• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.28 no.4
• /
• pp.339-347
• /
• 2006

Oral leukoplakia is the most common premalignant lesion and malignant transformation has been reported from verrucal lekoplakia. Homogenous, benign leukoplakia develops into a line of squamous cell carcinoma such as verrrucous carcinoma, papillary squamous cell carcinoma and invasive squamous cell carcinoma. Early diagnosis and intervention of premalignant leukoplakia is up-most important to prevent transformation into a oral squamous cell carcinoma. Any change in surface, size and color warrants repeated biopsy. If verrucous carcinoma is evidently derived from the previous leukoplakia, wide surgical excision and periodic follow up is needed. Surgically removed lesion of leukoplakia has the tendency to recur. Follow-up is very important to patient and clinician. Although many therapies have been reported to oral leukoplakia and verrucal carcinoma, accepted treatment principle is not exist so far. But surgical removal is recommended as the treatment of choice.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.17
• /
• pp.7141-7148
• /
• 2014

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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.33 no.4
• /
• pp.281-287
• /
• 2007

Purpose: This study was conducted in order to evaluate how chemiluminescent lighting($ViziLite^{(R)}$) could increase the sharpness of margin and contrast to normal mucosa in the diagnosis of oral lichen planus(OLP), the most frequent oral premalignant lesion, compared with direct visual inspection under incandescent light. Methods: 41 consecutive patients, diagnosed to have OLP with visual inspection under incandescent light, were further examined with chemiluminescent light. The degrees of margin sharpness and lesion contrast were ranked on a scale from 1 to 3 for all patients under visual inspection and chemiluminescent light. The presence of additional lesion only detected by chemiluminescent light, complication, and discomfort were checked for each patient. After both screening tests, biopsy specimens were harvested from all patients with scalpels and histopathologic assessments were done. Results: All 41 patients were diagnosed to have OLP by both visual inspection and chemiluminescent light examination. This result was definitively diagnosed by histopathology. Degrees of margin sharpness and lesion contrast were increased by chemiluminescent light compared with visual inspection, but only the difference of lesion contrast was statistically significant. In 22.0% of patients, additional lesions were detected and 88.9% of them were diagnosed to have OLP histopathologically. 17.1% of patients noted discomfort and 9.8% of patients showed complications after chemiluminescent test. Conclusion: Chemiluminescent light may not be proper for the screen test of oral cancer or premalignant lesion but showed some possibility for additional diagnostic tool for definitively diagnosed patients in determination of lesion margin and scope.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.11
• /
• pp.4899-4906
• /
• 2016

Aim: To assess the diagnostic utility of serum and salivary interleukin 6 (IL-6) levels in the differential diagnosis of potentially malignant lesions and conditions (PMLs/PMCs) and oral squamous cell carcinoma (OSCC) in a high oral cancer prevalence region. Methods: After appropriate ethical clearance and informed consent, salivary and blood samples were collected from 100 participants in each group (OSCC, PMLs, and healthy controls). Serum and salivary IL-6 levels were measured by enzyme-linked immunosorbent assay and data were subjected to appropriate statistical analysis. Results: Significant differences in IL-6 concentration were noted between OSCC and PML/C patients in both serum and saliva, with salivary levels being 2 to 3 fold higher than serum values in all the groups. Receiver operating characteristic curve analysis demonstrated 96% specificity and 99% sensitivity for salivary IL-6 in differentiating PML from OSCC. Conclusions: The results of the present study suggest that the pro-inflammatory cytokine, IL-6, is elevated in the saliva of patients with OSSC compared to PMD and controls, and thus may prove to have diagnostic and/or prognostic significance.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.34 no.2
• /
• pp.97-101
• /
• 2020

Oral leukoplakia is the most common premalignant lesion of the oral mucosa. This case report presents the effect of acupuncture on Oral leukoplakia. The 67 years old male patient who has suffered for 2 years was treated with Right side Saam acupucture Damjeonggyeok(BL66, GB43, LI1, GB44) without other treatment. Acupuncture was performed for 15 minutes. The effect of acupuncture was evaluated as photographic change and visual analog scale(VAS) of subjective symptoms in oral cavity. After 87th acupunture treatment during 226 days, Leukoplakias were decreased at the right side of ventral tongue and the left border of the tongue and the lower lip. Furthermore, ulcer, erosion at the left border of the tongue were disappeared and VAS of Burning pain in the tongue decreased from 8 to 2. Although acupuncture is unusual treatment for Oral Leukoplakia, this case report suggested the effectiveness of using Damjeonggyeok on Oral Leukoplakia according to Saam acupuncture method.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.11
• /
• pp.6979-6983
• /
• 2013

