBAS grade (P = .0101), mucosal wave (P < .0001), and molecular markers p53 (P < .0001) and Ki67 (P < .0001) were identified as correlates. RSI and RFS were significantly lowered by surgical intervention. A single side of leukoplakia was predictive of a lower risk of recurrence (odds ratio, 0.378; 95% confidence interval, 0.197–0.723; P = .0033). Absence of mucosal wave was associated with a shorter time-to-recurrence (P = .0357).The present work identified clinicopathological factors and molecular markers associated with the different histology of vocal cord leukoplakia, and also the prognostic factor for the low risk of recurrence after surgery.

CHEMOPREVENTIVE EFFECT OF TOPICAL APPLICATION OF S-ALLYLCYSTEINE IN THE MANAGEMENT OF ORAL DYSPLASTIC POTENTIALLY MALIGNANT DISORDERS

INTRODUCTION: Oral potentially malignant disorders (OPMDs) describe mucosal disorders with an increased risk of malignant transformation (MT) to oral squamous cell carcinoma (OSCC). Natural products like garlic represent a promising group of chemopreventive agents. Aged garlic extract (AGE) is one of the most commonly used garlic preparations as it contains more stable organosulfur compounds (OSCs); S-allylcysteine (SAC) is the most abundant organosulfur compound in AGE. SAC has been found to retard the growth of chemically induced and transplantable tumors in several animal models. OBJECTIVES: To evaluate the cancer chemopreventive effect of topically applied S-Allylcysteine in the management of oral dysplastic potentially malignant disorders. MATERIALS AND METHODS:10 subjects with oral dysplastic potentially malignant disorders, as proven clinically and histopathologically, were recruited for this study. They received topical S-Allylcysteine for 1 month, and then the lesions were evaluated both clinically and histopathologically after termination of therapy to assess any alterations in the lesions' size, pain score and mucosal dysplasia. RESULTS: S-allylcysteine was well tolerated by all the patients. After termination of the therapeutic phase (after one month), S-Allylcysteine was found to decrease the pain score in all symptomatic patients. The size of the lesions was also decreased although it was not statistically significant; however, histological improvement was remarkable. Complete histological response was observed in four leukoplakia patients and two lichen planus patients where the mild and moderate dysplastic changes showed histologic remission of dysplasia. However, two leukoplakia cases showed progression in the grade of dysplasia from mild to moderate. CONCLUSIONS: Topical application of S-Allylcysteine is beneficial for the management of dysplasia associated with oral potentially malignant disorders.

P53 Codon 72 Gene Polymorphism Studies and p53 Expression by Immunohistochemistry in Oral Lesions as Risk Factor for Malignancy.

Background:Wild-type p53 nuclear phosphoproteins are critical cell cycle regulatory tumor-suppressor gene. Genetic mutation of p53 gene is common in several head–neck cancers, usually associated with smoking and human papillomavirus (HPV) infection. In India, instead of HPV, tobacco/pan masala chewing is more commonly associated with oral cancer.Aim:The aim of this study was to investigate p53 codon 72 gene polymorphism and expression of p53 by immunohistochemistry (IHC) in oral lesions as a risk factor for its association with malignancy.Materials and Methods:A total of 41 cases of oral lesions comprising 6 cases of leukoplakia and 35 cases of oral squamous cell carcinoma (OSCC), between 30 and 60 years age and tobacco/pan masala chewers were taken. Molecular analysis of p53 codon 72 gene polymorphism was performed by polymerase chain reaction – restriction fragment length polymorphism for Arg/Arg, Arg/Pro, and Pro/Pro. Tissue expression of p53 was done by IHC.Results:Genotype frequencies of 35 carcinoma cases of p53 Arg/Arg, Arg/Pro, and Pro/Pro were 23%, 57%, and 20%, respectively, and six leukoplakia cases of p53 Arg/Arg and Arg/Pro genotype were 50% and 50%, respectively. By IHC for expression of p53 out of 35 cases of OSCC biopsies, 17 (48.57%) had weak staining, 14 cases (40%) showed evidence of p53 protein staining, and four cases (11.42%) showed negative staining. Among six cases of leukoplakia, 3 (50%) showed weak staining and 3 (50%) showed negative results.Conclusion:The findings of the study indicate that there is no significant association between p53 codon 72 gene polymorphism with OSCC and leukoplakia associated with tobacco/pan masala chewing.

