Squamous Cell Carcinoma Of The Tongue Research Articles

Enhancing sensitivity to oxaliplatin in tongue squamous cell carcinoma: mechanistic insights and therapeutic potential of DHA combination therapy.

Squamous cell carcinoma of the tongue, a common and aggressive malignancy, poses a substantial threat to health and well-being. Despite the promising results of combination therapy with dihydroartemisinin (DHA) and oxaliplatin (Oxa) in various cancers, its effectiveness in treating tongue squamous cell carcinoma had not been explored prior to this study. Our research found that DHA significantly enhances the sensitivity of tongue squamous cell carcinoma cells to Oxa, even at very low concentrations. The combination treatment was observed to modulate the activity of CDK1 and Cyclin B1, arresting the cell cycle in the G2 phase. Additionally, it reduces mitochondrial membrane potential, prompting the release of cytochrome c and activating cleaved caspase-3, which promotes apoptosis. Notably, surface plasmon resonance and immunoprecipitation experiments revealed that DHA targets and attenuates CDK1 modification, weakening its interaction with STAT3 protein. This leads to reduced expression of anti-apoptotic genes and facilitates programmed cell death in CAL-27 cells. The findings underscore the potential of DHA and Oxa as a potent therapeutic strategy for tongue squamous cell carcinoma, opening avenues for clinical application and further exploration into its mechanistic pathways.

Vital Staining Role in Resection and Reconstruction of Tongue Cancers with Free Flap - A Comparative Study

Abstract Introduction: The purpose of this study is to compare and infer the most suitable dye for visualisation of ipsilateral and contralateral sentinel lymph nodes (SLNs), positive, negative outcomes, sensitivity, their specificities and visualisation of anastomosed blood vessels in microvascular reconstruction of tongue cancers. Materials and Methods: This is a prospective in vivo comparative study involving twenty patients diagnosed with squamous cell carcinoma of the tongue treated with wide excision of primary tongue tumour, modified functional neck dissection and microvascular reconstruction with radial forearm free flap. Consecutive random allocation was done into two groups with ten patients each. Patients were injected with methylene blue as the first group and near-infrared fluorescence indocyanine green (ICG) into the second. The patients were evaluated intraoperatively regarding the better dye in methylene blue and ICG for identification of ipsilateral and contralateral SLNs, their positive, negative outcomes, sensitivity and specificities. Apart from these, in cases of group B, after microvascular transfers, ICG is used for visualisation of anastomosed vessels to prevent abnormal perfusions, leaks and post–flap failures. Descriptive statistics, independent samples t-test, and Chi-square were used for statistical analysis. Results: The present study revealed ICG being the better dye in the parameters mentioned. Discussion: Lymph node yield in neck dissection is a prognostic factor in oral cancers. ICG is inferred as the better dye for identification of SLN with 100% outcomes and in blood vessel visualisation after microvascular free tissue transfers. It is also useful in identifying positive contralateral sentinel nodes, which is helpful in undertaking bilateral neck dissections related to tongue carcinoma.

Radiation-Induced Intraosseous Malignant Peripheral Nerve Sheath Tumor: A Case Report.

The significance of radiation therapy in cancer treatment comes with associated complications, including fibrosis, osteonecrosis, and the development of secondary malignancies, such as malignant peripheral nerve sheath tumors (MPNSTs). We emphasize the importance of understanding these complications for an effective patient management. We report a 47-year-old man with a history of squamous cell carcinoma of the tongue, treated with surgery, chemotherapy, and radiation therapy. The patient later presented with symptoms that led to the discovery of an intraosseous MPNST. Histopathological examination revealed characteristic features of MPNST, including spindle cells arranged is sweeping fascicles with contrasting hypercellular and hypocellular areas, producing a marble-like pattern, with atypical wavy, buckled, hyperchromatic nuclei, and brisk mitotic activity. Immunohistochemical analysis showed patchy positive staining for S100 and SOX10, and a complete loss of H3K27me3 expression. This report underscores the challenge of diagnosing secondary malignancies post-radiation therapy and the importance of careful histological examination to differentiate them from other conditions. In conclusion, radiation-induced secondary malignancies are a significant late side effect of radiation therapy that can profoundly impact treatment decision-making and requires a high index of suspicion during post radiation surveillance. Malignant peripheral nerve sheath tumor serves as a pertinent example, highlighting the importance of considering long-term risks when developing optimal management plans for cancer patients.

