Malignant Lesions Of Head Research Articles

Correlation of serum biomarker (LDH, CRP, IL-8) levels in pre-malignant and malignant lesions of head and neck

A precancerous lesion is often defined as morphologically altered tissue during which the occurrence of carcinoma is more likely than its normal counterpart. Head and neck cancers include cancers of the mouth and therefore the larynx, also as some rarer cancers like cancer of the sinuses, salivary glands, nose, and tympanic cavity. Head and neck cancers are often described as consistent with the sort of cell they begin with. A biomarker could be defined and interpreted as biological molecule which is mostly found in body fluids, blood or even tissues that indicates abnormalities of our body. Here we've taken three biomarkers (LDH, CRP, IL-8) to gauge their level rise in pre-malignant and malignant lesions which are present in our head and neck. Patients attending ENT OPD with primary symptoms indicating premalignant and malignant lesions in the region of head and neck had been included for the analytical study. Complete ENT examination followed by biopsy of the suspicious lesion and blood sample collection was done. A complete of 30 patients were included in each group of premalignant and malignant lesions. No mean serum rise of serum LDH was noted in premalignant and malignant lesions. A mean serum rise of serum CRP was noted in premalignant lesions but was not noted in malignant lesions. However, both premalignant and malignant lesions noted a mean serum rise of IL-8. From a future perspective serum evaluation of biomarkers can become a replacement diagnostic modality for the early evaluation of premalignant lesions and malignant lesions and for monitoring the prognosis of an equivalent.

SPECTRUM OF MALIGNANT LESIONS IN HEAD AND NECK REGION: A TERTIARY CARE HOSPITAL BASED STUDY FROM NORTH EAST INDIA

Introduction: Most head and neck region malignancies arise in the epithelium of oral cavity, larynx, pharynx, nasal cavity and paranasal sinuses. Most of head and neck carcinomas are squamous cell carcinoma. It is the 6th most common carcinoma in the world according to Union for International Cancer control. AIM: To evaluate the spectrum of malignant lesions in head and neck region and to look for the associated risk factors. Methodology: A one year retrospective study was carried out in the Department of Pathology in collaboration with the Department of ENT, from Feb 2022 to Jan 2023, where 140 parafn embedded tissue blocks of head and neck biopsies were collected from the archives of the department. Results: A total 140 cases were included of which 104 (74.3%) were males and 36 (25.7%) were females. Male to female ratio = 2.8:1. The most affected age group is 51-60 years. The most important risk factor is betel nut consumption followed by tobacco chewing. The most common site involved is the oropharynx followed by tongue. Most of the carcinomas are moderately differentiated squamous cell carcinomas. Conclusion: Head and neck malignancies are quite common in Northeastern region of India, so wehave performed this study to evaluate the spectrum of malignant lesions in head and neck region. Its association with risk factors are also studied for the prevention, early detection, early treatment intervention and withdrawal from risk habits for improving the wellbeing of the people in the society

An Observational Study of Head and Neck Squamous Carcinomas from a Tertiary Cancer Centre of Marathwada Region, Maharashtra, India

Introduction: Head and neck cancer constitutes about one third of all the cancers in India. Head and neck squamous carcinoma is an important cause of morbidity and mortality with variability in geographical location, age, gender, habits, socio-economic status. Aim: To identify changing trends in age, gender, sites involved and histopathological grades of malignant and analyse potentially malignant lesions in head and neck region in Marathwada region of Maharashtra, India. Materials and Methods: This observational retrospective descriptive study was carried out in tertiary cancer hospital in Marathwada region of Maharashtra, India, over a period of two years which included 1008 cases. All the biopsy cases and biopsies obtained under ultrasound and also to computed tomography guidance showing invasive squamous carcinoma and potentially malignant lesions of head and neck region with their histological analysis were studied. Relevant clinical and demographic details were noted and statistical analysis was done and results were explained in tables and percentage. Results: Total 1008 cases were studied. The maximum number of cases were in the age group of 51-60 years. Males were more affected than females. The buccal mucosa (29.5%) was most common site affected and maxilla (0.8%) the least. Histologically invasive tumour were well differentiated (17.65%), moderately differentiated (79.93%) and poorly differentiated (2.42%). Rest lesions were distributed in following categories: carcinoma- in-situ, verrucous neoplasm, dysplasia, atypical squamous proliferation, leukoplakia, pseudoepitheliomatous hyperplasia. Age wise, site wise, gender wise distribution of cases and association between site of lesions and gender and grade of tumour were studied. Conclusion: The associated risk factors, lifestyle patterns, habits, addictions and geographic and demographic factors, socio-economic status and evolving Human Papilloma Virus (HPV) association and pathogenesis are still topic of debate where much progress is still to be made. It deserves closer study. Apart from invasive squamous malignancies, precursor lesions if investigated at an earliest along with increasing awareness among population in relation to healthy lifestyle changes, habits followed by thorough clinical examination and histopathology and HPV association, possibility of planning specific strategies of prevention, diagnosis and treatment help reduce morbidity and mortality.

