Squamous Cell Carcinoma Lesions Research Articles

A Cross Sectional Study on the Expression of MIB-1 and P16INK4a in Oral Carcinoma in a Tertiary Care Hospital

Background: Oral cancer is one of most prevalent cancer with high morbidity and mortality rate in India. Around 90% are squamous cell carcinomas among the oral cancers. Uncontrolled proliferation of cell is considered to be the key processes of oncogenesis. MIB-1 or Ki67 is expressed in all proliferating cells and used as a tool for estimating the percentage of dividing cells within a tumor. In addition to it, MIB-1 acts as a potentially prognostic marker in oral malignancies. Materials and Methods: Around 100 cases of oral squamous cell carcinoma were assessed for nuclear atypia, mitotic activity and necrosis. For Ki-67, strong nuclear positivity was seen as favorable. There were three grades: 1 for 10–30%, 2 for 30–50%, and 3 for 50% and above. The number of positive cells and staining intensity for p16 (nuclear or/and cytoplasmic staining) were computed. Results: Ki-67 and p16 expressions were seen in oral squamous cell carcinomas that are well, moderately, and poorly differentiated. Ki-67 expression increased when grades rose from well differentiated to poorly differentiated carcinoma. p16 had a better expression in well differentiated carcinoma compared to poorly differentiated carcinoma. The mean mitotic count, were increased in high grade neoplasms. Conclusions: Therefore, the expression of p16 and Ki-67 in malignant lesions of the oral squamous cell carcinoma can be used in conjunction with the histomorphological attributes to research their capacity for proliferation of oral malignancies.

HUMAN PAPILLOMA VIRUS-RELATED ORAL MUCOSAL LESIONS IN TURKEY: A RETROSPECTIVE COHORT STUDY.

The human papillomavirus (HPV) is the aetiological agent of a variety of oral mucosal benign and pre/malignant lesions, which demonstrate a wide range of prevalence according to geographic regions. This study specifically examined the typing of HPV-associated oral mucosal lesions in Turkish patients. The DNA from FFPE blocks of 228 lesions was utilised for this purpose. A total of 87 oral mucosal lesions were classified as benign, 68 as premalignant, and 73 as malignant. DNA from these lesions was amplified using PCR, and genotypes were identified using restriction fragment length polymorphisms (RFLP). HPV DNA was identified in 17 out of 228 patients, indicating a prevalence incidence of 7.4%. In benign oral lesions, the prevalence of HPV DNA was 9.2% (8/87 cases), whereas in premalignant, oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC) lesions, it was 6.9% (9/141 cases). A significant statistical difference was found between patients who tested positive for HPV and those who tested negative in terms of the location of the lesion and the age of the patients (p=0.0097, p=0.02, respectively). This study underscores the considerable prevalence of HPV infection in oral mucosal lesions among individuals in Central Anatolia, Turkey.

From applicator-based (Paris system) implantations to rhinoseptoplasty: the concept of anatomic implantation for interventional radiotherapy in squamous cell carcinoma of the nasal vestibule. Short term results in a monoinstitutional series

Aim: Interventional radiotherapy (IRT) is being increasingly advocated as the standard treatment for the primary lesion in nasal vestibule squamous cell carcinoma (NV-SCC). The respect of the anatomical planes of the nose tip during implantation has been hypothesized to reduce the classical IRT toxicities on the cartilages, such as septal and even alar perforations. The present work describes a monoinstitutional series of NV-SCC treated with an IRT technique that follows the above principle (anatomical implantation), with a focus on IRT toxicities. Methods: All consecutive patients with nasal vestibule (NV) carcinoma treated between March 2022 and October 2023 with IRT on the primary lesion at Azienda Ospedaliera Universitaria di Sassari and Mater Olbia Hospital were included. Results: A total of 15 patients were treated with IRT following the principles of anatomical implantation. The only treatment-related toxicity observed has been the mechanical damage to the skin from the buttons used to stabilize the plastic tubes. Conclusion: IRT with anatomical implantation allows a high nose preservation rate and very good cosmetic results, which appear to be decisive advantages in comparison with traditional surgery, while confirming comparable effectiveness from an oncological point of view. However, in the present series, we describe typical skin toxicity that may have a negative impact on cosmetic results. We propose a new strategy involving the use of a soft medium such as a sponge to protect the skin from damage.