AT11-guided liposomes for oral cancer cells: From characterization towards in vitro evaluation

The increasing prevalence of oral cancers, particularly those attributed to human papillomavirus infection, along with the associated drawbacks of conventional therapies, has spurred research into more effective treatment modalities. Liposomes have emerged as a potential strategy to improve the delivery of anticancer molecules to the cells of interest. However, functionalizing these nanoparticles with targeting agents could significantly enhance their selectivity. A prospective approach involves the incorporation of aptamers, which facilitate drug accumulation within cancer cells. Among these, the AT11 aptamer has garnered attention due to its improved toxicity and high affinity to nucleolin, making it a promising targeting moiety. Therefore, we propose to use AT11 for liposomes’ functionalization, to enhance the selectivity of C8, a potential anticancer compound, specifically targeting oral cancer cells. Thus, we produced liposomes (empty or C8-associated) by ethanol injection method and, then, proceeded with their functionalization with AT11-TEG-Cholesteryl. The resulting liposomes were characterized by dynamic light scattering and hydrodynamic diameters of 130–136 nm were obtained. Additionally, the effect of the produced liposomes on the viability of squamous cell carcinoma of the tongue (UPCI-SCC-154) and nonmalignant (Het1A) cells was determined, by MTT assay. It was demonstrated that the viability of cells treated with empty liposomes was almost unaffected until the 53.6 μg/mL concentration. After treating the cells with C8-associated liposomes, both cell lines showed a dose-response effect. Moreover, the AT11-functionalization of the obtained C8-associated liposomes enhanced the selectivity of the liposomes towards oral cancer cell line, as observed by the MTT assay (43.2 % in UPCI-SCC-154 versus 79.4 % in Het1A) and confocal microscopy. Furthermore, the anticancer potential of AT11 C8-associated liposomes was evaluated in terms of proliferation (ki67 positive cells), cell death (propidium iodide internalization in non-permeabilized cells and caspase-3 activity), migration (cell scratch assay) and invasion. Overall, the produced liposomes decreased tongue cancer cell proliferation (53.6 % versus 99.4 %), migration (from 24.6 % to −3.8 %) and invasion (to 19 %) and induced cell death (11.6-fold increase in propidium iodide positive cells, and a 140 % of caspase-3 activity). These findings suggest that the AT11 C8-associated liposomes are promising drug carriers for oral cancer therapy.

Role of midline raphe in compartmental surgery for squamous cell carcinoma of the tongue.

In the present study, we investigated how tumor distance from midline (TDFM) and depth of invasion (DOI) may affect survival outcomes after compartmental tongue surgery (CTS) for oral tongue squamous cell carcinoma (OTSCC). A retrospective series of cT2-T3 OTSCC treated with upfront CTS at our Department from 2010 to 2021 was evaluated. Radiological and pathological DOI and TDFM were correlated. The main outcomes were overall (OS) and loco-regional recurrence free survival (LRRFS). The linear relationship between DOI and TDFM with 2-year OS and LRRFS was tested. Survival estimates were obtained by the Kaplan-Meier method. Univariate analysis was performed for variables of interest, and results expressed in terms of hazard ratios and 95% confidence intervals. A total of 64 patients underwent CTS and neck dissection. No significant difference was found between pathological (pDOI) and radiological DOI (rDOI) (p = 0.321) or between pathological (pTDFM) and radiological TDFM (p = 0.435). Two- and 5-year OS and LRRFS were 85.7% and 70.4%, 84.3% and 76.1%, respectively. A linear and significant relationship with OS (p = 0.020) and LRRFS (p = 0.013) was found for pDOI; although linear, the relationship between pTDFM was not statistically significant for either survival outcomes. Once categorized, the ideal cut-off for pDOI according to OS was set at 10mm (p = 0.023). In patients undergoing CTS for primary OTSCC, magnetic resonance-derived rDOI represents an accurate estimate of pDOI, In contrast, TDFM was not associated with OS suggesting that the median raphe is a safe deep margin for CTS. BS/231,009 retrospectively registered.

Prediction of nodal disease in oral squamous cell carcinoma of the tongue: histopathological risk assessment with the focus on depth of invasion.

