Cell Carcinoma Of Oral Cavity Research Articles

Photodynamic therapy in treatment of squamous cell carcinoma of oral cavity with chlorine e6 photosensitizer with long-term follow up

Photodynamic therapy is an effective method for treating superficial forms of malignant neoplasms, characterized by a minimal risk of damage to normal tissues. In this study, we presented our experience of treating cancer of the oral mucosa using photodynamic therapy, and analyzed the immediate and long-term results of treatment. 38 patients with squamous cell carcinoma of oral cavity mucosa, with a depth of invasion no more than 7 mm, were included in the study. All patients underwent photodynamic therapy with chlorine e6 based photosensitizer. Photosensitizers were administered intravenously 3 hours before irradiation, at a dosage of 1 mg/kg of the patient’s weight. Photodynamic therapy was performed with the following parameters: P – 1.0 W, Ps – 0.31 W/cm2, E – 300 J/cm2. The area of one irradiation field ranged 1.0-2.0 cm2. Treatment effect was evaluated by RECIST 1.1. Overall survival, cancer-specific survival, and disease-free survival were calculated using Kaplan-Meier curves. Evaluation of adverse events was made by .TCAE 5.0 criteria. At 35 (92.1%) out of 38 cases, complete regression was observed after photodynamic therapy. Among them in 3 out of 35 patients relapse was diagnosed in 11.5 to 43.2 months. The total number of patients who didn’t respond to treatment was 6 (15.8%). Follow-up period was 4.2-87.3 months. (mean 42.9). 34 (89.5%) out of 38 patients are alive, 1 (2.6%) died from progression, and three died from other causes. The 5-year overall survival rate was 82.1%, cancer-specific survival rate was 97.0%, and disease-free survival rate was 81.1%. Among the factors significantly (p < 0.05) influencing relapse-free survival: depth of invasion < 5 mm (p – 0.013) and the presence of leukoplakia (p – 0.007). When assessing cancer-specific survival, factors worsening the prognosis were: age >70 years (p – 0.034) and the presence of leukoplakia (p – 0.007). Photodynamic therapy is an alternative treatment method of oral cancer superficial lesions, in case of proper assessment of primary lesion and in case of possibility of full irradiation of the tumor. Moreover, after using photodynamic therapy, the underlying connective-muscular structures are preserved, which promotes rapid healing with minimal scarring, the functions of the affected organ remain intact, and cosmetic defects do not form.

Expression of Bcl-2 in Squamous Cell Carcinoma of Oral Cavity

Objectives: To investigate the expression of Bcl-2 in squamous cell carcinoma of the oral cavity. Methodology: This descriptive cross-sectional study was conducted at the Department of Histopathology, Pakistan Institute of Medical Sciences, Islamabad, from December 2021 to June 2022. Sixty patients aged 30 to 85 years, of both genders, diagnosed with squamous cell carcinoma of the oral cavity based on histopathology reports, were included. Immunohistochemistry for Bcl-2 was performed and assessed. All results were subsequently analyzed using SPSS Version 20. Results: Out of the 60 cases studied, 36 were males (60%) and 24 were females (40%). The mean age of the patients was 55 years. The most common histological grade was well-differentiated squamous cell carcinoma, accounting for 26 out of 60 cases (43.3%), followed by moderately differentiated squamous cell carcinoma (21/60, 35%). Poorly differentiated squamous cell carcinoma was the least common grade, found in 13 out of 60 cases (21.7%). Bcl-2 expression was positive in 23 patients (38.3%). Regarding grade-wise expression of Bcl-2, there was an increasing expression with increasing grades of oral squamous cell carcinoma: 19% Bcl-2 expression in well-differentiated squamous cell carcinoma, 38% in moderately differentiated squamous cell carcinoma, and 77% in poorly differentiated carcinomas. This demonstrated a significant correlation between Bcl-2 expression and histopathological grades (p value <0.001). Conclusion: In summary, Bcl-2 expression was detected in 38.3% of oral squamous cell carcinoma cases. Its immuno-expression is significantly associated with the histopathological grades of oral squamous cell carcinoma. Therefore, Bcl-2 can be considered an important prognostic marker as well as a potential target for chemoresistance cases through Bcl-2 inhibition.