Precise Identification of Oral Cancer Lesions Using Artificial Intelligence.

Dentists, especially those who are not oral lesion specialists and live in rural areas, need an artificial intelligence (AI) system for accurately assisting them in screening for oral cancer that may appear in smartphone images. Not many literatures present a viable model that addresses the needs, especially in the context of oral lesion segmentation in smartphone images. This study demonstrates the use of a deep learning-based AI for simultaneously identifying types of oral cancer lesions as well as precisely outlining the boundary of the lesions in the images for the first time. The lesions of interest were oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) lesions. The model could successfully (1) detect if the images contained the oral lesions, (2) determine types of the lesions, and (3) precisely outline the boundary of the lesions. With future success of our project, patients will be diagnosed and treated early before the pre-cancer lesions can progress into deadly cancerous ones.

The periosteum provides a stromal defence against cancer invasion into the bone.

The periosteum is the layer of cells that covers nearly the entire surface of every bone. Upon infection, injury or malignancy the bone surface undergoes new growth-the periosteal reaction-but the mechanism and physiological role of this process remain unknown1,2. Here we show that the periosteal reaction protects against cancer invasion into the bone. Histological analyses of human lesions of head and neck squamous cell carcinomas (HNSCCs) show that periosteal thickening occurs in proximity to the tumour. We developed a genetically dissectible mouse model of HNSCC and demonstrate that inducible depletion of periosteal cells accelerates cancerous invasion of the bone. Single-cell RNA sequencing reveals that expression of the gene encoding the protease inhibitor TIMP1 is markedly increased in the periosteum at the pre-invasive stage. This increase is due to upregulation of HIF1α expression in the tumour microenvironment, and increased TIMP1 inactivates matrix-degrading proteases, promoting periosteal thickening to inhibit cancer invasion. Genetic deletion of Timp1 impairs periosteal expansion, exacerbating bone invasion and decreasing survival in tumour-bearing mice. Together, these data show that the periosteal reaction may act as a functional stromal barrier against tumour progression, representing a unique example of tissue immunity mediated by stromal cells.

Evaluation of Immunohistochemical Marker Bcl-2 in Epithelial Dysplasia and Squamous Cell Carcinoma of the Oral Cavity.

Squamous cell carcinoma of the oral cavity is the most common malignancy noted globally.Pathogenesis of premalignant and malignant oral lesions is mainly attributed to the alteration in the molecular mechanisms that regulate apoptosis and cell proliferation. B-cell lymphoma gene 2 (Bcl-2) is the anti-apoptotic gene that prolongs cell survival by inhibiting apoptosis and is associated with the aggressive behaviour of malignant tumours. The aim of the study was to evaluate Bcl-2 expression in oral squamous cell carcinoma and dysplastic lesions of the oral cavity and to compare its expression with various grades of dysplasia and carcinoma. A hospital-based cross-sectional study was done on 80 clinically suspected cases of dysplastic and malignant oral cavity lesions received in the histopathology section of the Department of Pathology of Shri BM Patil Medical College Hospital and Research Center, Vijaypura, Karnataka. Out of 80 cases, 40 were squamous cell carcinoma, and 40 were dysplastic lesions of the oral cavity. For each case, two sections measuring 4 μm thickness were prepared. Hematoxylin and eosin staining was performed on one section, and Bcl-2 IHC staining was performed on another. Bcl-2 expression evaluation was done for each case of oral epithelial dysplasia and squamous cell carcinoma. Out of 40 cases of squamous cell carcinoma, 15 were well-differentiated, 22 were moderately differentiated, and three were poorly differentiated. In well-differentiated oral squamous cell carcinoma, Bcl-2 positivity was grade 0 in 66.7% of cases and grade 1 in 33.3% of cases. In moderately differentiated oral squamous cell carcinoma, Bcl-2 positivity was grade 1 in 63.6% of cases and grade 2 in 36.4% of cases. In poorly differentiated oral squamous cell carcinoma, Bcl-2 positivity was grade 1 in 33.3% and grade 2 in 66.7% of cases. Out of 40 cases of dysplastic lesions, 11 cases showed severe dysplasia, 11 cases showed moderate dysplasia and 18 cases showed mild dysplasia. grade 2 positivity was seen in 72.7% of cases of severe dysplasia and 63.6 % of cases of moderate dysplasia. In mild dysplasia, all of the cases showed grade 0 Bcl-2 expression. In poorly differentiated oral squamous cell carcinoma Bcl-2 positivity was high and low in well-differentiated oral squamous cell carcinoma. Bcl-2 expression was higher in severe dysplasia compared to moderate dysplasia, which may indicate aggressive behaviour of tumour in poorly differentiated oral squamous cell carcinoma and severe dysplasia.