Cervical lymph node metastasis (CLNM) is one of the most relevant influencing factors for the oncological outcome of patients with oral squamous cell carcinoma (OSCC). Several studies showed that the tumors depth of invasion (DOI) influences the risk for CLNM, however varying across the oral subsites. The aim of this study is to investigate the role of DOI and other risk factors in OSCC of the tongue in relation to the occurrence of occult CLNM. In this retrospective study, n = 139 patients with primary OSCC of the tongue, treated by complete surgical resection (R0) with curative intention between 2013 and 2021, were included. For data analysis, epidemiologic data as well as preoperative tumor staging, surgical therapy including neck management, histopathological tumor data and follow-up were considered. Uni- and multivariate logistic regression were used to determine association between histopathological risk factors and the occurrence of occult CLNM. The rate of occult cervical metastasis was 19.4%. T-staging, cervical nodal disease (pN+) and lymphatic invasion were significantly associated with reduced OS and RFS. While DOI had no relevant influence on the OS and RFS (p = 0.88 and p = 0.91 respectively), there was significant correlation between DOI and the occurrence of occult CLNM (OR: 1.17, 95%CI: 1.05-1.30; p < 0.01). The optimal cutoff in predicting occult CLNM was 6mm (Sensitivity: 84.2%, Specificity: 73.5%, AUC: 0.75). The DOI is a helpful risk parameter to predict the occurrence of occult nodal disease in OSCC of the tongue. Given the critical decision cutoff between 2 and 4mm DOI for performing elective neck dissection in the current guidelines, our data suggests that in these cases, surgical de-escalation could be feasible with close follow-up. This study highlights the relevance of DOI as a risk parameter in the prediction of CLNM with the aim to specify the individual patient risk and to deescalate surgical therapy in order to decrease comorbidities while improving the oncological prognosis.

Prevalence of Squamous Cell Carcinoma of The Tongue In Dr. Hasan Sadikin General Hospital During 2017 – 2022

Introduction: Squamous cell carcinoma is the most common malignant neoplasm in the oral cavity, accounting for 90% of all malignancies in the oral cavity. Exposure of the oral epithelium to carcinogenic substances can cause squamous cell carcinoma. This study was show the prevalence of squamous cell carcinoma of the tongue in West Java which is used as education for the prevention of squamous cell carcinoma of the tongue. Purpose: This research is a descriptive study and carried out using purposive sampling method. The sample in this study were patients with a diagnosis of squamous cell carcinoma of the tongue at Dr. Hasan Sadikin Hospital Bandung during January 2017 - January 2022 who had been confirmed by histopathological examination results. Data analysis will be carried out on secondary data from collected medical records and the results of the pathologist's interpretation, then the results of the data analysis will be arranged and presented in tabular and percentage form. Methods: The data obtained were 218 cases. Based on age, the most patients were in the age group above 48 years (58%). Based on gender criteria, it shows more women (57%). Based on domicile criteria, the highest domicile was in Bandung (38%). Based on family history criteria, there were 215 patients with no family history or 99%. Based on the predisposing factor criteria, it shows more patients with a history of chronic irritation (48%). Based on the mass size criteria, it shows more patients with mass size T4 (60%). Based on KGB criteria, it shows more patient showed N1 lymph nodes involvement (63%). Based on tumor metastasis criteria, it shows more patients with Mx tumor metastasis (50%). Based on the therapy status criteria, it shows more patients with combined therapy (32%). Results: Type the result of your research, including statistical analysis. Conclusion: Patients suffering from squamous cell carcinoma in the tongue are mostly patients over 48 years old with female gender who live in Bandung City, West Java, and have no family history but have predilection factors such as irritation and infection. The size of the tumor mass in patients with squamous cell carcinoma mostly has a mass size &gt; 3 cm, with lymph node involvement mostly on the ipsilateral with a size &lt; 3 cm and metastasis to other organs is difficult to assess due to lack of supporting modalities. The therapy received was mostly combined therapy (surgery and chemotherapy or radiotherapy) Keywords: Squamous cell carcinoma of the tongue, prevalence, patient characteristics

Dyskeratosis congenita with squamous cell carcinoma of the tongue: A rare case report.

Dyskeratosis congenita is a rare inherited bone marrow failure disorder characterized by a classic triad: nail dystrophy, reticulate skin pigmentation, and oral leukoplakia. Patients with dyskeratosis congenita have also been described as having gastrointestinal, genitourinary, neurological, ophthalmic, pulmonary, and skeletal abnormalities. Also, 80% of patients are affected with oral leukoplakia and these areas are more prone to develop into oral squamous cell carcinoma. We hereby report a rare case of oral squamous cell carcinoma of the tongue in a young male patient with dyskeratosis congenita.

