• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8351-8359
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• 2014

Background: Recent epidemiological data have implicated human papilloma virus (HPV) infection in the pathogenesis of head and neck cancers, especially oropharyngeal cancers. Although, HPV has been detected in varied amounts in persons with oral dysplasia, leukoplakias and malignancies, its involvement in oral tongue carcinogenesis remains ambiguous. Materials and Methods: HPV DNA prevalence was assessed by PCR with formalin fixed paraffin embedded sections (n=167) of oral tongue squamous cell carcinoma patients and the physical status of the HPV16 DNA was assessed by qPCR. Immunohistochemistry was conducted for p16 evaluation. Results: We found the HPV prevalence in tongue cancers to be 51.2%, HPV 16 being present in 85.2% of the positive cases. A notable finding was a very poor concordance between HPV 16 DNA and p16 IHC findings (kappa<0.2). Further molecular classification of patients based on HPV16 DNA prevalence and p16 overexpression showed that patients with tumours showing p16 overexpression had increased hazard of death (HR=2.395; p=0.005) and disease recurrence (HR=2.581; p=0.002) irrespective of their HPV 16 DNA status. Conclusions: Our study has brought out several key facets which can potentially redefine our understanding of tongue cancer tumorigenesis. It has emphatically shown p16 overexpression to be a single important prognostic variable in defining a high risk group and depicting a poorer prognosis, thus highlighting the need for its routine assessment in tongue cancers. Another significant finding was a very poor concordance between p16 expression and HPV infection suggesting that p16 expression should possibly not be used as a surrogate marker for HPV infection in tongue cancers. Interestingly, the prognostic significance of p16 overexpression is different from that reported in oropharyngeal cancers. The mechanism of HPV independent p16 over expression in oral tongue cancers is possibly a distinct entity and needs to be further studied.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권4호
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• pp.427-434
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• 2000

The authors analyzed retrospectively the 36 patients with malignant salivary gland tumors who were treated at Department of Oral and Maxillofacial Surgery, Pusan National University Hospital from February, 1989 to September, 1997. The results obtained were as follows: 1. There were 14 males(38.9%) and 22 females(61.1%). The peak age of patients with major salivary gland tumors was the 6th decade, but with minor salivary gland was the 5th decade. 2. Of all salivary gland tumors, 5 cases arose in the parotid glands, 2 cases in the submanibular glands, 1 case in the sublingual gland and 28 cases in the minor salivary glands. 3. The incidence according to the anatomic primary site for minor salivary glands was 15 cases in the palate, 5 in the floor of mouth and 2 cases each arising in the tongue, lip, retromolar area and buccal mucosa. 4. Of all salivary gland tumors, adenoid cystic carcinoma was 5 cases in the major salivary glands and 8 in the minor salivary glands. mucoepidermoid carcinoma was 2 cases in the major salivary glands and 14 in the minor salivary glands and others were 2 cases of adenocarcinoma, 4 malignant mixed tumors and 1 undifferentiated carcinoma. 5. The incidence of cervical lymph node metastasis was 100%(2/2) in the submandibular glands, 80%(4/5) in the floor of mouth, 50%(1/2) in the tongue and 20%(1/5) in the parotid glands. The highest incidence of lymph node metastasis according to histopathological classfication was found in the high grade of mucoepidermoid carcinoma and tubular type of adenoid cystic carcinoma. 6. Nerve invasion was common in the adenoid cystic carcinoma. 7. The lung was the commonest site for distant metastasis comprising 7 cases among 7 cases in which distant spread occurred.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권1호
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• pp.15-20
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• 2011

Introduction: The characteristics of oral tongue squamous cell carcinomas (SCC) and the treatment results were reviewed to determine the appropriate treatment strategies. Materials and Methods: The medical records of 140 patients diagnosed and treated for oral tongue SCC at Yonsei University Health System from January 1995 to December 2004 were reviewed. For statistic analysis, the survival rate was determined using the Kaplan-Meier method with SPSS version 12.0, and the difference in survival rates was evaluated using a log-rank test. Results: The mean age of the patients with oral tongue SCC patients was 55 (19-85 years old). According to the T, N and pathologic stage, the patients were distributed from a higher to a lower incidence of cases, as follows: T2 (46.4%), T1 (37.9%), T4 (8.5%), and T3 (7.1%); N0 (65%), N1 (20.7%), N2 (13.6%), and N3 (0.7%); and stage I (31.4%), stage II(25.7%), stage IV (22.2%), and stage III (20.7%). Local and regional recurrence and distant metastasis was present in 13.6%, 5% and 4.2% of patients, respectively. The five-year survival rate was 72.2%, and the prognostic factors for oral tongue SCC included neck metastasis, pathologic stage of the disease, cell differentiation, treatment modality, neck dissection as part of the treatment plan, and neck node recurrence. Discussion: It is suggested that ipsilateral neck dissection or bilateral neck dissection should be selected as a treatment of tongue SCC patients with advanced stage.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권1호
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• pp.35-40
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• 2024