Clinical application of endoscopic submucosal dissection for superficially invasive squamous cell carcinoma/high-grade squamous intraepithelial lesion involving the canal anal.

Superficially invasive squamous cell carcinoma (SISCC) and high-grade squamous intraepithelial lesions (HSIL) involving the anal canal are rare, and their surgical management involves local excision. Endoscopic submucosal dissection (ESD) has recently emerged as a promising treatment. This study aimed to evaluate the feasibility and safety of ESD for SISCC and HSIL in the anal canal. All patients diagnosed with SISCC or HSIL in the anal canal who underwent ESD between November 2018 and May2023 were included. Patient age, sex, pathology, human immunodeficiency virus (HIV) status, human papillomavirus (HPV) status, T stage, en bloc rate, and R0 resection rate were analyzed. Ten patients, including two men and eight women, with a median age of 61 (51-68) years were enrolled. All patients were HIV-negative, but five (50%) were HPV-positive. Pathological examination showed tumor stage of two patients as T2, one as T0 of SISCC, and seven as Tis of HSIL. The median specimen and tumor sizes were 24 (6-65) mm and 18 (6-55) mm, respectively. The en bloc and R0 resection rates were 100% and 80%, respectively. No severe complications occurred and no recurrence was observed at the follow-up (median follow-up period, 9 (1-35) months). ESD is a reliable and minimally invasive procedure that enables more individualized treatment options for specific groups. As we were limited by the length of the observation period, the long-term performance of ESD for SISCC and HSIL involving the anal canal requires further investigation.

Effectiveness and Patient Experiences of Rhenium Skin Cancer Therapy for Nonmelanoma Skin Cancer: Interim Results from the EPIC-Skin Study.

Nonmelanoma skin cancer and its treatment represent a significant global cancer burden for health care systems and patients. Rhenium skin cancer therapy (Rhenium SCT) is a novel noninvasive radionuclide nonmelanoma skin cancer treatment, which can be provided in a single outpatient session. The aim of this prospective, multicenter, single-arm, international, phase IV study (EPIC-Skin) is to assess clinic- and patient-reported outcomes of Rhenium SCT as a treatment for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Methods: Eligible patients had biopsy-proven stage I or stage II BCC or SCC lesions no more than 3 mm deep and no larger than 8 cm2 in area. Rhenium SCT resin was applied to an adhesive foil affixed to the target lesion in a single session. Interim efficacy and safety analysis were planned once 50% of target patients had recorded a 6-mo follow-up visit. Primary outcome is the proportion of lesions achieving complete response using modified RECIST. Secondary and other outcome measures include patient-reported quality of life (QoL), treatment comfort, and cosmesis. Results: A total of 182 patients was enrolled and administered Rhenium SCT (50 Gy dose to deepest point of target) to at least 1 BCC or SCC. Of 81 patients who reached the 6-mo posttreatment follow-up, it was found that 97.2% (103/106) of lesions showed complete responses and 2.8% (3/106) had partial responses. Improvements in QoL were also reported, whereas no patients reported any pain or discomfort during treatment. Adverse events were reported in 15.9% (29/182) of patients and were rated grade 1 (n = 19), grade 2 (n = 9), or grade 3 (n = 1). Conclusion: This preliminary analysis of the EPIC-Skin study indicates that Rhenium SCT is safe and effective for the treatment of BCC and SCC and is associated with significant QoL improvements. It will be particularly beneficial for lesions that are difficult to treat surgically because of size and location. It is also beneficial for patients with comorbidities or those unable to receive conventional fractionated radiotherapy.