The Potential MicroRNA Diagnostic Biomarkers in Oral Squamous Cell Carcinoma of the Tongue.

Oral squamous cell carcinoma (OSCC) of the tongue is a common type of head and neck malignancy with a poor prognosis, underscoring the urgency for early detection. MicroRNAs (miRNAs) have remarkable stability and are easily measurable. Thus, miRNAs may be a promising biomarker candidate among biomarkers in cancer diagnosis. Biomarkers have the potential to facilitate personalized medicine approaches by guiding treatment decisions and optimizing therapy regimens for individual patients. Utilizing data from The Cancer Genome Atlas, we identified 13 differentially expressed upregulated miRNAs in OSCC of the tongue. Differentially expressed miRNAs were analyzed by enrichment analysis to reveal underlying biological processes, pathways, or functions. Furthermore, we identified miRNAs associated with the progression of OSCC of the tongue, utilizing receiver operating characteristic analysis to evaluate their potential as diagnostic biomarkers. A total of 13 upregulated miRNAs were identified as differentially expressed in OSCC of the tongue. Five of these miRNAs had high diagnostic power. In particular, miR-196b has the potential to serve as one of the most effective diagnostic biomarkers. Then, functional enrichment analysis for the target gene of miR-196b was performed, and a protein-protein interaction network was constructed. This study assessed an effective approach for identifying miRNAs as early diagnostic markers for OSCC of the tongue.

Free Flap Evaluation Following Reconstruction of Locally Advanced Squamous Cell Carcinoma of The Tongue

Background: Neoadjuvant chemotherapy (NAC) is a crucial component in the management of tongue-based locally advanced squamous cell carcinoma (LASCC) due to its ability to decrease tumor mass and facilitate free tissue transplantation. The utilization of adjuvant radiation and chemotherapy has been observed to decelerate the progression of post-operative tumor growth. Probability of free flap failure is elevated. Post-operative complications and the long-term functional outcomes of speaking, salivation, and swallowing determine the quality of free flaps. Methods: A retrospective review of tongue LASCC patients who underwent NAC followed by glossectomy and free tissue transfer from 2015 to 2018. Tongue functional outcomes of speaking, swallowing, and salivation were assessed using FACE-Q scale in 3 times follow-up period. Result: This study included 7 patients who underwent tongue reconstruction. Treatment modalities were based on tumor presentation, with 4 patients (57.1%) receiving Taxane, 5-Fluorouracil, and Paclitaxel/Doclitaxel (TPF), and 3 patients (42.1%) receiving Paclitaxel and 5-Fluorouracil (PF). Tongue reconstruction utilized the radial forearm free flap in 5 patients (71.4%) and the anterolateral thigh free flap in 2 patients (28.6%). Intraoperatively, NAC had no impact on the integrity of small and reliable donor vessels. Three patients died from tumor metastases after the second follow-up assessment, while one patient was lost to follow-up. The study found no significant association between chemotherapy dosage and free flap vitality (P = 0.629). FACE-Q assessments revealed moderate to low scores in speaking, eating, and drinking outcomes. Conclusion: Tongue reconstruction after NAC in LASCC patients remains a challenging procedure for surgeons. While the consideration of surgical difficulties due to damage of the donor vessels demands a more structured pre-operative plan. No correlation between the exposure of NAC or AR to free flap complication as well as functional outcome.

Clinical validation of the accuracy of an intra-operative assessment tool using 3D ultrasound compared to histopathology in patients with squamous cell carcinoma of the tongue