Effect of Smoking on Survival in patients with Squamous Cell Carcinoma of Oral Cavity

Background: Oral squamous cell carcinoma (OSCC) is a growing disease affecting older men and those without risk factors. It's also increasing in younger individuals. Understanding the disease's evolving patterns and risk factors is crucial for effective management. Tobacco is the primary cause, contributing to 95% of OSCC. New prevention and treatment approaches are possible with genetic markers and environmental triggers. Study Design: A cross-sectional study Place of Study: Chughtai Institute of Pathology, Lahore Study Duration: January 2022 to May 2023 Methodology: A study involving 46 patients with oral squamous cell carcinoma (OSCC) found that tobacco use significantly impacts the long-term prognoses and treatment. The patients underwent extensive surgery and received personalized adjuvant treatment. The study aimed to evaluate the impact of multimodal therapy on patient survival and quality of life. Result: The patient also exhibited the table's traits. Most patients were male. The tongue was the most affected with 26 instances (65%), whereas the buccal mucosa had 10 cases (25%) Floor of mouth (10%). It is highly probable that the mouth was involved. 24% of patients had PT1, 35% had pT2, 11% had pT3, etc. 56% of patients had pathogenic nodal stage pN0, 15% had pN1, 27% had pN2, and 2% had pN3. The median depth of invasion was 10 millimetres, with the smallest margin being six. Conclusion: The research also categorized patients based on age and tobacco consumption, revealing that smokers experience distinct psychological and functional effects. The findings could help tailor OSCC treatment to tobacco-consuming countries like Pakistan. Keywords: Squamous cell carcinoma, survival, Oral cancer, tobacco

Acute Oral Mucositis During Hypo-Fractionated Radiation in Squamous Cell Carcinoma of Oral Cavity

Acute Oral Mucositis During Hypo-Fractionated Radiation in Squamous Cell Carcinoma of Oral Cavity

Prevalence of Squamous Cell Carcinoma of Oral Cavity at Oral and Maxillofacial Surgery Department Dr. Hasan Sadikin Hospital Period of 2019-2020

Background: International Agency Data for Research on Cancer (IARC) in 2018 showed that cancer of the lips and oral cavity was ranked the 17th most common cancer in the world, there were 354,864 new cases of oral cancer in the world and cases of death from oral cancer were 177,384. case. New cases of oral cancer in Indonesia in 2018 were 5,078 cases and cases of death caused by oral cancer were 2,326 cases. Research on the characteristics of squamous cell carcinoma in the oral cavity in Indonesia is still relatively low. Objective: To analyze the prevalence of squamous cell carcinoma patients in the oral cavity at the Department of Oral and Maxillofacial Surgery, Dr. Hasan Sadikin Hospital Bandung from January 2019 to December 2020. Methods: Retrospective observational study by taking medical record data of patients with oral squamous cell carcinoma which had been clarified from histopathological results at the Oral Surgery Clinic, Dr. Hasan Sadikin Bandung. The sampling process was carried out using a purposive sampling method. The variables in this study were age, gender, location of the lesion, histopathological features, duration of the lesion and the complications caused. Data analysis using Microsoft Excel program. Results: The number of respondents aged 25-36 years as many as 4 people or 14%, ages 37-48 years as many as 7 people or 24%, and ages over 48 years as many as 18 people or 62%. There were 12 male patients or 41% and 17 female patients or 59%. Patients with a history of smoking as many as 10 people or 33%, a history of chronic irritation as many as 6 people or 20% and others as many as 14 people or 20%. The results of anatomical pathology showed that patients with poorly differentiated were 0 people or 0%, moderately differentiated were 9 people or 41%, well differentiated were 12 people or 55%, and others were 1 person or 4%. Conclusion: The age criteria of patients with the most squamous cell carcinoma are over 48 years old as many as 18 people or 62%. Based on the gender criteria, the patients with the highest incidence of squamous cell carcinoma tumors were 17 people or 59% female. anatomical pathology well differentiated as many as 12 people or 55%. Keywords: squamous cell carcinoma, oral cancer, patient characteristics

Bipaddle Pectoralis Major Myocutaneous Flap (PMMC) for Complex Composite Oral Cavity Defects: An Experience of a Tertiary Cancer Centre.