Management of close/positive margins in cutaneous squamous cell carcinoma of the head and neck: a systematised review

Introduction: The authors reviewed close/positive margins in cutaneous squamous cell carcinoma of the head and neck, ensuing recurrence, regional or systemic metastasis, mortality and follow-up management. Methods: The design was a systematised review from January 2000 to July 2021. The MEDLINE database was searched with 15 articles out of 3104 meeting the inclusion criteria. Pertinent references underpinning the National Comprehensive Cancer Network’s Squamous Cell Skin Cancer Guidelines Version 2.2022 were reviewed. Results: Overall, there were 13,671 cutaneous squamous cell carcinoma lesions. We found pooled rates for positive excision (14.6% at 99% CI [12.97, 16.26]), ensuing recurrence (14.7% at 99% CI [13.51, 15.83]), regional or systemic metastasis (33.8% at 99% CI [33.77, 33.87]), and mortality (46.6% at 99% CI [42.53, 50.65]). Positive excisions most frequently involved the deep margin (73.7%), nose (34.5%) and ear (33.14%). Re-excision of positive margins appeared to confer worse recurrence (35.4%). We found pooled rates for close/positive excision (17% at 99% CI [15.22, 18.84]), ensuing recurrence (17% at 99% CI [15.76, 18.16]), regional or systemic metastasis (30.4% at 99% CI [26.15, 34.73]), and mortality (46.6% at 99% CI [42.53, 50.65]). Mean follow up was 51 months. Surgical re-excision with adequate margins appeared to be most efficacious, followed by radiotherapy. Chemoradiation and chemotherapy appeared less efficacious. Conclusion: Surgical re-excision with adequate margins remains the gold standard for close/positive margins in cutaneous squamous cell carcinoma of the head and neck, followed by radiotherapy.

Analysis of the Ki-67 Proliferation Index in Relation to Tumor, Node, and Metastasis (TNM) Stage in Patients With Oral Cavity Squamous Cell Carcinoma.

Introduction Squamous cell carcinoma (SCC) comprises more than 90% of malignant tumors of the oral cavity, accounting for up to 40% of all malignancies in South Asia. Despite the progress made in cancer management, the five-year survival rate for SCC has remained around 50%. To improve this survival rate, it is essential to understand the tumor's biology at its core. In our study, the Ki-67 proliferation index of tumor cells was analyzed and correlated with the tumor stage, nodal stage, and tumor grade to determine the tumor's biological aggressiveness. Materials and methods The study was conducted in a tertiary care center in South Asia from 2018 to 2022. A total of 50 adult patients with biopsy-proven oral cavity SCC were taken for analysis. The Ki-67 index was assessed in tumor cells using immunohistochemistry. Results Ki-67 was classified into two subcategories: <20% and >20%. Patients with an advanced T stage (T3-T4) have a greater chance of having a higher Ki-67 index (>20%), with p = 0.047. However, there is no statistically significant association between nodal status and tumor grade. Conclusion The Ki-67 proliferation index predicts the behavior of SCC lesions regarding tumor size and invasiveness.

Discovery and validation of combined biomarkers for the diagnosis of esophageal intraepithelial neoplasia and esophageal squamous cell carcinoma

Early diagnosis and intervention of esophageal squamous cell carcinoma (ESCC) can improve the prognosis. The purpose of this study was to identify biomarkers for ESCC and esophageal precancerous lesions (intraepithelial neoplasia, IEN). Based on the proteomic and genomic data of esophageal tissue including previously reported data, up-regulated proteins with copy number amplification in esophageal cancer were screened as candidate biomarkers. Five proteins, including KDM2A, RAD9A, ECT2, CYHR1 and TONSL, were confirmed by immunohistochemistry on ESCC and normal esophagus (NE). Then, we investigated the expression of 5 proteins in 236 participants (60 NEs, 93 IENs and 83 ESCCs) which were randomly divided into training set and test set. When distinguishing ESCC from NE, the area under curve (AUC) of the multiprotein model was 0.940 in the training set, while the lowest AUC of a protein was 0.735. In the test set, the results were similar. When distinguishing ESCC from IEN or distinguishing IEN from NE, the diagnostic efficiency of the multi-protein models were also improved compared with that of single protein. Our findings suggest that combined detection of KDM2A, RAD9A, ECT2, CYHR1 and TONSL can be used as potential biomarkers for the early diagnosis of ESCC and precancerous lesion development prediction. SignificanceCandidate biomarkers including KDM2A, RAD9A, ECT2, CYHR1 and TONSL screened by integrating genomic and proteomic data from the esophagus can be used as potential biomarkers for the early diagnosis of esophageal squamous cell carcinoma and precancerous lesion development prediction.