BackgroundHistopathological analysis often shows close resection margins after surgical removal of tongue squamous cell carcinoma (TSCC). This study aimed to investigate the agreement between intraoperative 3D ultrasound (US) margin assessment and postoperative histopathology of resected TSCC.MethodsIn this study, ten patients were prospectively included. Three fiducial cannulas were inserted into the specimen. To acquire a motorized 3D US volume, the resected specimen was submerged in saline, after which images were acquired while the probe moved over the specimen. The US volumes were annotated twice: (1) automatically and (2) manually, with the automatic segmentation as initialization. After standardized histopathological processing, all hematoxylin-eosin whole slide images (WSI) were included for analysis. Corresponding US images were found based on the known WSI spacing and fiducials. Blinded observers measured the tumor thickness and the margin in the caudal, deep, and cranial directions on every slide. The anterior and posterior margin was measured per specimen.ResultsThe mean difference in all measurements between manually segmented US and histopathology was 2.34 (SD: ±3.34) mm, and Spearman’s rank correlation coefficient was 0.733 (p < 0.001). The smallest mean difference was in the tumor thickness with 0.80 (SD: ±2.44) mm and a correlation of 0.836 (p < 0.001). Limitations were observed in the caudal region, where no correlation was found.ConclusionThis study shows that 3D US and histopathology have a moderate to strong statistically significant correlation (r = 0.733; p < 0.001) and a mean difference between the modalities of 2.3 mm (95%CI: -4.2; 8.9). Future research should focus on patient outcomes regarding resection margins.

Tumor thickness and depth of invasion in squamous cell carcinoma of tongue as indicators of the loco-regional spread of the disease: A preliminary study

BackgroundMagnetic resonance imaging (MRI) is a routinely used imaging modality for pre-treatment radiologic evaluation of tongue carcinoma, providing accurate information regarding the extent of the disease. Aims and objectivesTo investigate the role of MRI-derived depth of invasion and tumor thickness evaluation in squamous cell carcinoma of the tongue, and to assess if any correlation exists between depth of invasion, tumor thickness, nodal metastasis, muscles, and space involved. Materials and methodsThirty-three patients with oral squamous cell carcinoma of the tongue who had undergone pre-treatment MRI and excisional biopsy were included. The tumor thickness (TT) and depth of invasion (DOI) were evaluated on MRI and histopathologic images. ResultThe relation between different methodologies for assessing showed a very high correlation for the tumor tissue thickness (r = 0.99, p < 0.05) and depth of invasion (r = 0.82, p < 0.05). The tumor thickness and the depth of invasion increased with the loss of differentiation in the carcinoma histopathologically. As the depth of invasion increases, the extent of the spread of the carcinoma to tongue musculature, lingual septum, and spaces also increases. ConclusionThe present study has depicted a high correlation between the tumor thickness and the depth of invasion between MRI and histopathological findings and is the first of its kind to correlate DOI to the invasiveness of the disease.

Bioinformatics analysis and validation of HAUS6 as a key prognostic gene in squamous cell carcinoma of the tongue

ObjectiveTo explore the expression of HAUS6 in squamous cell carcinoma of the tongue (TSCC) and its relationship with the clinicopathological features of patients, and to further provide new ideas and therapeutic targets for curing TSCC. DesignThe Cancer Genome Atlas (TCGA) database was used to screen for differentially expressed genes (DEGs) between TSCC and normal tissues and survival analysis. DEGs of HAUS6 were screened and analyzed for GO, KEGG and GSEA enrichment. Exploring the correlation of HAUS6 with immune cell infiltration and immune checkpoint-related genes. The expression of HAUS6 in tumor and paraneoplastic tissues was confirmed by immunohistochemistry and Western Blot. ResultsAnalysis of the TCGA database results showed that expression of HAUS6 mRNA was significantly enhanced and correlated with overall survival (OS, p < 0.05) in TSCC. HAUS6 expression correlated with the level of immune cell infiltration and immune checkpoint-related genes. Immunohistochemistry and Western Blot confirmed that the expression level of HAUS6 protein was significantly higher in tumor tissues than in paraneoplastic tissues, and that tumor size and hypo-differentiation were higher in the HAUS6 high expression group than in the low expression group in TSCC (p < 0.05). ConclusionsIn conclusion, these analyses suggest that HAUS6 can act as an independent predictor of prognosis (p < 0.05) and high HAUS6 expression is strongly associated with poor prognosis.

Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. "G.Pascale".

