Diagnosis Of Tongue Cancer Research Articles

Grading Classification of Tongue Cancer in Oral Images Using CNN Transfer Learning

- Oral cancer is one of the top 10 diseases in cancer incidence worldwide and its prognosis is not good as early diagnosis is not made and so the survival rate from it has not been improved greatly. Oral cancer occurs most commonly in tongue, floor of mouth, and lower lip and 5-year survival rate is very low at 50% and if diagnosed early, the average time of survival becomes longer. Therefore, to improve the survival rate of oral cancer patients, early diagnosis and discovery and patient habit improvement including smoking are very important. Oral cancer can be diagnosed with imaging equipment like CT and MRI or through invasive biopsy, but it is not easy to make an approach and generally difficult to discover early. Therefore, to identify if early diagnosis would be possible using the intraoral images obtained through ordinary camera, the reliability of tongue cancer grade classification was evaluated by applying deep learning analysis. The collected images of oral cavity were classified into four groups: normal, inflammatory lesion, pre-cancerous lesion, and malignant tumor depending on clinical importance and three (3) types of image pretreatment were applied. In case of deep neural network, Inception-ResNet-v2 was used and 70%(1,307 images) of the pretreated images were used as training data and after image enhancement processing, transfer-learned with SGDM technique. As test data, the remaining 30% data (561 images) were used. In confusion matrix, it appeared that sensitivity was 90.37%, specificity 95.03%, accuracy 93.21%, positive predictability 92.06%, and negative predictability 93.93%, and in ROC curve, AUC was normal because normal was 0.9781, inflammatory lesion 0.9102, precancerous lesion 0.8944, and malignant tumor 0.9688, and the classification performance of inflammatory lesion or pre-cancerous lesion was inferior to that of malignant tumor. The accuracy depending on pretreatment did not show a statistically significant difference in HE-1 and HE-2 compared to standard image. The performance of the diagnostic classifier applying deep learning into intraoral images showed accuracy at the average rate of 82.9% and so showed more excellent performance than the precedent studies using different RGB images. Deep learning study using such RGB images tends to be rapidly commercialized as it has disclosed big data whose images were easy to obtain and that were preclassified and so noninvasive data can be easily obtained unlike biopsy or blood test. Intraoral image does not have preclassified and disclosed big data yet, but have a distortion in an artifact or lesion in obtaining an image and so if we can standardize the image acquisition and organize big data through correct preclassification in cooperation with clinicians although this is limited, it will be helpful for early diagnosis of tongue cancer.

Potential of sonography in diagnosis of tongue tumors

Purpose of the study. An analysis of sonography potential in the primary diagnosis and clinical staging of tongue cancer.Patients and methods. The study included 18 patients aged 40–70 years with tongue tumors. The majority accounted males – 14 (77.7 %). Women were represented by 4 (22.2 %) examinees. Ultrasound examinations were performed using expert-class ultrasound systems with broadband linear multifrequency transducers. Transoral examination with linear transducers required tumor location in the anterior and lateral parts of the oral tongue. During ultrasound examinations we evaluated: tumor shape, tumor invasion depth; tumor sizes – width and thickness; tumor echogenicity and structure; tumor vascularization in Doppler modes. The results were compared with the data of histological examination.Results. Transoral ultrasound examination of patients with tongue cancer allows clear visualization of the tumor and assessment of it’s spread. The study showed that the round shape of tongue tumors prevailed in 13 (72.2 %) patients, the tumor echo structure in 10 (55.5 %) was heterogeneous, the contours were even and clear in the majority of patients – 13 (72.2 %), all tumors showed a reduced acoustic density, the depth of invasion ranged from 2 to 6 mm in 8 (44.4 %) patients and exceeded 6 mm in 6 (33.3 %) patients, which corresponded to stages III and IV of the diseas. Doppler ultrasonography recorded intense intratumoral blood flow in 100 % of cases. In 8 (44.4 %) cases, metastatic lesions of the cervical lymph nodes were observed.Conclusion. Transoral ultrasound diagnosis of tongue cancer is a highly informative, safe and modern method providing surgeons with information that helps in choosing the scope of surgical treatment and in determining the disease prognosis at the preoperative stage. The accuracy of the method was 87 %, the sensitivity was 85 %, and the specificity was 86.2 %.

Two cases of auxiliary diagnosis of tongue cancer using NBI endoscopy

Two cases of auxiliary diagnosis of tongue cancer using NBI endoscopy

Contemplating Resectability.

