Well-differentiated Squamous Cell Carcinoma Research Articles

Pencil Beam Scanning Proton Therapy as Single Vocal Cord Irradiation for Early-Stage Glottic Cancer

PurposeSingle vocal cord irradiation (SVCI) is a promising technique to maintain excellent oncologic control and potentially improve upon toxicities for treatment of early-stage glottic squamous cell carcinomas. We sought to investigate whether pencil beam scanning (PBS) proton therapy could improve upon the already favorable dose gradients demonstrated with volumetric modulated arc therapy (VMAT) SVCI. Patients and MethodsA 64-year-old gentleman was treated in our department with 6X-flattening filter-free VMAT SVCI to 58.08 Gy in 16 fractions for a T1a well-differentiated squamous cell carcinoma of the left true vocal cord and tolerated it well with good local control. Comparative PBS plans were created in Raystation for the Varian ProBeam with clinical target volume (CTVs) generated to mimic the prescription target volume extent of the VMAT planning target volumes when accounting for PBS plan robustness (±3 mm translational shifts, 3.5% density perturbation). A 3-field single-field optimization plan was selected as dosimetrically preferable. Dosimetric variables were compared. ResultsSeveral organs at risk doses improved with PBS, including the maximum and mean dose to ipsilateral carotids, maximum and mean dose to contralateral carotid, maximum dose to the spinal cord, maximum and mean dose to inferior constrictor/cricopharyngeus, maximum and mean dose to the uninvolved vocal cord, and mean dose to the thyroid gland. There are tradeoffs in skin dose depending on location relative to the target—with the highest and lowest isodoses extending more into the skin with the VMAT plan but with the moderate isodose lines covering a wider area with the PBS plan, but we deemed it tolerable regardless. ConclusionSVCI is a promising strategy for maintaining the oncologic effectiveness of whole-larynx photon radiation while potentially improving upon the historic toxicity profile. The favorable dose distribution with PBS with respect to organs at risk dosimetry for PBS may allow for further improvements upon VMAT SVCI strategies. Clinical implementation of PBS SVCI may be considered.

Carcinoma Cuniculatum Masquerading as Eumycetoma: An Unacquainted Entity Posing a Diagnostic Dilemma.

Carcinoma cuniculatum (CC) is a rare and distinct clinicopathological variant of well-differentiated squamous cell carcinoma. It is a rare and slow-growing tumor with a peculiar infiltrative growth pattern resembling rabbit burrows (cuniculi). It usually occurs over the plantar aspect of the foot but can also occur at other sites like the oral cavity and genitals. The pathogenesis is unknown, with various hypotheses of trauma as proposed by different authors. It is essential to be aware of this entity as it commonly mimics benign and other low-grade squamous cell carcinoma (SCC). Diagnosis of CC can be challenging and requires repeated histological evaluation and clinical correlation. Herein, we present a case report of CC of the plantar and dorsal aspect of the foot in a 60-year-old male with a history of multiple chronic non-healing ulcers, which was clinically suspected as eumycetoma and remained inconclusive on numerous biopsies.

3D stem-like spheroids-on-a-chip for personalized combinatorial drug testing in oral cancer

