Background: Oral squamous cell carcinoma (OSCC), the most common malignancy of the oral cavity, shows geographical variation with respect to the age, sex, site and habits of the population. The histolopathologic grade of the tumor is closely related to its tissue of origin. This study was conducted to establish the prevalence of OSCC in relation to patient sex, age, habits and sites of lesions. Materials and Methods: A total of 130 cases of histopathologically diagnosed OSCC were selected for the study, out of which 66, 38 and 26 were well (WD), moderately (MD)and poorly differentiated (PD), respectively. Sections were stained with haematoxylin and eosin and graded according to a modified Borders's system. Then statistically analyzed different grades of OSCC for correlations with other variables. Results: In our study the majority cases of OSCC were found in the 5th to 7th decades of life, males acconting for 53%. The most common site was the buccal mucosa and most cases had habit of tobacco use either in the form of chewing or smoking or both. When the different grades of OSCC were compared with different sites a statistically significant value was observed (P=0.029). Conclusions: The incidence of high grade PD is very much less in female patients but in males such lesions were common. In our location population the buccal mucosa is the most common site due to the tobbaco habits of the patients and majority cases of the buccal mucosa are WD whereas in tongue, floor of the mouth and palate PD are common.
Background: The interesting preponderance of Chinese with colorectal carcinoma (CRC) amongst the three major ethnic groups in Malaysia prompted a study to determine DNA mismatch repair (MMR) status in our CRC and attempt correlation with patient age, gender and ethnicity as well as location, grade, histological type and stage of tumour. Histologically re-confirmed CRC, diagnosed between $1^{st} $January 2005 and $31^{st}$ December 2007 at the Department of Pathology, University of Malaya Medical Centre, were immunohistochemically stained with monoclonal antibodies to MMR proteins, MLH1, MSH2, MSH6 and PMS2 on the Ventana Benchmark XT autostainer. Of the 142 CRC cases entered into the study, there were 82 males and 60 females (M:F=1.4:1). Ethnically, 81 (57.0%) were Chinese, 32 (22.5%) Malays and 29 (20.4%) Indians. The patient ages ranged between 15-87 years (mean=62.4 years) with 21 cases <50-years and 121 ${\geq}50$-years of age. 14 (9.9%) CRC showed deficient MMR (dMMR). Concurrent loss of MLH1 and PMS2 occurred in 10, MSH2 and MSH6 in 2 with isolated loss of MSH6 in 1 and PMS2 in 1. dMMR was noted less frequently amongst the Chinese (6.2%) in comparison with their combined Malay and Indian counterparts (14.8%), and was associated with right sided and poorly differentiated tumours (p<0.05). 3 of the 5 (60.0%) dMMR CRC cases amongst the Chinese and 1 of 9 cases (11.1%) amongst the combined Malay and Indian group were <50-years of age. No significant association of dMMR was noted with patient age and gender, tumour stage or mucinous type.
Aims and Background: To improve understanding of the relationship between schistosome-related enteropathy and colorectal carcinoma with particular focus on endoscopic findings and clinicopathological characteristics of colonic schistosomiasis. Materials and Methods: All cases of intestinal schistosomiasis diagnosed at West China Hospital, Chengdu, China, between October 2006 and October 2012 were included in this study. A total of 179 cases of colonic schistosomiasis diagnosed through colonoscopy and pathological examinations were collected for analysis and the demographics, symptoms, endoscopic findings and clinicopathological characteristics were retrospectively evaluated. Results: Of the 179 colonic schistosomiasis patients, 32 combined with colorectal cancer (CRC) were found, between the ages of 44 and 85 years (24 males, 75%). These 32 lesions were classified as 12 endophytic/ulcerative (37.5%), 10 exophytic/fungating (31.2%), 4 annular (12.5%), 3 giant polypus (9.4%), and 3 IIc (superficial depressed type) (9.4%). The segments of rectum and sigmoid colon were involved in 19 patients (59.4%) and 6 patients (18.8%), respectively. The histopathologic types were classified as follows: 30 welldifferentiated adenocarcinomas, one mucinous adenocarcinoma and one poorly differentiated adenocarcinoma. The pathological findings suggest colorectal malignancy with deposited schistosome ova. Conclusions: Chronic schistosomal infestation has a probable etiological role in promoting genesis of colorectal neoplasms.