Oral tongue squamous-cell carcinoma (OTSCC) is the most prevalent malignancy in the head and neck region. Lymphatic spread, particularly to cervical lymph nodes, significantly impacts 5-year survival rates, emphasizing the criticality of precise staging. Metastatic cervical lymph nodes can decrease survival rates by 50%. Yet, elective neck dissection (END) in T1-2 cN0 patients proves to be an overtreatment in around 80% of cases. To address this, sentinel lymph node biopsy (SLNB) was introduced, aiming to minimize postoperative morbidity. This study, conducted at the ENT and Maxillofacial Surgery department of the Istituto Nazionale Tumori in Naples, explores SLNB's efficacy in early-stage oral tongue squamous-cell carcinoma (OTSCC). From January 2020 to January 2022, 122 T1/T2 cN0 HNSCC patients were enrolled. Radioactive tracers and lymphoscintigraphy identified sentinel lymph nodes, aided by a gamma probe during surgery. Results revealed 24.6% SLN biopsy positivity, with 169 SLNs resected and a 21.9% positivity ratio. The study suggests SLNB's reliability for T1-2 cN0 OTSCC patient staging and early micrometastasis detection.

Targeting inhibitor of apoptosis proteins (IAPs) enhances susceptibility of oral squamous carcinoma cells to cisplatin

PurposeOral Squamous Cell Carcinoma (OSCC) is the 6th most common cancer worldwide. It is generally aggressive and closely associated with chemoresistance and poor survival. There is accumulating evidence for the involvement of inhibitors of apoptosis proteins (IAPs), including IAP1 and XIAP, in mediating chemotherapy resistance in OSCC. Various strategies for targeting IAPs have been designed and tested in recent years and several small molecule IAP inhibitors are in clinical trials as monotherapies as well as in combination with radiotherapy and chemotherapy. The purpose of this study was to evaluate and compare the efficacy and biological activity of three IAP inhibitors both as stand-alone and sensitising agents to cisplatin in a preclinical model of squamous cell carcinoma of the tongue. MethodsCisplatin-sensitive SCC4 and -resistant SCC4cisR cells were utilised in this study. Apoptosis was evaluated by flow cytometric analysis of Annexin V/Propidium Iodide-stained cells. Expression of IAP proteins was determined by western blotting and knockdown of cIAP1, livin and XIAP was conducted by transfection of cells with siRNA. ResultsWe establish for the first time the therapeutic efficacy of the Smac mimetic, BV6 and the XIAP inhibitor Embelin, for OSCC. Both of these IAP targeting agents synergistically enhanced cisplatin-mediated apoptotic cell death in resistant cells which was mediated in part by depletion of XIAP. In addition, knockdown of XIAP using siRNA enhanced cisplatin-mediated cell death, demonstrating the importance of targeting XIAP in this sensitisation. ConclusionThese findings provide pre-clinical evidence that IAP inhibition may be a valuable therapeutic option in OSCC.

Influence of Social Vulnerability in Treatment and Prognosis of Squamous Cell Carcinoma of the Tongue.

To investigate the association of social determinants of health (SDoH) in squamous cell carcinoma of the tongue in the United States and to evaluate the real-world contribution of specific disparities. Retrospective cohort study. United States. The Centers for Disease Control and Prevention-Social Vulnerability Index (SVI) and National Cancer Institute-Surveillance, Epidemiology, and End Results Programdatabase were used to study 62,103 adult tongue squamous cell carcinoma patients from 1975 to 2017. Regression analysis assessed trends in months of follow-up and survival across social vulnerability and 4 subcategories of social vulnerability. As overall SVI score increases (increased social vulnerability), there is a significant decrease in the average length of follow-up (22.95% decrease from 63.99 to 49.31 months; P < .001) across patients from the lowest and highest social vulnerability groups. As overall SVI score increases, there is a significant decrease in the average months of survival (28.00% decrease from 49.20 to 35.43 months; P < .001). There is also a significantly greater odds ratio (OR = 1.05; P < .001) of advanced cancer staging upon presentation at higher SVI scores. Patients with higher SVI scores have a lower OR (0.93; P < .001) of receiving surgery as their primary treatment when compared to patients with lower SVI scores. Patients with higher SVI scores also have a significantly greater OR (OR = 1.05; P < .001) of receiving chemotherapy as their primary treatment when compared to patients with lower SVI scores. Increased social vulnerability is shown to have a detrimental impact on the treatment and prognosis of patients with squamous cell carcinoma of the tongue.