BackgroundFunctional drug testing (FDT) with patient-derived tumor cells in microfluidic devices is gaining popularity. However, the majority of previously reported microfluidic devices for FDT were limited by at least one of these factors: lengthy fabrication procedures, absence of tumor progenitor cells, lack of clinical correlation, and mono-drug therapy testing. Furthermore, personalized microfluidic models based on spheroids derived from oral cancer patients remain to be thoroughly validated. Overcoming the limitations, we develop 3D printed mold-based, dynamic, and personalized oral stem-like spheroids-on-a-chip, featuring unique serpentine loops and flat-bottom microwells arrangement.ResultsThis unique arrangement enables the screening of seven combinations of three drugs on chemoresistive cancer stem-like cells. Oral cancer patients-derived stem-like spheroids (CD 44+) remains highly viable (> 90%) for 5 days. Treatment with a well-known oral cancer chemotherapy regimen (paclitaxel, 5 fluorouracil, and cisplatin) at clinically relevant dosages results in heterogeneous drug responses in spheroids. These spheroids are derived from three oral cancer patients, each diagnosed with either well-differentiated or moderately-differentiated squamous cell carcinoma. Oral spheroids exhibit dissimilar morphology, size, and oral tumor-relevant oxygen levels (< 5% O2). These features correlate with the drug responses and clinical diagnosis from each patient’s histopathological report.ConclusionsOverall, we demonstrate the influence of tumor differentiation status on treatment responses, which has been rarely carried out in the previous reports. To the best of our knowledge, this is the first report demonstrating extensive work on development of microfluidic based oral cancer spheroid model for personalized combinatorial drug screening. Furthermore, the obtained clinical correlation of drug screening data represents a significant advancement over previously reported personalized spheroid-based microfluidic devices. Finally, the maintenance of patient-derived spheroids with high viability under oral cancer relevant oxygen levels of less than 5% O2 is a more realistic representation of solid tumor microenvironment in our developed device.Graphical

Oral Papillary Squamous Cell Carcinoma and Oral Squamous Cell Carcinoma: A Histopathological and Immunohistochemical Comparative Study

PurposeThe aim of the study is to investigate the immunohistochemical expression of both Alpha smooth muscle actin and Transforming Growth Factor beta and compare their expression in oral papillary squamous cell carcinoma with their expression in different histological grades of oral squamous cell carcinoma. A correlation between these immuno-histochemical expressions and histological findings will then be performed. The research question is “Do the percentages of α-SMA and TGF-β immune-expression in OPSCC differ from that in the conventional OSCC?”.MethodsThis will be achieved by collecting archival blocks of oral papillary squamous cell carcinoma and different grades of oral squamous cell carcinoma, staining the specimens with Transforming Growth Factor beta and alpha smooth muscle actin, then measuring the mean staining index of expression in each group and the area percent of both markers.ResultsResults revealed that transforming growth factor beta expression in the epithelium was high in all cases of well-differentiated squamous cell carcinoma, most oral papillary squamous cell carcinoma, and poorly differentiated oral squamous cell carcinoma. On the other hand, different grades of oral squamous cell carcinoma showed a high staining index of alpha smooth muscle actin expression in the stroma. While cases of oral papillary squamous cell carcinoma were either moderate or low-staining.ConclusionsOral papillary squamous cell carcinoma has a favourable prognosis compared to different histological grades, and the prognosis does not depend only on histological grade but also on other prognostic factors.

14-3-3σ/Stratifin and p21 limit AKT-related malignant progression in skin carcinogenesis following MDM2-associated p53 loss.

To study mechanisms driving/inhibiting skin carcinogenesis, stage-specific expression of 14-3-3σ (Stratifin) was analyzed in skin carcinogenesis driven by activated rasHa/fos expression (HK1.ras/fos) and ablation of PTEN-mediated AKT regulation (K14.creP/Δ5PTENflx/flx). Consistent with 14-3-3σ roles in epidermal differentiation, HK1.ras hyperplasia and papillomas displayed elevated 14-3-3σ expression in supra-basal keratinocytes, paralleled by supra-basal p-MDM2166 activation and sporadic p-AKT473 expression. In bi-genic HK1.fos/Δ5PTENflx/flx hyperplasia, basal-layer 14-3-3σ expression appeared, and alongside p53/p21, was associated with keratinocyte differentiation and keratoacanthoma etiology. Tri-genic HK1.ras/fos-Δ5PTENflx/flx hyperplasia/papillomas initially displayed increased basal-layer 14-3-3σ, suggesting attempts to maintain supra-basal p-MDM2166 and protect basal-layer p53. However, HK1.ras/fos-Δ5PTENflx/flx papillomas exhibited increasing basal-layer p-MDM2166 activation that reduced p53, which coincided with malignant conversion. Despite p53 loss, 14-3-3σ expression persisted in well-differentiated squamous cell carcinomas (wdSCCs) and alongside elevated p21, limited malignant progression via inhibiting p-AKT1473 expression; until 14-3-3σ/p21 loss facilitated progression to aggressive SCC exhibiting uniform p-AKT1473. Analysis of TPA-promoted HK1.ras-Δ5PTENflx/flx mouse skin, demonstrated early loss of 14-3-3σ/p53/p21 in hyperplasia and papillomas, with increased p-MDM2166/p-AKT1473 that resulted in rapid malignant conversion and progression to poorly differentiated SCC. In 2D/3D cultures, membranous 14-3-3σ expression observed in normal HaCaT and SP1ras61 papilloma keratinocytes was unexpectedly detected in malignant T52ras61/v-fos SCC cells cultured in monolayers, but not invasive 3D-cells. Collectively, these data suggest 14-3-3σ/Stratifin exerts suppressive roles in papillomatogenesis via MDM2/p53-dependent mechanisms; while persistent p53-independent expression in early wdSCC may involve p21-mediated AKT1 inhibition to limit malignant progression.