Squamous Cell Carcinoma Lesion at Fibula Free Flap Donor Site Following Mandible Reconstruction in a Known Case of Carcinoma Mandibular Alveolus: Case Report and Review of Literature

Squamous Cell Carcinoma Lesion at Fibula Free Flap Donor Site Following Mandible Reconstruction in a Known Case of Carcinoma Mandibular Alveolus: Case Report and Review of Literature

Relationship between P16INK4a Overexpression in Human Papillomavirus Infection in High Grade CIN and Cervical Carcinoma

Background: High-risk HPV strains are a well-known contributor to the carcinogenesis of cervical squamous cell carcinoma (SCC). Indeed, there has been a high detection of HPV DNA in SCC and precancerous lesions. Objective: The aim of the study was to assess the Relationship Between Human Papillomavirus Infection and P16INK4a Overexpression in Cervical Squamous Cell Carcinoma. Methodology: This descriptive cross-sectional study was carried out in the Pathology Department of DMC with collaboration of Bangabandhu Sreikh Mujib Medical University (BSMMU), Microbiology Department and Bangladesh Agricultural University (BAU), Mymansingh, during July 2017 to June 2018. A total 50 VIA positive and clinically suspected premalignant and malignant patient’s attendant at DMC included as study population. Colposcopic biopsy specimens were sent to the Department of Pathology, DMCH, for histopathological examination. Some portion of biopsy samples were preserved at -4ºC for HR-HPV DNA detection. Statistical analyses were done by using the SPSS 26.0. Result: Highest number of cases 20 (40%) were in fourth decade and their mean age was found to be 44.20±11.20, ranging from 28 to 67 years. Among 50 positive cases, maximum number of 32 (62%) cases were married between 16 to 20 years of age, 12 (22%) cases were married in less than 15 years of age and 6 (8%) cases were married at more than 20 years of age. The findings of colposcopic examinations of total 50 cases. Common diagnoses were CIN II in 24 (48%) cases, 8(16%) case represented CIN III, Squamous cell carcinoma in 16 (32%) cases and Adeno Carcinoma 2(4%) cases. In comparison of p16 score with cervical lesions in study subjects there were 26 true positive cases and 13 true negative cases. According to p16 score a total 37 (26 true positive+ 11 false positive) cases were p16 positive. Out of which 16(32.0%) and 21(42.0%) were HR-HPV positive and negative respectively. Similarly according to p16 score 13 nevative cases ........

Non-invasive early detection on esophageal squamous cell carcinoma and precancerous lesions by microbial biomarkers combining epidemiological factors in China.

Microbiota may be associated with esophageal squamous cell carcinoma (ESCC) development. However, it is not known the predictive value of microbial biomarkers combining epidemiological factors for the early detection of ESCC and precancerous lesions. A total of 449 specimens (esophageal swabs and saliva) were collected from 349 participants with different esophageal statuses in China to explore and validate ESCC-associated microbial biomarkers from genes level to species level by 16S rRNA sequencing, metagenomic sequencing and real-time quantitative polymerase chain reaction. A bacterial biomarker panel including Actinomyces graevenitzii (A.g_1, A.g_2, A.g_3, A.g_4), Fusobacteria nucleatum (F.n_1, F.n_2, F.n_3), Haemophilus haemolyticus (H.h_1), Porphyromonas gingivalis (P.g_1, P.g_2, P.g_3) and Streptococcus australis (S.a_1) was explored by metagenomic sequencing to early detect the participants in Need group (low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia and ESCC) vs participants without these lesions as the Noneed group. Significant quantitative differences existed for each microbial target in which the detection efficiency rate was higher in saliva than esophageal swab. In saliva, the area under the curve (AUC) based on the microbial biomarkers (A.g_4 ∩ P.g_3 ∩ H.h_1 ∩ S.a_1 ∩ F.n_2) was 0.722 (95% CI 0.621-0.823) in the exploration cohort. Combining epidemiological factors (age, smoking, drinking, intake of high-temperature food and toothache), the AUC improved to 0.869 (95% CI 0.802-0.937) in the exploration cohort, which was validated with AUC of 0.757 (95% CI 0.663-0.852) in the validation cohort. It is feasible to combine microbial biomarkers in saliva and epidemiological factors to early detect ESCC and precancerous lesions in China.