Although microvascular free flaps are considered the first choice in head and neck cancer defect reconstruction, their use is limited in developing regions by availability of resources and the expertise .The Bipaddle pectoralis major myocutaneous flap (PMMC flap) is a commonly used flap in head and neck cancer reconstruction, but in literature flap is associated with high incidence of drawbacks including donor site morbidity and added bulk of the flap reducing cosmetics and function. The purpose of the study is to evaluate the Bipaddle PMMC flap reliability, operative technique and outcome in reconstructive head and neck cancer surgery in the era of microvascular free flaps. Its a prospective study in which the records of 50 patients treated with Bippadle PMMC flap reconstruction between January 2022 to July 2022 were systematically collected and reviewed. Data of recipient site, serum albumin, history of adjuvant, recurrence, defect dimension, type of donor site closure, length of hospital stay, postoperative complications and outcomes were analysed. There were 45 males and 5 females with a mean age of 41 years (31-60). Bipaddle PMMC flap reconstruction was done in all patients of advanced squamous cell carcinoma of oral cavity. There were two males with complete necrosis of flap salvaged with latissimus dorsi flap and forehead flap. Minor infections were noted in two female and one male patient, managed conservatively and recovered well with acceptable final outcome. The Bipaddle PMMC flap is reliable for large defects in head and neck reconstructive surgery, particularly when a bulky flap is required to reconstruct composite defects where the lesion is involving the skin. Placing the flap horizontally with inclusion of nipple and areola in most of the patients increased the reach and size of available flap.

Association of E-cadherin with epidermal growth factor receptor in squamous cell carcinoma of oral cavity

Oral cancer is the sixth most common cancer worldwide. Despite new modalities of treatment there has been no significant improvement in mortality and morbidity. E-cadherin responsible for cell-cell adhesion in epithelial tissues. It plays role in establishment and maintenance of polarity and structural integrity. Low expression helps in process of carcinogenesis. Epidermal growth factor receptor (EGFR) overexpression is found in majority of oral squamous cell carcinoma and association have been made between increased expression levels and an aggressive phenotype.To study the association of E-cadherin with epidermal growth factor receptor in different grades of oral squamous cell carcinoma.After taking informed consent from patients 75 cases of OSCC were included in the study and subjected to immunohistochemistry of E-cadherin and EGFR.It was concluded from the study that with decrease in differentiation of OSCC expression of E- cadherin decrease while expression of EGFR increases. On correlating both were found to be inversely proportional to each other.During EMT there is loss of cell adhesion molecules. In our study with decrease differentiation there is loss of E-cadherin. E-Cadherin expression was inversely correlated to EGFR expression.

Paramedian Lateral-angled Mandibulotomy for Resection of Squamous Cell Carcinoma in the Oral Cavity.

Mandibulotomy provides good access for monobloc compartmental resection of squamous cell carcinoma in the proper oral cavity. Various designs of osteotomy have been reported, but few of them have considered the local anatomical conditions, and thus related complications occasionally happen. We devised a paramedian lateral-angled mandibulotomy to reduce the side injuries.

CLO23-042: Clinical Outcomes of Radical Radiotherapy With or Without Chemotherapy in Inoperable Locally Advanced Squamous Cell Carcinoma of Oral Cavity

"CLO23-042: Clinical Outcomes of Radical Radiotherapy With or Without Chemotherapy in Inoperable Locally Advanced Squamous Cell Carcinoma of Oral Cavity" published on 31 Mar 2023 by National Comprehensive Cancer Network.

Photodynamic therapy treatment of oral cavity cancer in patients with comorbidities

We report the experience of radical treatment by photodynamic therapy of patients with squamous cell carcinoma of oral cavity with serious side diseases. Completed treatment of two patients with serious side diseases (HIV infection with associated pulmonary hypertension of high degree and cardiac pathology) suffered from cancer of oral cavity. Extensive surgical treatment and/or aggressive course of chemoradiation therapy were not indicated to them due to concomitant pathology. Both patients were diagnosed with squamous cell carcinoma of oral cavity, with appropriate stage Ist. сT1N0M0. Patients received treatment by photodynamic therapy with chorine photosensitizer in dose 1 mg/kg. Options of photodynamic were: output power – 1.5W, power density – 0.31 W/cm2, light dose – 300 J/cm2. After one time session of photodynamic therapy, in both cases full response was diagnosed (according to RECIST 1.1). In one case the second session of photodynamic therapy was performed due to concomitant disease of oral cavity – multiply lesions of leukoplakia and after was diagnosed full remission of all lesions. Major adverse event was pain during the first 5-7 days after treatment, curable by painkillers. Follow-up (IQR) was 12 and 18 month respectively with no evidence of progression. It is available to avoid extensive surgical treatment and aggressive course of chemoradiation therapy (as an alternative) with the use of photodynamic therapy. Photodynamic therapy is minimally invasive method of radical treatment of localized squamous cell carcinoma of oral cavity with minimal adverse events, and could be especially relevant in patients with serious concomitant diseases.