Relationship of microvascular density and tumor-associated macrophages with orofacial squamous cell carcinoma progression

The current study aimed to investigate the characteristics of tumor-associated macrophages (TAMs) and their association with microvascular density (MVD) in tumor progression in different grades of orofacial squamous cell carcinoma (OSCC) in the Pakistani population. This prospective study included 234 patients with oral cancer reported at different hospitals in Pakistan diagnosed with OSCC. Tumors were graded on the Anneroth grading system and the association between the frequency of TAMs and MVD was examined in vivo. The macrophages visible through immunohistochemistry for CD68 and the microvessels observed through immunohistochemistry for CD34 were manually counted in 3 high-power fields. The CD68 and CD34 counts were significantly lower in well-differentiated squamous cell carcinoma compared to poorly differentiated squamous cell carcinoma. Linear regression analysis revealed a positive correlation between the area percentage of CD68 immunoreactivity and the grade of the tumor (r = 0.776). Vice versa, a positive correlation also existed between the area percentage of CD34 immunoreactivity and the grade of the tumor (r = 0.690). Pearson correlation revealed a positive association between the TAMs and MVD (r = 0.680; P < .001). There was an increased population of tumor-associated macrophages and tumor angiogenesis with the increasing grade of orofacial squamous cell carcinoma. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).

Multiple cutaneous squamous cell carcinoma of the forehead in a patient with skin of color treated by wide local excision with adjuvant radiotherapy: a case report

Cutaneous squamous cell carcinoma is the second most common non-melanoma skin cancer, characterized by the proliferation of keratinocytes, with an increasing incidence worldwide. In cases of perineural invasion, surgical excision followed by adjuvant radiotherapy is the preferred treatment. An intraoperative frozen section is necessary to determine the cancer-cell-free margin. A 80-year-old male presented to the outpatient department of our hospital with two fungating growths over his right forehead (size 2.7×1.2 cm) and right temple region (size 4×1.2 cm) for 5 years. An incisional biopsy of the growths revealed well-differentiated squamous cell carcinoma. There was no evidence of lymphadenopathy. The patient was treated successfully by wide local excision of the growths with an intraoperative frozen section to determine negative margins. Local defects of the forehead and right temple were reconstructed with a scalp rotation flap and a split skin thickness graft, respectively. The final histopathological examination showed moderately differentiated squamous cell carcinoma with resection-free margins. Forehead growth showed perineural invasion. The patient underwent 30 fractions of image-guided adjuvant radiotherapy in view of perineural invasion and to avoid local recurrence. The patient recovered well without any recurrences or complications. Surgical excision and reconstruction followed by adjuvant radiotherapy is the most effective method for treating cutaneous squamous cell carcinomas with perineural or lymphovascular invasion. Intraoperative frozen section is necessary to reduce recurrence rates and metastasis. Ours is a rare case of multiple cutaneous squamous cell carcinomas involving the forehead region.