The expression of $p62^{c-myc}$ and $p21^{ras}$ can be seen in many solid tumor, but the pattern and incidence of expression were different according to organ, countries, and examiners, thus it is not definitely defined. Total 67 colorectal carcinoma in paraffin sections are analysed by immunohistochemically for evaluation of the $p62^{c-myc}$ and $p21^{ras}$ expression according to the age, sex, chief complaints, location, differentiation, modified Dukes stage, using the specific monoclonal antibodies. The results were summarized as follows : The age of patients ranged from 32 years to 82 years. The mean age was 57.6 years. The expression of $p62^{c-myc}$ and $p21^{ras}$ was not correlated with age. Male was 29 cases(43.3%) and female was 38 cases(56.7%). The male to female ratio was 1:1.31. The expression of $p21^{ras}$ was increased in female(p<0.05). Abdominal pain(43.7%) was the most frequent chief complaint. The most frequent tumor location was rectum(44.8%). The expression of $p62^{c-myc}$ was increased in the rectum(p<0.05). The 65 cases(97.0%) out of 67 cases showed positive reaction of $p62^{c-myc}$ in the nucleus, cytoplasmic membrane, and cytoplasm. The 62 cases(92.5%) out of 67 cases showed positive reaction of $p21^{ras}$ in the cytoplasmic membrane and cytoplasm. The positive rate of $p62^{c-myc}$ and $p21^{ras}$ was 97.0% and 91.4% in well differentiated adenocarcinoma, 100.0% and 95.0% in moderately differentiated adenocarcinoma, 90.0% and 90.0% in poorly differentiated adenocarcinoma, 100.0% and 100.0% in mucinous carcinoma. The positive rate of $p62^{c-myc}$ and $p21^{ras}$ was 94.1% and 88.2% in Dukes stage $B_1$, 96.0% and 96.0% in Dukes stage $B_2$, 100.0% and 100.0% in Dukes stage $C_1$, 100.0% and 88.9% in Dukes stage $C_2$, and 100.0% and 100.0% in Dukes stage D. The expression of $p62^{c-myc}$ in metastatic colorectal carcinoma showed diffuse and strongly positive reaction than primary colorectal carcinoma. The expression of $p21^{ras}$ in primary colorectal carcinoma showed diffuse and strongly positive reaction than metastatic colorectal carcinoma.
The definition of cancer, its diagnosis and its prognosis all depend upon description of growth. To the layman a synonym for cancer is a "growth". There are no quantitative terms for the description of growth or growth rate in clinical use. There has been no attempt to assign values that would define "rapidly" or "slowly" growing. Estimates of growth potentiality are implied in the descriptive phrases "poorly differentiated" or "well differentiated", "highly malignant" or "low grade malignancy". and in systems of grading. These qualifying terms represent a personal impression, clinically useful in prognosis, but relative in nature. They do not lend themselves to uniform application or precise measurement for purpose of comparison. Growth is related to size and time. The volume of tumor depends upon the duration of the period of growth and the rate of growth. If the interval and change in volume are known. the average growth rate can be determined. If the growth rate is determined, and assumed to be constant., the duration of a given tumor and the time of inception can be estimated. The commonest concept of the origin of cancer is that as a result of a mutation involving a single cell, succeeding divisions of cells establish a colony with the characteristics recognizable as cancer. If the growth rate of the hypothetical tumor were constant it could be described in terms of "tumor volume doubling time". In the department of thoracic surgery of St. Mary hospital in Catholic Medical College, a clinical evaluation for the growth rate, degree of malignancy, resectability and prognosis was done on a total 24 cases of primary bronchogenic carcinoma which contour was significant on the chest X-ray film as possible estimating the tumor volume doubling time. The following results were obtained: 1. In the cases of 6.0cm or more in diameter of minor size at operation the resectability rate was lower and in the cases of 60 days or more in the tumor or volume doubling time the resectability rate was higher. 2. If differentiation of cancer cells was lower graded in tissue pathology, the tumor volume was shorter and the resectability rate was lower. 3. The tumor volume doubling time of the primary bronchogenic carcinoma occured more over 60 years of age was slightly shorter than under 60 years of age. 4. The tumor size at operation was more important to evaluate the survival time and prognosis than the tumor volume doubling time because the tumor growth was not always constant, we presume.mor volume doubling time because the tumor growth was not always constant, we presume.
Objectives: Cancer lethality is usually the result of local invasion and metastasis of neoplastic cell from the primary tumor. Because of their ability to degrade extracellular matrix components, matrix metalloproteinases (MMPs) and basic fibroblast growth factor (bFGF) have been implicated in the breakdown of basement membrane and underlying stroma, thereby facilitating tumor growth and invasion. It has been well established that MMPs and bFGF expression correlate with cervical lymph node metastasis, but studies on expression in the metastatic cervical lymph node itself are not enough. We have analyzed matrix metalloproteinases (MMPs) and basic fibroblast growth factor (bFGF) in squamous cell carcinoma of the head and neck and metastatic cervical lymph node, and evaluated their relationship and clinicophathologic significance. Material and Methods: 20 cases of squamous cell carcinoma of the head and neck were entered on the study of immunohistochemical stains for MMP-9 and bFGF in the obtained tissue from primary tumor and metastatic cervical lymph node. We analyzed the relationship between MMP-9, bFGF expression of the primary tumor and metastatic node with age, sex, T-stage, N-stage, histologic grade, pathologic stage and disease free survival. Results: Expression of MMP-9 and bFGF in cancer cell and metastatic lymph node was higher than that in normal cell and lymph node. According to histologic differentiation, expression of MMP-9 of the metastatic cervical lymph node was higher than primary tumor. Considering to other clinicopathologic factor, no statistical significance was seen in MMP-9 and bFGF. Conclusion: We found that expression of MMP-9 is higher in the metastatic lymph node than primary tumor in the poorly differentiated squamous cell carcinoma. But we don't find out the statistical significance in relation between bFGF and clinical factors. So we guess that some different mechanism of MMP-9 and bFGF in Head & Neck squamous cell carcinoma exist. Further studies will be necessary to establish their pathogenesis in the Head and Neck cancer.
