Squamous Cell Carcinoma Of Gingiva Research Articles

Prognosis of South Asian Buccal Mucosa Cancer Patients in the United States: Association of Race with Overall Survival.

Squamous Cell Carcinoma (SCC) of the buccal mucosa and gingiva accounts for approximately 10% of oral and pharyngeal cancers diagnosed in the United States each year, with a disproportionally higher incidence in individuals of South Asian descent. However, little has been documented regarding trends pertaining to overall survival. Thus, this research serves to identify predictors of survival and determine if overall survival (OS) differs for South Asians compared to other races once they develop non-metastatic buccal mucosa or gingiva squamous cell carcinoma. A population-based, cohort study of patients registered in the National Cancer Database® (NCDB) between the years 2004-2016 was performed. Kaplan-Meyer Survival Curves were executed to examine overall survival, while univariable (UVA) and multivariable analysis (MVA) was performed to determine the effect of multiple variables on OS. South Asians had longer median OS at 88.7 months, compared to 58.6 months and 38.3 months for Caucasians and African Americans respectively (p<0.001). In UVA, race was highly significant, but when the cohort was selected to include only those who had undergone surgical resection, no statistically significant difference remained. On MVA, lack of surgery, older age, higher grade, higher T and N stage, use of chemotherapy, higher comorbidity scores were associated with worse OS, but race was not significant. South Asians in the US with non-metastatic buccal mucosa or gingiva SCC have better OS compared to Caucasians or African Americans, likely due to younger age at diagnosis (median 59 vs. 71 and 62 years old) and more frequent surgical resection (75% vs. 72% and 64%). In MVA, South Asians have similar OS as Caucasians.

Texture analysis using short-tau inversion recovery magnetic resonance images to differentiate squamous cell carcinoma of the gingiva from medication-related osteonecrosis of the jaw.

Despite the difficulty in distinguishing between squamous cell carcinoma (SCC) and medication-related osteonecrosis of the jaw (MRONJ) on the basis of medical imaging examinations, the two conditions have completely different treatment methods and prognoses. Therefore, differentiation of SCC from MRONJ on imaging examinations is very important. This study aimed to distinguish SCC from MRONJ by performing texture analysis using magnetic resonance imaging (MRI) short-tau inversion recovery images. This retrospective case-control study included 14 patients with SCC of the lower gingiva and 35 with MRONJ of the mandible who underwent MRI and computed tomography (CT) for suspected SCC or MRONJ. SCC was identified by histopathological examination of tissues excised during surgery. The radiomics features of SCC and MRONJ were analyzed using the open-access software MaZda version 3.3 (Technical University of Lodz, Institute of Electronics, Poland). CT was used to evaluate the presence or absence of qualitative findings (sclerosis, sequestrum, osteolysis, periosteal reaction, and cellulitis) of SCC and MRONJ. Among the 19 texture features selected using MaZda feature-reduction methods, SCC of the gingiva and MRONJ of the mandible revealed differences in two histogram features, one absolute gradient feature, and 16Gy level co-occurrence matrix features. In particular, the percentile, angular second moment, entropy, and difference entropy exhibited excellent diagnostic performance. Non-contrast-enhanced MRI texture analysis revealed differences in texture parameters between mandibular SCC and mandibular MRONJ. MRI texture analysis can be a new noninvasive quantitative method for distinguishing between SCC and MRONJ.

Nomograms for Predicting Cancer-Specific Survival of Patients with Gingiva Squamous Cell Carcinoma: A Population-Based Study.

The use of the traditional American Joint Committee on Cancer (AJCC) staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma (GSCC) patients. We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system. Patients were identified from SEER database. Variables were selected by a backward stepwise selection method in a Cox regression model. A nomogram was used to predict cancer-specific survival rates for 3, 5 and 10 years in patients with GSCC. Several basic features of model validation were used to evaluate the performance of the survival model: consistency index (C-index), receiver operating characteristic (ROC) curve, calibration chart, net weight classification improvement (NRI), comprehensive discriminant improvement (IDI) and decision curve analysis (DCA). Multivariate analyses revealed that age, race, marital status, insurance, AJCC stage, pathology grade and surgery were risk factors for survival. In particular, the C-index, the area under the ROC curve (AUC) and the calibration plots showed good performance of the nomogram. Compared to the AJCC system, NRI and IDI showed that the nomogram has improved performance. Finally, the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC, whether training set or a validation set. We developed and validated the first GSCC prognosis nomogram, which has a better prognostic value than the separate AJCC staging system. Overall, the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3, 5 and 10 years.