Leiomyosarcoma of the esophagus, arising from lamina muscularis mucosae, in a combination with microinvasive squamous cell carcinoma-A case report.

Leiomyosarcoma of the esophagus is a very rare disease, accounting for less than 0.5% of malignant esophageal tumors. Esophageal leiomyosarcoma combined with squamous cell carcinoma is even rarer than solitary leiomyosarcoma. To our knowledge, there are less than ten cases of simultaneously diagnosed leiomyosarcoma and squamous cell carcinoma of the esophagus. A 66-year-old male was admitted to our hospital suffering from epigastric pain, asthenia, weight loss, and difficulties when feeding with solid food which had been present for 2 weeks. A computed tomography scan showed a large tumor tissue mass in the mid-to-distal part of the esophagus. The patient underwent robot-assisted surgery-an esophagectomy with esophagogastrostomy. Histologically, the tumor consisted of highly pleomorphic spindle cells with multiple atypical mitosis and necrotic areas. An immunohistochemical examination was performed to distinguish leiomyosarcoma from spindle cell squamous carcinoma or malignant GIST. Tumor cells stained diffusely positive for smooth muscle actin, but negative for p63, CD117, and CKAE1/AE3. Tumor invasion involved mucosa and submucosa, without tunica muscularis propria. Microinvasive well-differentiated squamous cell carcinoma was also noted in the mucosa at the borders between the tumor and the healthy part of the esophagus. The aim of the manuscript is to present an extremely rare case of combined polypoid leiomyosarcoma and microinvasive squamous cell carcinoma of the esophagus, cured by robot-assisted surgical intervention and to emphasize that such cases should be examined carefully, including additional diagnostic tests such as Immunohistochemistry (IHC) in order to define the correct diagnosis.

Vulva lesions seen at a tertiary health centre in southwest Nigeria

Background: Some researchers have emphasised the need for more studies on vulvar cancers. The aim of our study is to describe the vulvar lesions identified in biopsies seen in our department over a five-year period to serve as baseline data for future studies. Methods: We conducted a five-year cross-sectional study on all vulva specimens received by the department of Morbid Anatomy and Forensic medicine at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria. From the departmental records, we retrieved data on the patients' biodata, medical history, and vulva lesion diagnosis. Results: We recorded 15 vulva biopsies during the study period, with an age range of 13 to 80 years. Two cases were benign tumours, and two cases were inflammatory in nature. A case of a pre-malignant lesion was seen. Nine cases were malignant tumours, all of which are epithelial in origin. We saw two non-neoplastic lesions. These are acute on chronic inflammation and lichen sclerosus et atrophicus. Of the malignant tumours seen, five were well-differentiated squamous cell carcinoma (SCC), two were moderately differentiated SCC, and two were cases of verrucous carcinoma. One case of verrucous carcinoma and a well-differentiated SCC had a background HIV. Conclusion: Vulva lesions are rarely seen at our centre. The absence of preinvasive lesions in our study may be due to the late presentation of cases in clinics or the reluctance of gynaecologists to take biopsies of non-tumoral lesions of the vulva. HIV may be associated with an increased risk of HPV-related cancers.

Clinical Presentation, Tumour Characteristics, Sociodemographic, And Lifestyle-Related Factors of Oral Cancer In Patients Visiting Abbasi Shaheed Hospital, Karachi Pakistan

Clinical Presentation, Tumour Characteristics, Sociodemographic, And Lifestyle-Related Factors of Oral Cancer In Patients Visiting Abbasi Shaheed Hospital, Karachi Pakistan

Squamous cell carcinoma initially occurring on the tongue dorsum: a case series report with molecular analysis