Suzie loves to talk. A successful mid-thirties businesswoman, she is a self-described social butterfly-which made her diagnosis of tongue cancer even more devastating. She came to the clinic complaining of a lump in her throat, which in most young healthy people turns out to be benign and easily treated. But not for Suzie, who had a very rare salivary tumor arising in the back of her tongue. Its slow growth was both a blessing and a curse; such tumors do not kill people quickly, but they typically require surgery. It would slowly and relentlessly grow until and unless we removed most of her tongue. In head and neck surgery, issues of appearance, identity, function, and communication are the foremost considerations when we decide when, and whether, to operate. As the adage goes, knowing when not to operate is the sine qua non of the wise surgeon. But the inverse is also true.

Evidence that circulating proteins are more promising than miRNAs for identification of patients with squamous cell carcinoma of the tongue.

Despite intense research, squamous cell carcinoma of the tongue remains a devastating disease with a five-year survival of around 60%. Late detection and recurrence are the main causes for poor survival. The identification of circulating factors for early diagnosis and/or prognosis of cancer is a rapidly evolving field of interest, with the hope of finding stable and reliable markers of clinical significance. The aim of this study was to evaluate circulating miRNAs and proteins as potential factors for distinguishing patients with tongue squamous cell carcinoma from healthy controls. Array-based profiling of 372 miRNAs in plasma samples showed broad variations between different patients and did not show any evidence for their use in diagnosis of tongue cancer. Although one miRNA, miR-150, was significantly down-regulated in plasma from patients compared to controls. Surprisingly, the corresponding tumor tissue showed an up-regulation of miR-150. Among circulating proteins, 23 were identified as potential markers of squamous cell carcinoma of the tongue. These findings imply that circulating proteins are a more promising source of biomarkers for tongue squamous cell carcinomas than circulating miRNAs. The data also highlight that circulating markers are not always directly associated with tumor cell properties.

Tongue Cancer

Introduction The tongue have a muscle body on which we can differ four anatomical parts-tip ,lateral borders, root and lower surface. The tongue take part in mechanical processing of food also it is involved of voice formation because its mobility. The tongue cancer is one of the most common intraoral tumor localization in many countries. The oral cancer frequency varies a lot due to the different risk factors. Because of the variety the tongue carcinoma is very serious problem, which affects public health with significant mortality and morbidity rate. Materia and methods In our study we include 43 patients 39 male and 4 female who were diagnosed and receive treatment in University Hospital St.George, Plovdiv, Bulgaria ENT department, in period of 8th years 2009-2016. We divided the patients in: Stage I – 1 patient 2.3% , II – Stage 8 patients 18.6%, III – Stage 10 patients 23.2% , IV – Stage 21 patients 48.8%, tumor recurrence 3 patients – 6.9%. Results After the complex therapy which included radical surgical excision of the primary tumor, neck dissection, palliative surgical treatment, radiotherapy, chemotherapy we can present the following results: In the study period 28 patients has died – 65.1%, 9- recovered after the treatment 20%, for 6 patients 13% we don’t have available data. Eleven patients 25.5 % have survived one year after the treatment, 2 patients 4.6% have survived 2 years after the treatment, 4 patients 9.3% survived 3 years, 9 patients 20.9% over 5 years period. Conclusion: The early diagnosis of tongue cancer give us better chances for the upcoming treatment and results. Very often the diagnosis of tongue cancer is delayed. Many of the cases are diagnosed and admitted in the department with advanced tumors III – IV Stage. Complex therapy can lead to better results rather than separately surgical treatment or radiotherapy especially in the advanced cases III – IV stage.

Folate‑targeted polymeric micelles loaded with superparamagnetic iron oxide as a contrast agent for magnetic resonance imaging of a human tongue cancer cell line.

The aim of the present study was to investigate the feasibility of using folate‑targeted superparamagnetic iron oxide nanoparticles (SPIO) as a magnetic resonance (MR) contrast agent that targets human tongue cancer cells. Folate‑targeted and folate‑free bilayer micelles composed of a diblock copolymer of polyethylene glycol (PEG) and poly‑caprolactone (PCL) that encapsulated SPIO in their hydrophobic core (SPIO‑PEG‑PCL micelles) were synthesized. The cytotoxicity of each set of micelles towards Tca‑8113 cells was examined using methyl thiazolyl tetrazolium (MTT) assays. Tca‑8113 cells were incubated with folate‑free SPIO‑PEG‑PCL micelles and folate‑targeted SPIO‑PEG‑PCL micelles at an Fe concentration of 80µg/ml for 0.5, 1 and 2h. MR imaging was subsequently performed and relative T2 relaxation time was recorded. Endocytosis of each micelle type was observed using Prussian blue staining. The MTT assays demonstrated that varying concentrations of folate‑targeted SPIO‑PEG‑PCL micelles did not result in statistically significant differences in Tca‑8113 cell viability when compared with folate‑free SPIO‑PEG‑PCL micelles (F=0.698; P=0.676). In the MR images obtained, decreased T2‑weighted signal intensity was observed for the folate‑targeted SPIO‑PEG‑PCL and folate‑free SPIO‑PEG‑PCL micelle treatments, particularly after the 2‑h incubation period. However, the folate‑targeted micelles exhibited a significantly greater decrease in signal intensity and a higher relative T2 relaxation time at each time point (P=0.002). In addition, blue intracellular particles were observed in the cells that were incubated with each type of micelle and stained with Prussian blue. However, a greater number of blue particles underwent endocytosis in the folate‑targeted group. Thus, folate‑targeted SPIO‑PEG‑PCL micelles exhibited preferential targeting of Tca‑8113 cells when compared with folate‑free SPIO‑PEG‑PCL micelles, and these results support the potential for these micelles to be used for the early diagnosis of tongue cancer.