Childhood-onset systemic lupus erythematosus (cSLE) and malignancy: a nationwide multicentre series review

BackgroundIncreased malignancy frequency is well documented in adult-systemic lupus erythematosus (SLE), but with limited reports in childhood-onset SLE (cSLE) series. We explored the frequency of malignancy associated with cSLE, describing clinical and demographic characteristics, disease activity and cumulative damage, by the time of malignancy diagnosis.MethodA retrospective case-notes review, in a nationwide cohort from 27 Pediatric Rheumatology centres, with descriptive biopsy-proven malignancy, disease activity/damage accrual, and immunosuppressive treatment were compiled in each participating centre, using a standard protocol.ResultsOf the 1757 cSLE cases in the updated cohort, 12 (0.7%) developed malignancy with median time 10 years after cSLE diagnosis. There were 91% females, median age at cSLE diagnosis 12 years, median age at malignancy diagnosis 23 years. Of all diagnosed malignancies, 11 were single-site, and a single case with concomitant multiple sites; four had haematological (0.22%) and 8 solid malignancy (0.45%). Median (min–max) SLEDAI-2 K scores were 9 (0–38), median (min–max) SLICC/ACR-DI (SDI) score were 1 (1–5) Histopathology defined 1 Hodgkin's lymphoma, 2 non-Hodgkin's lymphoma, 1 acute lymphoblastic leukaemia; 4 gastrointestinal carcinoma, 1 squamous cell carcinoma of the tongue and 1 anal carcinoma; 1 had sigmoid adenocarcinoma and 1 stomach carcinoid; 3 had genital malignancy, being 1 vulvae, 1 cervix and 1 vulvae and cervix carcinomas; 1 had central nervous system oligodendroglioma; and 1 testicle germ cell teratoma.ConclusionEstimated malignancy frequency of 0.7% was reported during cSLE follow up in a multicentric series. Median disease activity and cumulative damage scores, by the time of malignancy diagnoses, were high; considering that reported in adult series.

Magnetic resonance imaging-based radiomics and deep learning models for predicting lymph node metastasis of squamous cell carcinoma of the tongue

ObjectiveThis study aimed to establish a combined method of radiomics and deep learning (DL) in magnetic resonance imaging (MRI) to predict lymph node metastasis (LNM) preoperatively in patients with squamous cell carcinoma of the tongue. Study DesignIn total, MR images of 196 patients with lingual squamous cell carcinoma were divided into training (n=156) and test (n=40) cohorts. Radiomics and DL features were extracted from MR images and selected to construct machine learning models. A DL radiomics nomogram was established via multivariate logistic regression by incorporating the radiomics signature, the DL signature, and MRI-reported LN status. ResultsNine radiomics and 3 DL features were selected. In the radiomics test cohort, the multilayer perceptron model performed best with an area under the curve (AUC) of 0.747, but in the DL cohort, the best model (logistic regression) performed less well (AUC = 0.655). The DL radiomics nomogram showed good calibration and performance with an AUC of 0.934 (outstanding discrimination ability) in the training cohort and 0.757 (acceptable discrimination ability) in the test cohort. The decision curve analysis demonstrated that the nomogram could offer more net benefit than a single radiomics or DL signature. ConclusionThe DL radiomics nomogram exhibited promising performance in predicting LNM, which facilitates personalized treatment of tongue cancer.

Perineural invasion in incisional biopsy is an indication for in-continuity resection in oral squamous cell carcinoma of the tongue and floor of the mouth.

The histologic finding of perineural invasion is a poor prognostic factor in oral squamous cell carcinoma patients. The aim of this study is to detect factors that influence prognosis in patients operated for oral cancer with perineural invasion in their histopathology report and to propose safer options of treatment with respect to recurrence and survival rates. We performed a prospective cohort study of all oral squamous cell carcinoma cases operated in our department from January 2018 to January 2022. Overall, 75 cases of patients operated for oral squamous cell carcinoma were included in the study. Of these cases, 14 with perineural invasion were found. We created two groups: one group of patients treated with in-continuity resection and a second group of patients treated with a discontinuous resection between the primary site and the neck. Type of operation was considered the predictor variable and recurrence, survival or death, the outcome variables. Oral cancer patients with known perineural invasion treated with in-continuity resection had a much better overall and disease-specific survival than patients treated with a discontinuous manner (p < .001). The difference in recurrence rate between these two groups of patients was found to be very significant in our study (p < .0005). It is therefore our suggestion that in oral squamous cell carcinoma of the tongue and floor of the mouth with perineural invasion detected in the incisional biopsy, an extended in-continuity resection to include the affected nerves should be performed.

Current Research Status of MicroRNAs in Squamous Cell Carcinoma of the Tongue

Current Research Status of MicroRNAs in Squamous Cell Carcinoma of the Tongue