BackgroundSquamous cell carcinoma (SCC) of the dorsum of the tongue is extremely rare, and it clinically resembles various benign lesions. Somatic mutations in TP53 and some driver genes were implicated in the development of SCC; however, the somatic genetic characteristics of dorsal tongue SCC remain unknown. With a detailed analysis of gene mutations in dorsal tongue SCC, we aimed to better understand its biology.MethodsFour cases of SCC initially occurring on the tongue dorsum were evaluated for clinical and histological findings and immunohistochemical expression of p53 and p16. Gene mutations were analyzed using next-generation sequencing with a custom panel of driver genes.ResultsWe retrospectively investigated 557 cases of tongue SCC, and only four cases of SCC initially occurred on the tongue dorsum. The four patients (cases 1–4) were one woman and three men with a mean age of 53.75 years (range: 15–74 years). Histological analysis revealed well-differentiated SCC. Through molecular analysis, we identified pathogenic somatic mutations, namely, TP53 p.C176F (c.527G > T) in case 3 and TP53 p.R282W (c.844 C > T) in case 4. No pathogenic variants were identified in the PI3K/AKT or RAS/RAF pathways. The p53 immunohistochemical examination revealed a wild-type expression pattern in cases 1–3 and strong expression in case 4. The results of p16 immunostaining were negative in all cases.ConclusionsWe described four previously unreported genetic characteristics of dorsal tongue SCC. Somatic TP53 mutations may contribute to the development of a subset of dorsal tongue SCC; however, more cases with genetic analysis need to be accumulated.

Necroptosis could serve as an indicator of therapeutic resistance in viral induced well-differentiated oral squamous cell carcinoma?

Goal of the perspectiveExploring necroptosis as an indicator of therapeutic resistance in viral-induced well-differentiated oral squamous cell carcinoma (OSCC) is to elucidate its potential role in predicting treatment outcomes and guiding therapeutic decisions. By understanding the relationship between necroptosis levels and therapeutic resistance, oncologists can aim to identify novel biomarkers and therapeutic targets that could improve patient management and outcomes in viral-induced OSCC. DiscussionViral-induced oral squamous cell carcinoma (OSCC) presents with disrupted cellular functions, dysregulation of apoptotic pathways, evasion of programmed cell death and resistance to conventional anticancer treatments. Concurrently, alterations in pro-inflammatory cytokines and chemokines drive tumorigenesis in viral-induced squamous cell carcinoma, impairing anti-viral immune responses. ConclusionMonitoring necroptosis levels in viral-induced OSCC offers insights into therapy resistance, as high levels may indicate reduced responsiveness to standard treatments. Understanding the role of necroptosis in therapy resistance could pave the way for the development of targeted therapies that exploit necroptosis pathways to overcome resistance and improve treatment outcomes in viral-induced OSCC.

Evaluation of the significance of tumor stromal patterns and peri-tumoral inflammation in head and neck squamous cell carcinoma with special reference to the Yamamoto-Kohama classification.

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with 878,348 new cases. Cancer-associated fibroblasts (CAFs) are the predominant cell type in tumor stroma and are important promoters of tumor progression. The aim of the study was to evaluate the pattern of desmoplastic stromal reaction and peri-tumoral inflammatory infiltrate with the histological grade and clinical data. A total of 60 cases of HNSCC were included in the study. The hematoxylin and eosin (H and E)-stained sections from all cases were examined by two experienced pathologists for the grade, nature of stomal reaction (SR), peri-tumoral inflammatory infiltration, Yamamoto-Kohama classification grade, worst pattern of invasion (WPOI), depth of invasion (DOI), and other histopathological parameters. Correlation analysis was conducted using the Chi-square test. P- value less than 0.05 was considered statistically significant. Immature SR was not observed in any of the well-differentiated squamous cell carcinoma (SCC) cases. However, one (3.7%) case of moderately differentiated SCC and two (28.6%) cases of poorly differentiated SCC showed signs of immature SR. In the case of the higher grades of the YK classification, specifically grades 4C and 4D, a more profound depth of tumor cell invasion, equal to or exceeding 10 mm, was evident in six (66.67%) and two (28.57%) cases, respectively. Additionally, among the seven (11.7%) cases classified as poorly differentiated carcinoma, three (42.85%) displayed a WPOI score of 5. SR and the tumor invasive pattern in HNSCC are related to prognosis and may indicate tumor aggressiveness.