Objectives: Oral carcinoma cuniculatum (OCC) is a rare variant of squamous cell carcinoma (SCC). It has similar clinicopathological characteristics to SCC and verrucous carcinoma (VC). We present a case series of OCC and analyse its unique features, diagnosis, and management. Patients and Methods: We retrospectively reviewed the medical records of oral cancer patients treated by Oral and Maxillofacial Surgery department from 2009 to 2020 with OCC biopsy findings. The clinicopathological characteristics and management of the OCC cases were analysed. Results: Four patients were identified with histologic findings of OCC, including three on the alveolar ridge mucosa and one on the tongue. Imaging revealed that two of the lesions located in the maxilla had osseous lysis. All four patients were all treated with radical excision, and the histopathology showed findings of SCC cuniculatum. It was decided that no further treatment was necessary. None of the patients has experienced recurrence during follow-up. Conclusion: OCC is a distinct entity that is more locally aggressive than VC but is associated with good prognosis. Radical surgical removal is considered appropriate for OCC. Emphasis should be given on an early diagnosis, as it remains challenging.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권6호
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• pp.390-395
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• 2013

Locoregional recurrence of tongue cancer is higher than that of other sites of the oral cavity. Locoregional control has shown improvement over the past 20 years, however, a high rate of recurrence and second primary tumor occurrence is still frequently reported. Leukoplakia is a clinical term, which describes a whitish lesion of the oral cavity. Clinicopathologic features may range from hyperkeratosis to malignancy. Because of its diverse pathologic characteristics, management of this lesion for diagnosis, treatment planning, establishment of a clear surgical margin, and periodic follow-up is difficult. We report on a case of successfully treated tongue cancer which developed from leukoplakia over 10 years. Periodic follow-up strategy and surgical planning are most important to management of locoregional recurrence.

• International Journal of Oral Biology
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• 제41권3호
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• pp.113-118
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• 2016

An FDA approved drug for the treatment of type II diabetes, Troglitazone (TRO), a peroxisome proliferator-activated receptor gamma agonist, is withdrawn due to severe idiosyncratic hepatotoxicity. In the search for new applications of TRO, we investigated the cellular effects of TRO on YD15 tongue carcinoma cells. TRO suppressed the growth of YD15 cells in the MTT assay. The inhibition of cell growth was accompanied by the induction of cell cycle arrest at $G_0/G_1$ and apoptosis, which are confirmed by flow cytometry and western blotting. TRO also suppressed the expression of cell cycle proteins such as cyclin D1, cdk2, cdk4, cyclin B1, cdk1(or cdc2), cyclin E1 and cyclin A. The inhibition of cell cycle proteins was coincident with the up-regulation of $p21^{CIP1/WAF1}$ and $p27^{KIP1}$. In addition, TRO induces the activation of caspase-3 and caspase-7, as well as the cleavage of PARP. Further, TRO suppressed the expressions of Bcl-2 without affecting the expressions of Bad and Bax. Overall, our data supports that TRO induces cell cycle arrest and apoptosis on YD15 cells.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권3호
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• pp.182-187
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• 2002

Matrix metalloproteinase(MMP) is the proteolytic enzyme of the extracellular matrix. MMPs play a role in the invasion and metastasis of malignant tumor, but it is not known whether the expression of MMPs in squamous cell carcinoma of the tongue is related to the prognostic factors of this tumor. In this study, 32 paraffin-embedded tumor specimens were examined immunohistochemically using monoclonal antibodies of MMP-2, MMP-3, MMP-10 and MMP-13. The possible relationships between the expressions of the MMPs and TNM staging, the differentiation of tumor cells, size of tumor mass and lymph node metastasis were anlaysed statistically. The results were as follows. 1. The expression of MMP-2 increased according to TNM staging (P<0.05) and lymph node metastasis (P<0.05) and the expression of MMP-2 was not affected by the differentiation of tumor cells or tumor size. 2. The expression of MMP-3 increased with increasing tumor size (P<0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. 3. The expression of MMP-10 was unrelated to TNM staging, differentiation of tumor cells, lymph node metastasis or tumor size. 4. The expression of MMP-13 increased as tumor size increased (P<0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. We concluded that the expression patterns of MMP-2, MMP-3, and MMP-13 may play a role in the diagnosis, treatment plan and prognostic evaluation of malignant tumors of the tongue.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5061-5065
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• 2013