Role of Human Papilloma Virus (HPV) in Potentially Malignant and Malignant Lesions of Head and Neck

Role of Human Papilloma Virus (HPV) in Potentially Malignant and Malignant Lesions of Head and Neck

FNAC Spectrum of head and neck tumors

Fine needle aspiration cytology is a relatively painless procedure, speedy and less costly with low risk of complications. FNAC was first used as diagnostic tool in 1904 by Greig and Gray and by Martin and Ellis, who developed its use in the diagnosis of malignancy. Fine needle aspiration cytology (FNAC) is a valuable technique in investigation of nodules and masses arising within the head and neck. The diagnosis of head and neck swelling is a common clinical dilemma. Head and neck lesions are very commonly encountered superficial lump in cytopathology department and swellings in this region rarely go unnoticed. FNAC (fine needle aspiration cytology) is of great value in early diagnosis and differentiation of large number of infective, benign and malignant lesions in head and neck region.

In Vitro Assessment of the Composition and Microhardness of the Hard Tissues of Oral Cavity Submitted To Gamma Irradiation

Introduction: Clinical radiotherapy is one of the most important techniques for the treatment of malignant lesions in head and neck; however, exposure to ionizing radiation may lead to both systemic and local complications, immediately and after this treatment, where the main issue is the xerostomia and its consequent oral mucositis. Regarding late complications produced by radiation, decay of radiation and osteoradionecrosis, both dosedependent lesions, showed a high level of incidence in recent decades and it would be difficult to manage, although patients referred after treatment’s completion and under the influence of local factors. Methodology: Then, This study evaluated the effect of ionizing radiation from gamma source onto samples of enamel, root dentin and jawbone samples undergone to the same absorbed dose / dose rate that those in patients with head and neck cancer. The non-irradiated and irradiated samples were analyzed by microhardness surface analysis; scanning electron microscopy (SEM) and Fourier transform infrared spectrometry (FTIR). Results and discussion: Microhardness data were analyzed statistically with a confidence level of 95% (p value <0.05%), using parametric Student’s t-test for related averages and ANOVA statistical test, finding a statistically significant result (p = 0.00) to all four groups samples. Conclusion: It was observed a high deleterious and statistical significant effect of gamma radiation on hard tissues from oral cavity, regarding to physical, compositional and morphological properties.

ATR-FTIR Assessment of the Biochemical Composition and Micro Hardness of the Hard Tissues of Oral Cavity Submitted to Gamma Irradiation

Back ground: Clinical radiotherapy is one of the most important techniques for the treatment of malignant lesions in head and neck; however, exposure to ionizing radiation may lead to both systemic and local complications, immediately and after this treatment, where the main issue is the xerostomia and its consequent oral mucositis. Regarding late complications produced by radiation, decay of radiation and osteoradionecrosis, both dosedependent lesions, showed a high level of incidence in recent decades and it would be difficult to manage, although patients referred after treatment’s completion and under the influence of local factors. Methodology: Then, this study evaluated the effect of ionizing radiation from gamma source onto samples of enamel, root dentin and jawbone samples undergone to the same absorbed dose/dose rate that those in patients with head and neck cancer. The non-irradiated and irradiated samples were analyzed by microhardness surface analysis; scanning electron microscopy (SEM) and Fourier transform infrared spectrometry (ATR-FTIR). Results and Discussion: Microhardness data were analyzed statistically with a confidence level of 95% (p value <0.05%), using parametric Student’s t-test for related averages and ANOVA statistical test, finding a statistically significant result (p=0.00) to all four groups samples. Conclusion: It was observed a high deleterious and statistical significant effect of gamma radiation on hard tissues from oral cavity, regarding to physical, compositional and morphological properties.