CLINICAL CASE OF KERATOACANTHOMA

Keratoacanthoma is a common, rapidly growing skin tumour that has long been considered benign due to its staged course and ability to spontaneously regress. However, according to the latest World Health Organization classification, keratoacanthoma is classified as a well-differentiated form of squamous cell carcinoma.&#x0D; Despite its long history keratoacanthoma remains a subject of controversy with regard to epidemiology, diagnosis, prognosis, and treatment.&#x0D; The etiology and pathogenesis of keratoacanthoma are also not clearly defined. However, a number of factors have been identified that are highly likely to lead to the development of a tumour. In particular, these are ultraviolet and X-ray radiation, thermal and traumatic injuries, chemical carcinogens, genetic and immunological predictors, human papillomaviruses and certain drugs (sorafenib, infliximab, etc.).&#x0D; Clinically, keratoacanthoma appears on the skin as a single or multiple crater-like nodule. Dermoscopy can be used for early diagnosis and differentiation from other tumour formations. The choice of therapy varies widely and depends on the location, stage of development, and size of the tumour.&#x0D; The publication presents a number of cases which demonstrate the clinical, dermoscopic, and histological picture of keratoacanthomas.&#x0D; Case presentation. Patient A, 44 years old, skin with signs of photodamage. A single dense nodule, up to 0.5 cm in diameter, on the anterior surface of the right lower leg. It appeared and grew rapidly over the past month.&#x0D; Dermoscopy with photographic fixation was performed. A non-pigmented dome-shaped lesion with central yellow-brown keratinous masses, sporadic haemorrhages, and white structureless areas was observed. The vascular pattern was represented by looped, glomerular and helical vessels in a radial arrangement. The lesion was surgically excised. A pathohistological study was carried out. The conclusion was a well-differentiated squamous cell carcinoma of the skin.&#x0D; In typical cases, the diagnosis of keratoacanthoma is not difficult. However, the combination with other skin lesions can distort the clinical picture. For example, in Patient B, keratoacanthoma developed against the background of seborrheic keratosis. In such cases, the use of dermoscopy can provide additional clues to the diagnosis and, accordingly, influence treatment methods.&#x0D; Considering keratoacanthoma as a well-differentiated squamous cell carcinoma, surgical excision is preferred. The metastatic potential of this tumour is not significant, but in high-risk areas such as the lip or ear, it can reach 30%. At the same time, surgery reduces the risk of local recurrence. Other approaches include electrodissection and curettage, cryodestruction, intratumoural administration of methotrexate, 5-fluorouracil, bleomycin, and photodynamic therapy. These methods are appropriate in cases where the size or location of the tumour do not allow achieving the desired aesthetic effect.&#x0D; Conclusions: 1. Keratoacanthoma is a well-differentiated squamous cell carcinoma with a low potential for metastasis. 2. Central yellow-brown keratinous masses, sporadic haemorrhages, white structureless areas, in combination with looped and glomerular vessels in radial disposition seen during dermoscopy of a nodule, may be a sign of keratoacanthoma. 3. The choice of treatment method for keratoacanthoma depends on its location and size; surgical excision of the tumour should be preferred.

Oral Verrucous Carcinoma: Case Report

Verrucous carcinoma is usually considered a low-grade variant of squamous cell carcinoma. Our case is a 56-year-old woman presented to our department of maxillofacial surgery of Ibn Sina hospital in Rabat with a budding lesion of the upper lip evolving 2 years ago. The diagnosis retained was that of well-differentiated squamous cell carcinoma of the verrucous type with infiltration of the chorion. The therapeutic decision was to perform a surgical excision with a safety margin of 1 cm followed by suturing of the defect and commissuroplasty. Its diagnosis is based on clinical and histological features. The treatment is not well codified. Surgery remains the treatment of choice.