GINGIVAL SQUAMOUS CELL CARCINOMA: A CASE REPORT

Squamous cell carcinoma rarely occurs in the gingiva and may be misdiagnosed as inflammatory lesions that most commonly affect this area. A 51-year-old patient was referred for evaluation of a lesion in the gingiva. The patient was nonsmoker and nondrinker, and he reported local symptomatology for 3 years since the lower left first molar was rehabilitated with porcelain crown. On oral examination an erythematous lesion in the vestibular marginal gingiva of the lower left first molar was observed. In addition, white areas in the lower anterior vestibular gingiva were present. In view of the clinical hypothesis of malignant neoplasia, incisional biopsy was performed, and the histopathologic analysis confirmed the diagnosis of squamous cell carcinoma. The patient was referred to a head and neck surgeon, who performed a surgical removal of the tumor. This report emphasizes that although is uncommon, squamous cell carcinoma of gingiva may occur and may mimic an inflammatory process. Squamous cell carcinoma rarely occurs in the gingiva and may be misdiagnosed as inflammatory lesions that most commonly affect this area. A 51-year-old patient was referred for evaluation of a lesion in the gingiva. The patient was nonsmoker and nondrinker, and he reported local symptomatology for 3 years since the lower left first molar was rehabilitated with porcelain crown. On oral examination an erythematous lesion in the vestibular marginal gingiva of the lower left first molar was observed. In addition, white areas in the lower anterior vestibular gingiva were present. In view of the clinical hypothesis of malignant neoplasia, incisional biopsy was performed, and the histopathologic analysis confirmed the diagnosis of squamous cell carcinoma. The patient was referred to a head and neck surgeon, who performed a surgical removal of the tumor. This report emphasizes that although is uncommon, squamous cell carcinoma of gingiva may occur and may mimic an inflammatory process.

Correlation of BMI1 and ZEB1 expression with epithelial–mesenchymal transition in gingiva squamous cell carcinoma

ObjectiveOral squamous cell carcinoma is characterized by diverse histopathological features, tumorigenesis, and invasion. Gingiva squamous cell carcinoma (GSCC) is characterized by easily invading the jawbone. Epithelial–mesenchymal transition (EMT) is a crucial event for invasion of cancer cells and progression of carcinogenesis, inducing stem-like properties in epithelial cells. Here, expression of BMI1, which controls stem cell self-renewal, and ZEB1, a transcription factor that regulates EMT, was evaluated for its role in EMT and invasion of GSCC. Materials and methodsWe analyzed 36 gingival specimens (24 carcinomas and 12 dysplasias) by measuring protein and mRNA expression levels of BMI1, ZEB1, vimentin, and E-cadherin, and examining associations between their expression and clinicopathological parameters. ResultsCompared with adjacent normal squamous epithelium, E-cadherin expression was decreased significantly (P<0.05) and vimentin expression levels were increased significantly (P<0.05) at the invasive front, which are indicative of EMT in GSCC. Vimentin expression was significantly increased in poorly differentiated carcinoma (P=0.027), and vimentin and BMI1 expression was significantly increased in grade 4 mode of invasion (P<0.05). Furthermore, elevated levels of BMI1 were accompanied by downregulation of E-cadherin. A significant correlation was found between E-cadherin and BMI1 expression levels (P=0.014) and between BMI1 and ZEB1 mRNA expression (P=0.034). ConclusionThe present study shows that the expression levels of several biomarkers of gingiva carcinogenesis have unique characteristics that differ from those in tongue carcinogenesis. BMI1 and ZEB1 may be important factors associated with EMT in the invasion and progression of GSCC.