Retrospective Evaluation of Radiological Findings in Patients with Oral Malignancy

Aim: Oral cancer ranks among the most prevalent cancers worldwide. Imaging methods play a vital role in assessing patients. This study aimed to evaluate the age, sex, and localization distribution as well as panoramic and cone-beam computed tomography (CBCT) image findings in patients with oral malignancy with bone involvement. Materials and Method: Patients who were histopathologically diagnosed with malignant oral lesions at Gazi University, Faculty of Dentistry, Department of Oral Pathology between 2009 and 2023 were reviewed. Patients with oral malignancies whose panoramic images or CBCT images were available in the radiology archive were included in this study. Age-sex distribution was recorded. Localization of lesions and radiological features such as internal structures, borders, and effects on surrounding tissues were evaluated. Results: The mean age of the patients was 58.2 years; nine of them were female and thirteen were male. The incidence of malignancies included in this study was higher in men than in women, and the mandible/maxilla ratio was equal. The most common primary tumor was squamous cell carcinoma (SCC) (n=12). SCC lesions caused destruction in the cortical borders of neighboring structures in the region where they were located and showed the potential to spread toward these regions. Mucoepidermoid carcinoma was observed as an unilocular radiolucent lesion with clear borders, and it was determined that it destroyed the cortical bone. Conclusion: Panoramic radiography and CBCT images are valuable imaging methods in the evaluation of bone involvement of oral malignancies.

Multimodal analysis of cfDNA methylomes for early detecting esophageal squamous cell carcinoma and precancerous lesions

Detecting early-stage esophageal squamous cell carcinoma (ESCC) and precancerous lesions is critical for improving survival. Here, we conduct whole-genome bisulfite sequencing (WGBS) on 460 cfDNA samples from patients with non-metastatic ESCC or precancerous lesions and matched healthy controls. We develop an expanded multimodal analysis (EMMA) framework to simultaneously identify cfDNA methylation, copy number variants (CNVs), and fragmentation markers in cfDNA WGBS data. cfDNA methylation markers are the earliest and most sensitive, detectable in 70% of ESCCs and 50% of precancerous lesions, and associated with molecular subtypes and tumor microenvironments. CNVs and fragmentation features show high specificity but are linked to late-stage disease. EMMA significantly improves detection rates, increasing AUCs from 0.90 to 0.99, and detects 87% of ESCCs and 62% of precancerous lesions with >95% specificity in validation cohorts. Our findings demonstrate the potential of multimodal analysis of cfDNA methylome for early detection and monitoring of molecular characteristics in ESCC.

Molecular Classification of Vulvar Squamous Cell Carcinoma and Precursor Lesions Using Immunohistochemistry

Abstract Introduction: Vulvar malignancies are very rare. Two pathogenic pathways have been described in the development of vulvar squamous cell carcinoma.One is related to HPV infection and the other is related to TP 53 mutation. HPV infection related squamous cell carcinomas have a good prognosis and squamous cell carcinomas related to TP 53 mutation have the worst prognosis. Recently a third pathway which is neither HPV dependent nor p53 mutant has been identified. This pathway is found to have intermediate prognosis with better clinical outcome. Aims: The aim of this study was to classify vulvar squamous cell carcinoma and its precursor lesions molecularly using two immunohistochemical stains p16 and p53 in a cohort of South Indian population. Subjects and Methods: A retrospective observational study was conducted between January 2011 and December 2020 in the department of histopathology at a tertiary care hospital in Hyderabad, India. A total of 22 cases including all the vulval biopsies with suspected squamous cell carcinoma or precursor lesions and excision specimens operated for squamous cell carcinoma were included in this study. Paraffin blocks of representative cases were stained with hematoxylin and eosin stain, p16 and p53 immunohistochemistry (IHC) stains. Results: Out of 22 cases, two cases (9.0%) were precursor lesions of the vulva and 20 cases (90.9%) were invasive squamous cell carcinoma. Eleven (50%) of these cases were p53 mutant (p53+/p16−), 10 (45.4%) of these cases were HPV positive (p16+/p53−), and one of these cases (4.5%) was neither HPV positive nor p53 mutant (p16−/p53−). Conclusions: Classification of vulvar squamous cell lesions molecularly using simple immunohistochemical stains in routine diagnostic workup will aid in risk stratification of patients and help in their management and prognostication.