Expression of Bcl-2 in Squamous Cell Carcinoma of Oral Cavity

Objectives: To investigate the expression of Bcl-2 in squamous cell carcinoma of the oral cavity. Methodology: This descriptive cross-sectional study was conducted at the Department of Histopathology, Pakistan Institute of Medical Sciences, Islamabad, from December 2021 to June 2022. Sixty patients aged 30 to 85 years, of both genders, diagnosed with squamous cell carcinoma of the oral cavity based on histopathology reports, were included. Immunohistochemistry for Bcl-2 was performed and assessed. All results were subsequently analyzed using SPSS Version 20. Results: Out of the 60 cases studied, 36 were males (60%) and 24 were females (40%). The mean age of the patients was 55 years. The most common histological grade was well-differentiated squamous cell carcinoma, accounting for 26 out of 60 cases (43.3%), followed by moderately differentiated squamous cell carcinoma (21/60, 35%). Poorly differentiated squamous cell carcinoma was the least common grade, found in 13 out of 60 cases (21.7%). Bcl-2 expression was positive in 23 patients (38.3%). Regarding grade-wise expression of Bcl-2, there was an increasing expression with increasing grades of oral squamous cell carcinoma: 19% Bcl-2 expression in well-differentiated squamous cell carcinoma, 38% in moderately differentiated squamous cell carcinoma, and 77% in poorly differentiated carcinomas. This demonstrated a significant correlation between Bcl-2 expression and histopathological grades (p value &lt;0.001). Conclusion: In summary, Bcl-2 expression was detected in 38.3% of oral squamous cell carcinoma cases. Its immuno-expression is significantly associated with the histopathological grades of oral squamous cell carcinoma. Therefore, Bcl-2 can be considered an important prognostic marker as well as a potential target for chemoresistance cases through Bcl-2 inhibition.

The Role of Salivary Micro RNAs as a Diagnostic Marker in Early Detection of Oral Squamous Cell Carcinoma

OBJECTIVE: To assess the diagnostic role of salivary microRNA for early detection oforal squamous cell carcinoma and to compare the salivary microRNA with Biopsy in thediagnosis of oral squamous cell carcinoma.Methodology: The descriptive cross-sectional study was conducted in the department of pathology and molecular laboratory, department of oral &amp;amp; maxillofacial surgery of Liaquat University of Medical Health Sciences, Jamshoro / Hyderabad.Inclusion Criteria: All histopathologicaly diagnosed OSCC patients of both genders with age group 18 years and above will be included in the study after taking their informed consent. Whole saliva samples (inactivated) were collectedfrom subjects diagnosed as OSCC and controls. The subjects were counseled to avoid eating, drinking, smoking or oral procedures for at least 1 h prior to the collection of saliva. Subjects are asked to rinse their mouth well with distilled drinking water for one minute before taking the saliva samples. After five minutes of oral rinsing spit 5 mL of saliva into a 50 mL sterile tube placed on the ice. The tube should remain on ice while collecting the saliva samples. Fourhundred microliters of the whole saliva mixture (200 ?L whole saliva and 200 ?L RNA later),and 400 ?L of the supernatant saliva was used for RNA extraction. Saliva samples wereextracted using the mirVana™ miRNA Isolation Kit according to the manufacturer&amp;#39;s guideline(Ambion Inc., Austin, TX). Whole saliva samples were preserved with RN Alater (QIAGENInc., Valencia, CA) and supernatant saliva samples were preserved with SUPE Rase. In™ (Ambion Inc., Austin, TX). The data was entered in the statistical package for social sciences for windows (SPSS) V: 26.RESULTS: A total of 120 samples of oral squamous cell carcinoma were taken, which met theinclusion criteria. Mean age of the patients was 47.45+10.85 years. 85(70.8%) were married and35 (29.2%) were unmarried. 90.0% were married and 5.0% were unmarried, while 5.0% werewidow. Cigarette smoking, paan, chaalia and naswar were the commonest cause of the oralsquamous cell carcinoma. Lips, buccal mucosa and tong were the commonest t sites of the oralsquamous cell carcinoma. 16.7% cases had positive family history of oral squamous cellcarcinoma. Out of all study subjects, most of the cases 59.2% had moderately differentiatedSCC, 30.0% cases had well-differentiated SCC and 10.8% of the cases had poor differentiatedSCC. Out of all study subjects, 87.5% of the patients had positive micro-RNA expression.Micro-RNA expression was significantly associated, with poorly differentiated squamous cellcarcinoma (p=0.016). CONCLUSION: Study revealed that the salivary miroRNA expression were significantlypositive in patients of OSCC. Therefore, salivary microRNA could be considered as a useful andadvantageous biomarker for the detection and tracking of OSCC across various levels of tissueabnormalities