The role of chromosomal aberrations in premalignant and malignant lesions in head and neck squamous cell carcinoma

The objectives of this study are to uncover the molecular mechanisms involved in head and neck squamous cell carcinoma (HNSCC) pathogenesis by studying the chromosomal aberrations in both premalignant and malignant patients and to highlight the genotype of HNSCC in Upper Egypt. From March 2001 to December 2003, prospective study was conducted in 41 patients with precancerous, 79 patients with cancerous laryngeal, oesophageal, nasopharyngeal, nasal, and oral lesions and 50 controls in ENT department, Sohag Faculty of Medicine, Sohag, Egypt. Samples taken by punch biopsy were frozen and stored at -80 degrees C and were subjected to histopathological examination. Metaphase cells were digitally imaged and karyotyped. Karyotypes have been analysed via anatomical image capture and compared with standard human chromosome ideograms. In precancerous lesions, there were 41% 3p loss, 51% 3q gain, 29% 8q gain, and 22% 11q13 gain. In malignant lesions, there were 63% 3p13-p24 loss, 59.5% 5q12-23 loss, 49.5% 8p22-p23 loss, 45.5% 9p21-p24 loss, 40.5% 18q22-q23 loss, 66% 3q gain, 39% 8q gain, and 16% 11q13 gain. In conclusion, early diagnosis of HNSCC can be achieved by DNA extraction from suspicious lesions in high-risk groups (smokers and alcoholics) and examination of chromosomal aberrations of 3p, 3q, 8q, and 11q13. If there are high percent of chromosomal aberrations in these chromosomes, active intervention should be done (chemoprevention and regular follow-up of head and neck examination for very early detection and management).

Field cancerization in oral lichen planus

Background The concept of field cancerization describes the tendency of patients with premalignant and malignant lesions of head and neck mucosal sites to develop multiple carcinomas of the upper aerodigestive tract. Here we address whether this concept should be extended also to patients affected by oral lichen planus (OLP), an inflammatory disorder associated with an increased risk of cancer development. Methods Data from a cohort of 45 patients with OLP who subsequently developed severe dysplastic changes and/or oral squamous cell carcinoma were retrospectively reviewed. Patients who presented more than one oral neoplastic event were considered for further data analysis as regards incidence, localization, management and prognosis. Results Twenty (44.4 %) patients were affected by one single neoplastic event while 25 (55.6 %) developed multiple and often multifocal oral dysplastic and/or malignant events. In most cases, a careful surveillance programme led to diagnosis and effective treatment of oral neoplasias at an early intraepithelial and microinvasive stage, leading to long-term survival. In some patients, however, additional primary tumours occurred suddenly with rapid invasion, leading to advanced stage diagnosis and poor prognosis. Overall, three patients (12 %) died due to malignant oral disease. Conclusions Patients with OLP and subsequent development of dysplasia/ oral squamous cell carcinoma are at risk of having multiple and multifocal neoplastic events of the oral cavity, a phenomenon which parallels the concept of field cancerization of traditional head and neck cancers. If detected at an early stage, these neoplasias can be managed with superficial and complete resection. However a small number of patients have loco-regional tumour spread despite a standard surveillance protocol.

The flow cytometric analysis of premalignant and malignant lesions in head and neck squamous cell carcinoma

We attempted to identify the molecular mechanisms involved in Head and Neck Squamous Cell Carcinoma (HNSCC) pathogenesis by measuring the nuclear DNA content (ploidy) in premalignant (potentially malignant) and malignant patients as compared to normal controls, and to determine whether DNA ploidy could be used to predict the clinical outcome. From March 2001 to December 2003, the analysis was carried out in a set of 41 patients with premalignant lesions and 79 suffering from squamous cell carcinoma of laryngeal, oesophageal, nasopharyngeal, nasal and oral lesions and 50 controls. Representative samples were taken by punch biopsy and processed using standard formol-paraffin technique for histopathological examination. Fifty micrometer thick sections of paraffin-embedded tissues were analyzed to detect the DNA content by image cytometry. Of the potentially malignant patients, 46% had diploid lesions, 37% had tetraploid lesions and 17% had aneuploid lesions. While of the patients with cancer, 90% had aneuploid lesions, 10% had diploid lesions and none had tetraploid lesions. DNA diploidy tended to occur earlier in the progression from premalignant to malignant lesions and this helps us early detection of HNSCC by DNA from lesions in high risk groups and examination of its ploidy. Knowledge of tumor cell ploidy by DNA image cytometry may facilitate the evaluation of malignant and premalignant lesions in HNSCC. The present findings are promising to supplement clinical and histopathological parameters in evaluating prognosis and to demonstrate methods that are readily applicable for routine diagnostic work.

Diagnostic and prognostic significance of serum glycoprotein (fucose) level in patients with head and neck tumours

Sera from 25 healthy subjects, 10 patients with benign neoplastic lesions and 30 patients having malignant lesions of Head and Neck region, were analysed for protein bound fucose levels. The levels were significantly elevated in the malignant group, as compared to other two groups. In 10 cases of the malignancy, the fucose levels were repeated after one week of complete removal of the growth, whence the values were found to be lowered to normal range in 7 patients. Thus serum protein bound fucose estimation is a useful adjunct to clinical examination in the diagnosis and prognosis of Head and Neck malignancies.