Background: Oral tongue squamous cell carcinoma (OTSCC) is the most common cancer diagnosed within the oral cavity worldwide. Many studies in India report OTSCC ranking among the top two most common subsites within the oral cavity. India is often labeled the oral cancer capital of the world. The incidence of tongue cancers in the population-based cancer registry (PBCR) of Chennai is showing an increasing trend. A majority of the oral cavity cancers (85%) in our cancer center present in advanced stages (III and IV). In contrast, early tongue cancers (stages I and II) constitute nearly 45% of all OTSCCs. Aim: The aim of this study was to analyze the clinical profile and epidemiological trends in our early stage tongue cancer patients with an emphasis on tobacco and alcohol habits. Materials and Methods: This retrospective analysis was based on a prospectively collected database of 458 consecutive early stage OTSCC in-patients at a tertiary care oncology centre in Chennai between 1995 and 2008. Results: Our study suggests that the earlier trends have clearly changed whereby nearly half of our patients are now never-tobacco users. The findings of the study indicate that a majority of the patients were never alcohol users (86.4%) and nearly half of them were never tobacco users (49.3%), and they had the best survival outcomes. This increasing trend of OTSCC among non-tobacco users is in contrast to our earlier experience of tongue cancer more than five decades ago.The median age of patients in our study was 53.3 years; the male to female ratio was approximately 2:1. The median follow up for the 458 patients was 53 months. Conclusions: Our study importantly as well as interestingly shows a conspicuous absence of association with the traditional risk factors, tobacco and alcohol.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.249-258
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• 2022

The specific muscular structure of the tongue greatly affects margin shrinkage and tumor invasion, making the optimal surgical margin controversial. This study investigated surgical margin correlated prognosis of TSCC (tongue squamous cell carcinoma) according to margin location and its value, and the histopathologic factors which are suggestive of tumor invasion. And we would like to propose defining of the surgical margin for TSCC via prognosis according to location and margin values. We reviewed 45 patients diagnosed with TSCC who visited Seoul National University Dental Hospital (SNUDH) (Seoul, Republic of Korea) from 2010 to 2019, who were managed by a single surgical team. Patient clinical and pathological data of patients were retrospectively reviewed, and in 36 out of 45 patients, the pathologic parameters including the worst pattern of invasion (WPOI) and tumor budding were investigated via diagnostic histopathology slide reading. When standardized with as 0.25 cm anterior margins, as 0.35 cm deep margin, there was no significant difference in disease specific survival (DSS) or loco-regional recurrence-free survival (LRFS). Additionally, there was a non-significant difference in DSS and LRFS at the nearest margin of 0.35 cm (P_DSS=0.276, P_LRFS=0.162). Aggressive WPOI and high tumor budding showed lower survival and recurrence-free survival, and there were significant differences in close margin and involved margin frequencies. In TSCC, the value and location of the surgical margin did not have a significant relationship with prognosis, but WPOI and tumor budding suggesting the pattern of muscle invasion affected survival and recurrence-free survival. WPOI and tumor budding should be considered when setting an optimal surgical margin.

• International Journal of Oral Biology
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• 제39권4호
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• pp.193-199
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• 2014

Fluoride has been accepted as an important material for oral health and is widely used to prevent dental caries in dentistry. However, its safety is still questioned by some. Autophagy has been implicated in cancer cell survival and death, and may play an important role in oral cancer. This study was undertaken to examine whether sodium fluoride (NaF) modulates autophagy in SCC25 human tongue squamous cell carcinoma cells. NaF demonstrated anticancer activity via autophagic and apoptotic cell death. Autophagic vacuoles were detectable using observed to form by monodansylcadaverine (MDC) and acridine orange (AO). Analysis of NaF-treated SCC25 cells for the presence of biochemical markers revealed direct effects on the conversion of LC-3II, degradation of p62/SQSTM1, cleavage formation of ATG5 and Beclin-1, and caspase activation. NaF-induced cell death was suppressed by the autophagy inhibitor 3-methyladenine (3-MA). NaF-induced autophagy was confirmed as a pro-death signal in SCC25 cells. These results implicate NaF as a novel anticancer compound for oral cancer therapy.