Carcinosarcoma is a rare malignant, biphasic tumor comprised of carcinoma and sarcoma components. In the gastrointestinal tract, carcinosarcoma is most frequently seen in the esophagus and rarely in the stomach. We report a 51-year-old female patient with 2-month-history of epigastric pain and dyspepsia. Endoscopic finding revealed a huge ulcerative lesion that infiltrated from the antrum to the mid-body. An endoscopically taken biopsy revealed poorly differentiated malignant round cell neoplasm. After the palliative subtotal gastrectomy, immunohistochemical studies showed two positive reactions for the epithelial marker and mesenchymal marker. Based on the above findings, the patient was diagnosed with gastric carcinosarcoma. The immunohistochemical analysis is a critical method in making an accurate diagnosis of carcinosarcoma.
Gastric cancer is a major cause of cancer-related mortality. At the time of diagnosis, majority of the patients usually have unresectable or metastatic disease. The most common sites of metastases are the liver and the peritoneum, but in the advanced stages, there may be metastases to any region of the body. Bone marrow is an important metastatic site for solid tumors, and the prognosis in such cases is poor. In gastric cancer cases, bone marrow metastasis is usually observed in younger patients and in those with poorly differentiated tumors. Prognosis is worsened owing to the poor histomorphology as well as the occurrence of pancytopenia. The effect of standard chemotherapy is unknown, as survival is limited to a few weeks. This report aimed to evaluate 5 gastric cancer patients with bone marrow metastases to emphasize the importance of this condition.
Kim, Moon-Key;Lee, Eun-Ha;Kim, Jin;Yook, Jong-In;Cha, In-Ho
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.35
no.4
/
pp.199-204
/
2009
Purpose: The purpose of this study is to investigate the epithelial-mesenchymal transition (EMT) induced by Snail transcription factor and Snail-transfected in vivo tumors with histopathological features. Materials and methods: We induced in vivo xenografted tumorigenesis in the oral vestibules of nude mice by a Snail transfected HaCaT cell line and investigated morphological and immunohistochemical features in Snail expressive tumors. Results: We identified tumor masses in 14 out of 15 nude mice in the HaCaT-Snail cell inoculation group, but no tumors were present in any of the HaCaT cell inoculation group. Induced tumors showed features of poorly differentiated carcinoma with invasion to neighboring muscles and bones. The HaCaT-Snail tumors showed decreased expressions of E-cadherin and cytokeratin, but showed increased expressions of vimentin and N-cadherin. Discussion: The Snail transfected xenograft can improve productivity of malignant tumors, show various histopathological features including invasive growth, and aid in the investigation of tumor progression and the interaction with surrounding tissues.
Background: Oral squamous cell carcinoma (OSCC) is an important malignancy throughout the world; early detection is an important criterion for achieving high cure rate. Out of the many reported markers for OSCC, this study validated the efficacy of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in differentially diagnosing premalignant oral lesions and OSCC. Also, the study aimed to correlate the levels of salivary and serum TNF-${\alpha}$ with clinicopathologic factors. Materials and Methods: A prospective experimental laboratory study was designed. Serum and salivary samples from 100 subjects in each group of healthy control, premalignant disease (PMD) and OSCC were collected for the study following appropriate exclusion and inclusion criteria. Serum and salivary level of TNF-${\alpha}$ was analysed by enzyme linked immunosorbent assay. The data obtained were subjected to appropriate statistical analysis. Results: Increased level of both serum and salivary TNF-${\alpha}$ was observed in OSCC subjects compared to healthy control and PMD group. Receiver operator characteristic curve analysis and area under curve values showed high specificity and sensitivity for salivary TNF-${\alpha}$ in differentiating OSCC from PMD and healthy controls. There was significant increase in TNF-${\alpha}$ level in moderately and poorly differentiated lesion compared to well differentiated lesion and in stage IV of clinical stage. A positive correlation was observed only with histological grading of OSCC and TNF-${\alpha}$. Conclusions: Salivary TNF-${\alpha}$ is proved to be superior for detecting OSCC. Increase in TNF-${\alpha}$ with histological grading and clinical staging suggests a role in prognosis.
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