Oral squamous cell carcinoma: A case report with scanning electron microscopy, Mallory’s, Masson’s trichrome, orcein, and Papanicolaou staining

Squamous cell carcinoma is a malignant epithelial tumor with squamous differentiation. It is characterized by formation of keratin or presence of intercellular bridges. This neoplasm is also known as epidermoid carcinoma and is the second most common malignant neoplasm of the oral cavity. This neoplasm is seen more frequently in the lower lip, tongue, floor of the mouth, upper lip, buccal mucosa, gingiva, and in some cases, in the hard palate and maxillary sinus. Multiple reports on oral squamous cell carcinoma (OSCC) are found in the literature but very few report the various investigations done using special stains and scanning electron microscopy. There is a need for investigations using special stains as it is less expensive and may also help in identifying various characteristics of OSCC. Here, we present a case report of well-differentiated squamous cell carcinoma in a 60-year-old male patient with complaints of pain and ulcers on both cheeks for 2–3 months.

Tracing human papillomavirus in skin and mucosal squamous cell carcinoma: a histopathological retrospective survey.

Worldwide, squamous cell carcinoma (SCC) incidence is rising. The literature debates the human papillomavirus (HPV)'s role in cutaneous SCC development. We examined HPV histopathology in SCC samples in this study. Retrospective study at tertiary referral skin center in 2020. Histopathological features of HPV, including koilocytosis, hyperkeratosis, acanthosis, hypergranulosis, parakeratosis, solar elastosis, papillomatosis, and tumor grade, were examined in SCC specimens. Two dermatopathologists independently reevaluated all samples. We examined 331 SCC cases (male:female ratio = 3.9:1). The mean age was 68.1, with 15.1 standard deviation. Lesions were most common on the face (40.5%), scalp (22.7%), and extremities (20.8%). Koilocytes were found in 50 (15.1%) lesions. Nail (38.1%, p=0.007), oral cavity (36.8%, p=0.014), and genitalia (60.0%, p=0.026) lesions had higher koilocytosis rates. SCCs were found in 6.6% of specimens, but in situ tumors had the highest koilocytosis (64.7%), significantly higher than other grades (p<0.001). SCC pathology often shows HPV and specific koilocyte histopathology. Well-differentiated SCC has a stronger association with nail, oral, and genital lesions.

Laparoscopic transfundal approach to cervical dilation: a novel treatment for cervical stenosis and cervical factor infertility

To demonstrate a novel technique used to restore cervical patency in a patient with severe iatrogenic cervical stenosis. Surgical video case report. A single academic institution. We highlight the case of a 35-year-old nulliparous woman with a history of primary infertility. Her past medical history was significant for focal, invasive, well-differentiated squamous cell carcinoma of the cervix, for which she underwent a loop electrosurgical excision procedure. During her infertility assessment, she was found to have an extremely stenotic cervix that was refractory to conventional treatment options. This video highlights our innovative laparoscopic transfundal technique used to restore her cervical patency. None, as this is a descriptive case report. Postoperatively, the patient had continued cervical patency for >1 year with successful fertility treatment resulting in pregnancy. To our knowledge, this is the first case report describing a laparoscopic transfundal approach used to reestablish cervical patency. This approach may be considered for patients with cervical stenosis who have not responded to standard conservative therapies.