Invasive Oral Squamous Cell Carcinoma Mimicking a Dentoalveolar Abscess: Report of a Case in a 14-Year-Old Patient

IntroductionA diagnosis of oral squamous cell carcinoma in adolescent patients is extremely rare. When an oral squamous cell carcinoma lesion arises near the teeth and/or periodontium, it can be easily misdiagnosed as an inflammatory condition of endodontic or periodontal origin. MethodsThis is a case report of an otherwise healthy 14-year-old patient who was referred for endodontic evaluation and treatment of a soft-tissue swelling in the anterior maxilla. ResultsThe unexpected definitive diagnosis of invasive oral squamous cell carcinoma underscores the importance of proper diagnostic testing. ConclusionsAccurate interpretation of pulp testing results, periapical and cone beam computed tomography imaging, timely biopsy, and prompt definitive treatment are critical when a lesion of nonodontogenic origin is suspected.

Identifying SCC Lesions Capable of Spontaneous Regression by Using Immunohistochemistry: A Systematic Review and Meta-Analysis.

Keratoacanthoma (KA) and squamous cell carcinoma (SCC) are two cutaneous conditions with morphological resemblance, which can complicate the diagnosis in some cases. Using immunohistochemistry staining of biomarkers could be beneficial in resolving this obstacle. We investigated a variety of biomarkers assessed in different studies in order to find the most important and helpful biomarkers for differentiation between SCC and lesions capable of spontaneous regression. MEDLINE via PubMed and Google Scholar database were used to identify relevant literature up to 15 June 2022. The aim of our analyses was to determine the capability of biomarkers to distinguish between SCC and lesions capable of spontaneous regression using calculated individual and pooled odds ratios (OR) and 95% confidence intervals (CI) and I2 tests. Six potential biomarkers were CD10 with pooled OR= 0.006 (95% CI: 0.001-0.057) and I2=0%; COX-2 with pooled OR=0.089 (95% CI: 0.029-0.269) and I2=17.1%; elastic fibers with pooled OR= 6.69 (95% CI: 2.928-15.281) and I2=0%; IMP-3 with pooled OR=0.145 (95% CI: 0.021-1.001) and I2=44.5%; P53 with pooled OR=0.371 (95% CI: 0.188-0.733) and I2=55.9%; AT1R with OR=0.026 (95% CI: 0.006-0.107). We suggest the utilization of the following IHC biomarkers for discrimination between lesions with spontaneous regression such as KA and SCC: CD10, COX-2, and elastic fibers.

HRU-Net: A high-resolution convolutional neural network for esophageal cancer radiotherapy target segmentation

Background and objectiveThe effective segmentation of esophageal squamous carcinoma lesions in CT scans is significant for auxiliary diagnosis and treatment. However, accurate lesion segmentation is still a challenging task due to the irregular form of the esophagus and small size, the inconsistency of spatio-temporal structure, and low contrast of esophagus and its peripheral tissues in medical images. The objective of this study is to improve the segmentation effect of esophageal squamous cell carcinoma lesions. MethodsIt is critical for a segmentation network to effectively extract 3D discriminative features to distinguish esophageal cancers from some visually closed adjacent esophageal tissues and organs. In this work, an efficient HRU-Net architecture (High-Resolution U-Net) was exploited for esophageal cancer and esophageal carcinoma segmentation in CT slices. Based on the idea of localization first and segmentation later, the HRU-Net locates the esophageal region before segmentation. In addition, an Resolution Fusion Module (RFM) was designed to integrate the information of adjacent resolution feature maps to obtain strong semantic information, as well as preserve the high-resolution features. ResultsCompared with the other five typical methods, the devised HRU-Net is capable of generating superior segmentation results. ConclusionsOur proposed HRU-NET improves the accuracy of segmentation for squamous esophageal cancer. Compared to other models, our model performs the best. The designed method may improve the efficiency of clinical diagnosis of esophageal squamous cell carcinoma lesions.