Quantitative Diagnosis of Tongue Cancer from Histological Images in an Animal Model.

We developed a chemically-induced oral cancer animal model and a computer aided method for tongue cancer diagnosis. The animal model allows us to monitor the progress of the lesions over time. Tongue tissue dissected from mice was sent for histological processing. Representative areas of hematoxylin and eosin (H&E) stained tissue from tongue sections were captured for classifying tumor and non-tumor tissue. The image set used in this paper consisted of 214 color images (114 tumor and 100 normal tissue samples). A total of 738 color, texture, morphometry and topology features were extracted from the histological images. The combination of image features from epithelium tissue and its constituent nuclei and cytoplasm has been demonstrated to improve the classification results. With ten iteration nested cross validation, the method achieved an average sensitivity of 96.5% and a specificity of 99% for tongue cancer detection. The next step of this research is to apply this approach to human tissue for computer aided diagnosis of tongue cancer.

Fibrous dysplasia mimicking vertebral bone metastasis on 18F-FDG PET/computed tomography in a patient with tongue cancer

A 50-year-old man presented to our hospital with complaints of back pain. He had been following with the diagnosis of tongue cancer for 2 years. The physical examination and laboratory findings were normal. Bone scintigraphy was done to rule out bone metastasis. Bone scintigraphy showed focally increased radiotracer uptake in the fifth thoracal vertebrae and right sixth rib, suspicious for metastasis. 18F-FDG PET-computed tomography was done for metastasis to other organs. On PET images, hypermetabolicfocuswasseenintheregionsdetectedonbonescintigraphy(Figs.1and2).Percutaneoustrucutbiopsywasperformed for the accurate diagnosis, and the diagnosis of fibrous dysplasia (FD) was made after a pathologic examination. Fibrous dysplasia is a benign and slowly progressive disorder in which normal bone is replaced by abnormal fibroosseous tissue [1]. The ribs, femur, tibia, calvarium, long bones, spine, and pelvis are the most frequently involved sites in FD [2]. Patients are often asymptomatic and the disease is detected incidentally on radiologic and scintigraphic examinations made for other reasons. Benign and malign bone conditions can show increased 18F-FDG uptake on PET-computed tomography, and increased FDG uptake may mimic bone metastasis of primary malignancy in cancer patients with FD [2,3]. Bone lesions should be carefully evaluated in patients with known malignancies, and FD should be given as a differential diagnosis.

Tongue cancer after primary radiotherapy for nasopharyngeal carcinoma: Three cases report and literature review

Purpose: Radiation induced cancer is a significant problem that can alter long term survival and quality of life after radiotherapy for nasopharyngeal carcinoma (NPC). Reports detailing radio induced tongue cancer are few. The aim of this study was to analyze clinicopathologic characteristics, treatment outcomes of radio induced tongue cancer developing after successful primary radiotherapy for NPC. Patients and methods: Between 1993 and 2010, 507 patients with non metastatic NPC were treated by radical radiotherapy (70-75Gy) to the nasopharynx and involved lymph nodes with or without chemotherapy. Follow up was performed to evaluate tumor control and to detect late toxicity. We found 9 cases (1.7%) of second malignant tumor with no evidence of primary disease recurrence. Three of these patients (0.6%) had tongue localization. Results: The age of patients at the time of primary radiotherapy was 24, 38 and 47 years. All patients had no history of cigarette smoking and alcohol drinking. The latency between radiotherapy for NPC and the diagnosis of tongue cancer was 36, 39 and 230 months. The three histopathology types were well- or moderately differentiated squamous cell carcinoma. The second tongue cancer occurred at the tongue base in two cases and the junction between the oral and the tongue base in one case. After undergoing treatment for second malignant tumor, one patient had no evidence of disease and two patients had never achieved complete response tumor and were alive with uncontrolled loco-regional disease. Conclusion: Radio-induced tongue cancer is an uncommon complication of external beam radiotherapy for nasopharyngeal carcinoma. The risk may increase with a long term follow up and improved survival. The treatment of this second tumor is not well codified and the prognosis is poor comparatively with primary tongue cancer. Long term follow after treatment for NPC is necessary for early detection of this late complication.