Head and neck cancer: hypofractionated adjuvant radiation therapy

INTRODUCTION: Effect of adiuvant radiation therapy (RT) on oncologic outcomes is well-known and confirmed by different trials. Optimal time to start RT is 6–8 weeks after surgery. Increasing duration of RT delay beyond that interval leads to decrease in overall survival (OS) and makes loco-regional recurrence (LRC) more probable. However, more than 50% patients do not receive adjuvant treatment in time (Mitra S. et al., 2022). Overall treatment time (77–100 days) is another factor that influences effectiveness of adjuvant RT. In order to keep within that time limits non-conventional regimens of RT can be used.OBJECTIVE: To test safety and feasibility of hypofractionated adjuvant RT in patients with locally advanced squamous cell carcinoma of oral cavity and oropharynx.MATERIALS AND METHODS: Patients with stage III–IV squamous cell carcinoma of oral cavity and oropharynx (n=11) who underwent surgery and have to recieve adjuvant RT in 8 weeks and more after surgery are included. Dose was delivered using Volumetric Modulated Arc Therapy (VMAT) and simultaneous integrated boost.RESULTS: Patients (n=11) completed RT successfully. Surgery-to-RT interval ranges between 9 and 15 weeks. Dose per fraction on high-risk-CTV varies between 2,5 and 2,75 Gy. Acute side-effects (oral mucositis grade II) presented after 27–32 Gy (11–13 fractions) in 9 patient out of 11 and reached maximum (oral mucositis grade III, radiation dermatitis grade II) at the end of the treatment.CONCLUSIONS: Hypofractionated adjuvant RT (VMAT) can be safely used in patients with locally advanced squamous cell carcinoma of oral cavity and oropharynx and local acute toxicity can be controlled.

Immunohistochemical Expression Of Cyclind1 In Conventional Squamous Cell Carcinomaof Oral Cavity.

Oral squamous cell carcinoma (OSCC) is the most common malignant neoplasm of the oral cavity, the incidence of which has significantly increased in the last 10 years. In Pakistan, it is reported to be the most common cancer among men and the second most common in women. Cyclin D1 is a protein involved in cell cycle regulation from G1 phase to S phase. Down regulation of this molecule causes inhibition of cell cycle transition and may lead to carcinogenesis. We studied the expression of Cyclin D1 in biopsies of oral squamous cell carcinoma to evaluate the staining patterns in various grades and sites of the oral cavity. Cyclin D1 was expressed in 53.8% cases of OSCC and showed a significant association with tumour differentiation, with higher intensity staining seen in poorly differentiated cases of OSCC. Thus, Cyclin D1 can be regarded as a marker of malignant potential of OSCC and can help identify cases with poorer outcome.

RECURRENCE FREE SURVIVAL AND PATTERNS OF RECURRENCE IN SQUAMOUS CELL CARCINOMA OF ORAL CAVITY: AN INSTITUTIONAL PERSPECTIVE

Objective: To determine the recurrence-free survival (RFS) in patients with squamous cell carcinoma of oral cavity (OSCC) Methodology: It was a longitudinal study conducted on oncology patients who were diagnosed as having squamous cell carcinoma of the oral cavity and treated in our tertiary care hospital in the department of medical oncology. Patients were followed for the evaluation of disease recurrence. The Chi-square test was used to see the association between outcomes and clinicopathological features of the tumor. Results: Of 97 patients, 85(87.62%) patients had no disease, however, 12(12.37%) patients had residual/recurrent disease in the first post-treatment follow-up scans performed three months after the completion of curative treatment. Subsequent follow-up scans showed disease recurrence in 87(89.69%) patients, out of which 52 (59.77%) had loco-regional disease recurrence while 35(40.22%) patients had combined loco-regional and systemic disease recurrence with lung(n=18) being the most common site of distant metastasis. The mean RFS was 15 months (IQR= 8, 26). Patients with lymph vascular invasion (LVI), perineural invasion (PNI), positive margin, and extranodal extension(ENE) had a significantly higher risk of progressive disease after primary treatment, on follow up scans. The relationships between treatment outcomes and LVI, PNI, positive margin and ENE were statistically significant (p<0.05). Conclusion: Our study shows that there is a higher frequency of recurrence in patients with OSCC among patients with extra nodal extension, lymph vascular and perineural-invasion, and positive margins. Clinical trials are required to identify other poor prognostic factors and the need of developing a prognostic model for risk-stratification of such patients.