Severe Intraoperative Albumin Transfusion Reaction and Review of the Literature

Reactions to human albumin are rare, but happen at a frequency to warrant caution since it is routinely produced from batched human plasma. Albumin preparations have advanced substantially in purity since their inception, but despite this achievement severe reactions may still occur. These reactions may include a rash, urticarial, hypotension, dyspnea, or even anaphylaxis. The patient is a 74 year old male with history of recurrent squamous cell carcinoma of gingiva undergoing a neck dissection for lymph nodes. The patient was given 500 mL of albumin and suddenly developed intractable hypotension. In addition, once the surgical drapes were removed, the patient exhibited a rash and flushing on both the chest and abdomen. The patient was treated with pressor agents and a severe reaction to albumin was logged in the allergy alert section of the patient chart. Although human albumin has an excellent safety profile, it is important to recognize allergic transfusion reaction symptoms quickly and initiate an appropriate investigation. * IgA : immunoglobulin A IgG : immunoglobulin G PPF : plasma protein fraction FDA : United States Food and Drug Administration BP : blood pressure BPM : beats per minute RR : respiratory rate

Gingival squamous cell carcinoma in young patients: report of a case and review of the literature

Squamous cell carcinoma is a malignant neoplasm of epithelium, most frequently occurring in intraoral tumors. In this article we describe a rarely reported, because the frequency of oral cancer in young people is extremely low, case of a 16-year-old Chinese girl with squamous cell carcinoma of anterior mandibular gingiva. The clinicopathologic features, etiology, clinical evaluation, management of squamous cell carcinoma of gingiva in young patients are discussed and the applicable literatures are reviewed.

１０歳，男子の上顎歯肉へん平上皮癌の１例

Carcinoma of the oral cavity arising in children is extremley rare. A case of squamous cell carcinoma of the maxillary gingiva in a 10-year-old boy is presented.The patient visited our departmet on June 20, 1989 complaining of pain and swelling inthe labiogingival region of the right upper jaw. Clinical examination revealed a whitishverrucous growth in the right upper labial gingiva and alveolar mucosa. The growth ex-tended from the central incisor to the deciduous first molar. Radiography showed slightalveolar bone resorption in right upper lateral incisor and deciduous canine region. Inscintigraphy, there was no abnormal uptake. TNM classification was T2N0M0. Biopsyrevealed a well-differentiated squamous cell carcinoma of the gingiva. Marginal resection of the maxilla from the central incisor to the deciduous first molar was performed under generalanestheia. The patient is well without any signs of recurrence 3 years after operation.

ヒロ口腔へん平上皮癌細胞に対するモノクローナル抗体の作製

Three monoclonal antibodies (MoAb), 1 F 9, 1 G 5 and 3 B 4, were produced by fusion of spleen cells of a BALB/c mouse immunized with Ca 9-22 cell from human squamous cell carcinoma of gingiva and murine myeloma cells SP 2/o.They were screened by 51Cr release assay of complement dependent cytotoxicity.Their isotypes were all IgM which recognized the cell surface antigens.Five MoAbs, 1 B 11, N 2, N 4, N 18 and 4 B 3, were prepared against NA cell from human tongue squamous cell carcinoma by the same procedure, but they were screened by radioimmunoassay using 125I-protein A.All MoAbs had isotypes IgG and only four recognized their antigen in the cytoplasm.N 4 recognized the antigen existing in both cytoplasm and cell membrane.The reactivity of each MoAb to various cells and tissues was analyzed by immunostaining method.They were separable into three groups by the cell specificity, i.e.the first group including 1 F 9, 1 G 5, and 4 B 3 reacted to all squamous cell carcinoma cells tested but not to the normal diploid fibroblast WI 38.The second group comprising of 1 B 11, N 2, N 4 and N 18 was reactable to both squamous cell carcinoma cells and WI 38.The third group of 3 B 4 reacted to only Ca 9-22 used as the immunogen.From the study using paraffin embedded tissues including oral cancers and normal tissues, it was revealed that 1 F 9 and 1 G 5 stained the cell membrane of the cancer nest in squamous cell carcinoma and the prickle cell layer in the oral mucosa.The second group of MoAb, 1 B 11, N 2, N 4 and N 18, stained both parenchymal and stroma cells simultaneously.3 B 4, interestingly, showed different reactivity between individuals, namely in a positive case it stained not only the normal and malignant cell of squamous epithelial origin but also endothelial cells and erythrocytes in the stroma.However, in a negative case it did not stain any type of cell, suggesting that 3 B 4 may recognize an antigen related to the blood group.