Microinvasive oral squamous cell carcinoma- A clinicopathological study

Abstract:Background and objectives: Microinvasive oral squamous cell carcinoma is an early stage malignancy characterized by invasion of superficial lamina propria without invasion of deeper structures. These lesions have a varied clinical presentation, minimal lymphatic involvement and a better prognosis. However, there is no clear consensus on its diagnosis and subsequent management. The aim of this study is to assess the depth of invasion of confirmed cases of microinvasive oral squamous cell carcinoma using special stains and immunohistochemistry with clinical correlation of these lesions.Method: Tissue specimen of clinically diagnosed cases of oral leukoplakia (n=90), oral submucous fibrosis (n=60) and oral carcinoma (n=50) were microscopically evaluated for the presence of microinvasion by two independent examiners. The next step involved confirming the basement membrane breach by using Periodic acid Schiff (PAS) stain for evaluating the integrity of basement membrane. The confirmed cases were assessed using special stain and immunohistochemistry to measure the depth of invasion and were further correlated with the clinical features.Results: A total of 29 cases were confirmed as microinvasive OSCC. These included clinically diagnosed 11 cases of leukoplakia, 7 cases of OSMF and 11 cases of carcinoma. Median age at diagnosis was 46 yrs; males (69%) were more affected than females (31%). The predominant risk factor was tobacco chewing alone (31.03%) which was in the form of gutkha and arecanut; common site was buccal mucosa (76%); predominant clinical presentation was a patch; and histopathology revealed varying grades of epithelial dysplasia. The mean depth of invasion was 31.29 µm (0.03 mm) with the range being 16.91 – 66.6 µm (0.02 – 0.07 mm).Conclusion: The study suggest that depth of invasion could be a reliable marker to assess microinvasion and that severity of epithelial dysplasia is not a pre-requisite for microinvasive carcinoma.Keywords: Microinvasion; Oral squamous cell carcinoma; Epithelial dysplasia; Depth of invasion; Oral leukoplakia; Potentially malignant disorders

Retrospective View of Two Years of Colposcopy Practice in a Gynecologic Clinic in Cotonou

Objective: To analyse the colposcopy results at the Gynaecological Clinic of Houeyiho. Patients and methods: Retrospective, descriptive and analytical studies were conducted by the Clinic of Houeyiho in Cotonou from January 2013 to December 2015. Results: 440 women were received in colposcopy including 251 (57%) referred by health workers for VIA (Visual Inspection with Acetique Acid)/VILI (Visual Inspection with Lugol’s Iodine) abnormalities, forty-seven (47) for abnormal smears (10.7%), thirty-eight (38) for metrorrhagia (8.6%). 10% of cases were mainly concerned with post-therapeutic monitoring (six colposcopies of the vagina fundus after hysterectomy for cervical cancer and four after conization). The average age of patients is 41 years within plus or minus 5 years. Forty (40) cases of Grade 1 Atypical Transformation, twenty-nine (29) cases of Grade 2 Atypical Transformation including two (2) cases of leukoplakia (1 post-conization for CINIII, 1 in a HIV+ patient), ten (10) cases of Grade 1 Atypical Transformation/Grade 2 Atypical Transformation association were recorded. A colposcopy biopsy was performed in 95 patients meaning 21.6% of patients. Five biopsies were realized for a cervical neoplasia suspicion and were sent to Pasteur Cerba laboratory in France for the sake of efficiency and rapidity of results. In Grade 1 Atypical Transformation, 66.6% of CIN1 and condylomata plana were noted. Nevertheless, a case of mucinous adenocarcinoma with metaplasia has been discovered in a TAG1 with a 23-year old patient. In Grade 2 Atypical Transformation, the histology reveals 44.4% of CIN 1, 40.7% of severe dysplasia and 11.1% of carcinomas. Conclusion: The colposcopy may be a good screening method with a good colpo-histology agreement in Cotonou. But it’s relatively expensive (20.000 CFA francs) and the reduced number of colposcopists restricts its use in Benin.