Oral cavity adjuvant therapy (OCAT) -a phase III, randomized controlled trial of surgery followed by conventional RT (5 fr/wk) versus concurrent CT-RT versus accelerated RT (6fr/wk) in locally advanced, resectable, squamous cell carcinoma of oral cavity

BackgroundLimited data exists regarding the impact of intensification of adjuvant therapy in resected Oral Cavity Squamous Cell Carcinomas (OCSCC) with adverse prognostic features on histopathology. Patients and methodsThis was a three-arm phase III, randomised trial including patients with resected advanced OCSCC. Randomisation was done in a 1:1:1 ratio: Arm-A- standard adjuvant radiation therapy (RT) 60Gy/30 fractions over 6 weeks versus Arm-B-concurrent chemoradiation versus Arm-C-accelerated radiation therapy (6 d a week). The trial was powered to detect an absolute difference of 10% in 5-year Locoregional Control (LRC). ResultsThe trial was conducted between June 2005 and March 2013. Majority of the patients were males, had T3-T4 disease, had N2–N3 nodal status and had Extra-Capsular Extension (ECE) in nodes. The median follow-up was 95.9 months. There was no difference between the three arms (A versus B versus C) for 10-year locoregional control (LRC): 60.2% versus 61.4% versus 65.7%, p = 0.57; disease free survival (DFS): 37.4% versus 43.9% versus 39.6%, p = 0.40; or Overall Survival (OS): 39.7% versus 46.6% versus 40.4%, p = 0.40. There was no benefit of intensification with either modality in patients with any single adverse pathological factor. A benefit of intensification could be seen in patients with a combination of high-risk features: T3-T4 primary tumours with N2–N3 nodes along with ECE for DFS (Arm B versus Arm A HR) = 0.53, Arm C versus Arm A HR = 0.63) and OS (Arm B versus Arm A HR = 0.58, Arm C versus Arm A HR = 0.60). ConclusionsAll optimally resected OCSCC with adverse features did not benefit from intensification of adjuvant therapy. Only a cohort of patients with a combination of high-risk features are likely candidates for intensification. Clinical trial registrationNCT00193843.

Changes in Body Mass Index Are Associated with Squamous Cell Carcinomas of Oral Cavity, Oropharynx and Larynx: A Case-Control Study in Brazil

Head and neck cancer (HNC) significantly impacts nutritional status because the tumor limits swallowing function. In this sense, it is important to monitor the nutritional status throughout the life of any individual. A multicenter case-control study was carried out to analyze the BMI at 30 years of age, two years before diagnosis and at the time of diagnosis of individuals with oral cavity, oropharynx, and larynx cancers. It was observed that a 5% reduction in BMI during the two years before enrollment was associated with an increased risk of the oral cavity (OR = 3.73), oropharyngeal OR = 5.25), and laryngeal (OR = 5.22). Reduced BMI of more than 5% over two years before diagnosis was associated with HNC. Weight loss remained significant at diagnosis, but it is not possible to exclude reverse causality since most cases are at an advanced stage. BMI monitoring of individuals at potential risk for HNC can promote early diagnosis and nutritional interventions for HNC.

Identification of Extranodal Extension for Patients with Squamous Cell Carcinoma of Oral Cavity in Pretreatment Computed Tomography Using Deep Learning Networks