A Case of Deep Venous Thrombosis Occurring After Tongue Cancer Surgery

A 74-year-old woman underwent hemilateral resection of the mobile tongue and right modified radical neck dissection after preoperative chemotherapy following a diagnosis of tongue cancer, T2N1M0. Fever and swelling of the left lower limb occurred 34 days after surgery. Computed tomography (CT) and ultrasonography (US) examinations suggested left femoral venous thrombosis. Immediately, anticoagulant fibrinogenolysis therapy for thrombosis was administered. Thereafter, fever and swelling of the left lower limb gradually subsided without complications such as pulmonary embolism. The presence of cancer, the patient's advanced age, major surgery for 5 hours, and preoperative chemotherapy were considered to the main factors for thrombus formation. To date, the patient's recovery has been good without recurrent thrombosis.

ぼうこう癌にひきつづく舌癌治療中に甲状腺癌を発見した３重複癌の１例

Improved diagnostic and treatment techniques for malignant tumors and increased numbers of elderly patients have led to the detection of greater numbers of multiple primary cancers. We describe our experience with a case of synchronous primary triple cancers. Thyroid cancer was discovered during treatment for tongue cancer, following a bladder cancer.After the diagnosis of tongue cancer, the recurrence of bladder cancer was detected. The recurrent bladder cancer was treated first, followed by the tongue cancer. Radical neck dissection for the tongue cancer revealed occult lymph node metastasis from thyroid cancer. Although thyroidectomy was scheduled to be performed after treatment for the tongue cancer, the second recurrence of bladder cancer was diagnosed. After therapy for this bladder cancer, thyroidectomy was performed.Treatment for synchronous primary triple cancers should be planned to achieve the best outcome for each cancer. Outcome is poorer for patients with multiple primary cancers than for those with single primary cancer. To improve the outcome of synchronous primary cancers, early detection, prompt and effective treatment, and close follow-up of the patient's course, including examination of predilection sites, are considered important.

免疫賦活剤ＯＫ‐４３２により好酸球性血管性浮腫を認めた舌癌患者の１例

Episodic angioedema associated with eosinophilia (EAE) was first reported by Gleich et al. in 1984. Clinical features of EAE include recurrent edema, urticaria, fever, increased body weight, and peripheral eosinophilia. We encountered a patient with EAE during the treatment of tongue cancer and describe the clinical features and mechanism considered responsible for the development of EAE. A 24-year-old man was given a diagnosis of tongue cancer (T 2 N 0 M 0) and underwent partial resection of the tongue. After the operation, the patient received immunochemotherapy, including UFT and OK-432, as well as radiotherapy. Shortly after beginning treatment, localized edema in the limbs and peripheral eosinophilia developed. In addition, because interleukin (IL)-5 and eosinophil cationic protein (ECP) were detected in serum, EAE was diagnosed. The symptoms disappeared after immunochemotherapy and radiotherapy were withdrawn. Because the symptoms became serious after increasing the dose of OK-432 and the patient showed positivity for OK-432 on examination of lymphocyte blastogenesis, EAE in our patient was attributed to OK-432.

A CASE OF SYNCHRONOUS TRIPLE CANCER

A case of synchronous triple cancer which involved the tongue, breast and esophagus was experienced. A 58-year-old woman underwent right partial resection of the tongue with a diagnosis of tongue cancer. This was in stage I showing the histological feature of well-differentiated squamous cell carcinoma. The second neoplasm, a right breast cancer, was diagnosed about two months after the first operation. A modified radical mastectomy was done (stage II), and the solid tubular carcinoma was histologically revealed. Around 4 months after the second operation for breast cancer, poor appetite and a gradual body weight loss occurred, and then 3 months later, an esophageal cancer was detected. Biopsy specimen revealed moderately differentiated squamous cell carcinoma in an advanced stage. It was inoperable. Systemic chemotherapy failed to cure and the patient died 6 months later. In this paper clinical course as well as flow cytometric DNA analysis of this synchronous triple cancer which was performed by using these paraffin-embedded tissues is described. Triple carcinomas seen in the literature are also discussed.

The current state of the tongue cancer treatment

The author points out the importance of early diagnosis of tongue cancer and suggests biopsy of any tongue ulcer that has not healed within 15 days. In this suffering, the regional lymph glands are affected extremely early.