Comparison of effectiveness of Calendula officinalis extract gel with lycopene gel for treatment of tobacco-induced homogeneous leukoplakia: A randomized clinical trial.

Aim:The aim of the study is to assess the efficacy of Calendula officinalis gel as cost-effective treatment modality in comparison to lycopene gel in the treatment of leukoplakia.Materials and Methods:The study comprised of sixty patients of clinically diagnosed and histopathologically confirmed cases of homogeneous leukoplakia which were divided into Group I and Group II with thirty patients each. Group I patients were dispensed C. officinalis extract gel whereas Group II patients were given lycopene gel. The therapy was instituted for 1 month to assess the change in the size of the lesion at the baseline and posttreatment.Results:The results revealed a statistically significant difference in both Group I and Group II when the pre- and post-treatment results were compared in the same group. The mean difference in the reduction in size before and after treatment for Group I was 2.0% ±1.0 cm while for the Group II, it was 1.57% ±0.87 cm. The intergroup comparison for the evaluation of reduction in the size of the lesion did not reveal statistically significant results.Conclusion:C. officinalis extract gel can be effectively used as an alternative to conventional treatment modality.

Immunohistochemical evaluation of p63 and cyclin D1 in oral squamous cell carcinoma and leukoplakia

ObjectivesThere are only a limited number of studies on cyclin D1 and p63 expression in oral squamous cell carcinoma (OSCC) and leukoplakia. This study compared cyclin D1 and p63 expression in leukoplakia and OSCC to investigate the possible correlation of both markers with grade of dysplasia and histological grade of OSCC.Materials and MethodsThe study included a total of 60 cases, of which 30 were diagnosed with OSCC and 30 with leukoplakia, that were evaluated immunohistochemically for p63 and cyclin D1 expression. Protein expression was correlated based on grades of dysplasia and OSCC.ResultsOut of 30 cases of OSCC, 23 cases (76.7%) were cyclin D1 positive and 30 cases (100%) were p63 positive. Out of 30 cases of leukoplakia, 21 cases (70.0%) were cyclin D1 positive and 30 (100%) were p63 positive (P<0.05).ConclusionThe overall expression of cyclin D1 and p63 correlated with tumor differentiation, and increases were correlated with poor histological grades, from well-differentiated to poorly-differentiated SCC. Increased cyclin D1 and p63 expression was associated with the severity of leukoplakia. Based on these results cyclin D1 and p63 products can be a useful tool for improved leukoplakia prognosis.

Detection of HPV16 in tissues of oral leukoplakia by polymerase chain reaction and p16 immunohistochemistry

Background: Globally, India accounts for highest incidence for oral cancer. Potential malignant disorders precede development of oral cancers. Leukoplakia is the one of the most common potentially malignant disorders and tobacco is a known risk factor for oral cancer. Role of viruses in oral carcinogenesis is not yet clear and its association with oral cancer has been a debated topic. The present study was aimed to evaluate the presence of human papillomavirus (HPV) in oral leukoplakia using polymerase chain reaction (PCR) and immunohistochemistry (IHC). Methodology: Fifty clinicopathologically confirmed oral leukoplakia cases were included in the study. Detection of HPV was done using PCR and further validated with IHC. Results: Among 50 subjects with oral leukoplakia, 43 specimens were reported as HPV positive through PCR and IHC confirmed p16 positivity in 5 specimens. Conclusion: Study showed lower a prevalence of HPV in oral leukoplakia. Whenever in doubt, combined tests would often be beneficial for the detection of HPV.