<h3>Purpose/Objective(s)</h3> Dissociation between clinical and pathologic lymph node status is always noted in patients with squamous cell carcinoma of oral cavity (OSCC), especially at extranodal extension (ENE) status. Also, the lymph node texture after underwent radiotherapy and chemotherapy is considered different and cause difficulty in recognition. We used a deep learning neural network from preoperative computed tomography (CT scan) for accuracy improvement of ENE status for patients with OSCC. <h3>Materials/Methods</h3> Patients who diagnosed as OSCC with in our hospital were enrolled from 2019 to 2022. All enrolled patients underwent curative or salvage ipsilateral/bilateral neck lymph node dissection with preoperative contrast enhanced head and neck CT scan within 30 days before operation. The radiation-oncologist segmented, and annotated lymph nodes based on pathologic reports. Total two hundred and fourteen patients were enrolled, and 196 metastatic lymph nodes were identified from 402 dissected lymph nodes. Positive ENE status found in 130 metastatic lymph nodes. We divided them into two groups: curative treatment and salvage treatment. In curative group, 203 nodes in training set and 60 nodes in testing set. In salvage group 139 nodes in training set and 60 nodes in testing set. We used deep learning neural network (DLNN) of 2 different size input layers (dual-input), with framework of convolutional layers, the model with 74 epochs. <h3>Results</h3> The result AUC is 0.84 on salvage group and 0.82 on curative treatment patients, outperforming 0.69 of clinical experts. Under stratified analysis, patient with higher pathological nodal stage, achieved higher accuracy. <h3>Conclusion</h3> Deep learning algorithm is a useful tool in identification of lymph node ENE status from CT scan for patients with OSCC. Our work proved the deep learning model can also utilize on patient experienced radiotherapy and chemotherapy. The future prospective trial can evaluate the practicality when deploy in clinical decision making.

A Study to Evaluate the Efficacy of Purely Accelerated 6 Fraction-per-Week Radiotherapy in Post-Operative Oral Cavity Squamous Cell Carcinoma

<h3>Purpose/Objective(s)</h3> To determine the efficacy of pure modestly accelerated fractionated radiotherapy (PM-ART) in postoperative setting in patients of squamous cell carcinoma of oral cavity (OCSCC) in terms of Locoregional control (LRC), Overall survival (OS), and Disease-free survival (DFS). <h3>Materials/Methods</h3> 40 post-operative OCSCC patients with one or more high risk features (pT3 or higher, close margins, DOI >10 mm, lymphovascular invasion, perineural invasion, >1 node positive, extra capsular extension) were treated between May 2015 and July 2016 with adjuvant PM-ART alone (60Gy in 30 fractions @ 2Gy per fraction; 6 fractions per week, over 5 weeks by three-dimensional conformal technique on a linear accelerator). Primary endpoint of the present study was to evaluate the efficacy of PM-ART and secondary endpoint was late toxicity assessment. <h3>Results</h3> 40 patients were followed up till July 2021 of which four were lost to follow up. At a Median follow up of 45.5 months (range 4-70 months), 3-year LRC was 75%. Out of 40 patients, 17 patients had expired at the time of analysis of which 3 deaths occurred due to other competing causes after the completion of RT. DFS rate at 3 years was 64.8% and median DFS was 64.2 months; 3-year OS rate was 59%, and median OS was not yet reached. 23 patients were available for evaluation of late toxicity at the time of analysis. Xerostomia and subcutaneous fibrosis were the main late toxicities observed as follows – xerostomia grade 2 in 2 patients (9%), grade 1 in 11 patients (48%), subcutaneous fibrosis grade 2 was seen in 2 patients (9%), and grade 1 in 12 patients (52%). There was no grade 3 or higher late toxicities recorded. <h3>Conclusion</h3> Intensification of treatment by using PM-ART (6 fractions per week) was found to have good locoregional control rates and survival outcomes with acceptable late toxicities and needs to be evaluated in the context of randomized controlled trials to validate the findings.

Prognostic Significance of STING Immunoexpression in Relation to HPV16 Infection in Patients with Squamous Cell Carcinomas of Oral Cavity and Oropharynx.

Infection with HPV16 in cancers of the oral cavity (OCSCC) and oropharynx (OPSCC) is, today, an important etiological and prognostic factor. Patients with HPV-positive OPSCC have a better prognosis than uninfected patients. However, in over 40% of these patients, cancer progression is noticed. Their identification is particularly important due to the ongoing clinical trials regarding the possibility of de-escalation of anticancer treatment in patients with HPV-positive OPSCC. Some studies suggest that there is possibility to differentiate prognosis of HPV16-positive patients by STING (Stimulator of Interferon Genes) immunoexpression. The aim of the present study was to analyze the influence of STING immunoexpression on overall (OS) and disease-free survival (DFS) of patients with HPV16-positive and -negative OCSCC and OPSCC. The study was performed in a group of 87 patients with OCSCC and OPSCC for which in our earlier study active HPV16 infection was assessed by P16 expression followed by HPV DNA detection. To analyze STING immunoexpression in tumor area (THS) and in adjacent stromal tissues (SHS) H score (HS) was applied. In the subgroup with HPV16, active infection patients with tumors with THS had significantly better DFS (p = 0.047) than those without THS. In this subgroup, TSH did not significantly influence OS, and SHS did not significantly correlate with OS and DFS. In the subgroup of patients without active HPV16 infection, THS and SHS also did not significantly influence patients’ survival. Presented results indicated prognostic potential of tumor STING immunoexpression in patients with active HPV16 infection in cancers of oral cavity and oropharynx.

A pro-oxidant combination of resveratrol and copper down-regulates hallmarks of cancer and immune checkpoints in patients with advanced oral cancer: Results of an exploratory study (RESCU 004).

BackgroundOur earlier studies have shown that cell-free chromatin particles (cfChPs) that are released from dying cancer cells are readily internalised by bystander cells leading to activation of two hallmarks of cancer viz. genome instability and inflammation. These hallmarks could be down-regulated by deactivating cfChPs via medium of oxygen radicals generated upon admixing small quantities of the nutraceuticals resveratrol (R) and copper (Cu). In this exploratory study, we investigated whether oral administration of R and Cu (R-Cu) would down-regulate the hallmarks of cancer and immune checkpoints in advanced squamous cell carcinoma of oral cavity (OSCC).Patients and methodsThe study comprised of 25 patients divided into 5 equal groups. Five patients acted as controls; the remaining 20 were given R-Cu in four escalating doses. The lowest dose of R-Cu was 5.6mg and 560ng respectively, and the highest dose was 500mg and 5mg respectively. An initial biopsy was taken from patients at first presentation, and a second biopsy was taken 2 weeks later on the operating table. R-Cu was administered orally twice daily in the intervening period. Confocal microscopy was performed on tumour sections after fluorescent immuno-staining with anti-DNA and anti-histone antibodies to detect presence of cfChPs in the tumour micro-environment (TME). Immunofluorescence analysis was performed for 23 biomarkers representing the 10 Hallmarks of cancer, including 5 immune checkpoints, defined by Hanahan and Weinberg.ResultsConfocal microscopy detected copious presence of cfChPs in TME of OSCC, which were eradicated/deactivated following two-week treatment with R-Cu. Eradication of cfChPs from TME was associated with marked down-regulation of 21/23 biomarkers, including the five immune checkpoints. The lower two doses of R-Cu were more effective than the higher doses. No adverse effects attributable to R-Cu were observed.ConclusionThese results suggest that cfChPs released into TME from dying cancer cells are global instigators for cancer hallmarks and immune checkpoints in surviving cancer cells. The ability of R-Cu to deactivate cfChPs raises the prospect of a novel and non-toxic form of cancer treatment which sans killing of cancer cells, and instead induces healing by down-regulating cancer hallmarks and immune check-points.Clinical Trial Registration http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=19801&EncHid=&userName=CTRI/2018/03/012459.

Study of the expression of CD44 and Bcl-2 in oral squamous cell carcinoma and it’s correlation with histological grading

Introduction :Oral squamous cell carcinoma is one of the most prevalent cancers worldwide, with a global incidence of around 3,54,864 new cases and 1,77,384 deaths every year.Aim :To demonstrate and assess the prognostic significance of the expression of CD44 and Bcl-2 in squamous cell carcinomas of oral cavity by it’s correlation with the histological grade of the tumour.Methodology :This is a hospital based prospective study done over a period of 3 years at Kakatiya Medical College/MGM Hospital, Warangal, Telangana and includes 76 cases diagnosed as OSCC. Immunohistochemistry was done with markers CD44 and BCL2. ResultS:61.9% of WDSCC cases showed weak expression of CD44, 56.3% of MD SCC cases showed moderate expression, 50% of PD SCC cases showed strong expression and 50% showed moderate expression. 71.5% of WD SCC cases showed weak expression of BCL2, 46.9% of MD SCC cases showed moderate expression, 50% of PD SCC cases showed strong expression and 50% showed moderate expression. Conclusion: The present study, has showed that there is significant correlation between the histopathological grade of OSCC and the overexpression of CD44 and Bcl-2.