Background: Oral lichen planus (OLP) is categorized as premalignant lesion although its malignant potential is a matter of controversy. The objective of this study was to investigate Ki67 expression in OLP, oral epithelial dysplasia and oral squamous cell carcinoma (OSCC). Materials and Methods: Expression of Ki67 was evaluated through immunohistochemistry (IHC) in groups of A (17 cases of epithelial hyperplasia), B (16 cases of OLP), C1 (10 cases of mild epithelial dysplasia), C2 (10 cases of severe epithelial dysplasia), D1 (10 cases of well-differentiated OSCC), and D2 (10 cases of poorly-differentiated OSCC). Results: There was a significant difference in Ki67 expression based on quantitative analysis among the six studied groups as well as group B compared bilaterally with groups C2, D1 and D2 (p< 0.0001). However, there was no significant difference between groups B and C1 or between groups D1 and D2 (p> 0.05). Conclusions: Based on the results of the present study it may not be possible to definitely consider malignant transformation potential for OLP. However, expression of Ki67 was significantly higher in OLP than that of epithelial hyperplasia with no significant difference from that of mild epithelial dysplasia. This should be considered by clinicians to carefully and regularly follow up OLP lesions to detect potential subtle changes at an early stage.

• International Journal of Oral Biology
• /
• v.45 no.1
• /
• pp.1-7
• /
• 2020

Oral lichen planus (OLP) is a chronic inflammatory disease observed in approximately 0.5-2.2% of the population, and it is recognized as a premalignant lesion that can progress into oral squamous cell carcinoma (OSCC). The rate of malignant transformation is approximately 1.09-2.3%, and the risk factors for malignant transformation are age, female, erosive type, and tongue site location. Malignant transformation of OLP is likely related to the low frequency of apoptotic phenomena. Therefore, apoptosis-related genetic factors, like p53, BCL-2, and BAX are reviewed. Increased p53 expression and altered expression of BCL-2 and BAX were observed in OLP patients, and the malignant transformation rate in these patients was relatively higher. The involvement of microRNA (miRNA) in the malignant transformation of OLP is also reviewed. Because autophagy is involved in cell survival and death through the regulation of various cellular processes, autophagy-related genetic factors may function as factors for malignant transformation. In OLP, decreased levels of ATG9B mRNA and a higher expression of IGF1 were observed, suggesting a reduction in cell death and autophagic response. Activated IGF1-PI3K/AKT/mTor cascade may play an important role in a signaling pathway related to the malignant transformation of OLP to OSCC. Recent research has shown that miRNAs, such as miR-199 and miR-122, activate the cascade, increasing the prosurvival and proproliferative signals.

• Journal of Oral Medicine and Pain
• /
• v.34 no.1
• /
• pp.49-54
• /
• 2009

Lichen planus is a relatively common chronic inflammatory disease involving the skin and mucous membranes showing small flat polygonal papules. The accurate etiology is unknown but it's suggested that cell-mediated immune response to an induced antigenic changes in skin or mucosa. Oral lichen planus was regarded as an benign lesion but oral lichen planus was classified as premalignant lesion by WHO criteria. It was not known that progress of malignat transmmission in the the patient with oral lichen planus, and chronic inflammatory disease including oral lichen planus showed malignacy in oral cancer unrelated common risk factors(Ex: tabacco, alcohol). Although malignant development in the patient with oral liche planus was various greatly in the literature, from 0.5% upward to 5%. It has been reported that a specific clinical type of oral lichen planus, hyperkeratotic or erosive had a higher chance of transformation into an squamous carcinoma. Clinician has to follow-up check of at least one or two visit per year to detect of malignancy of oral lichen planus and improved prognosis with squamous cell carcinoma. At this case with the middle aged women with squamous cell carcinoma developed from oral lichen planus of more than a decade of persisting, we try to discuss the malignacy of oral lichen planus and cosideration with follow-up.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.15
• /
• pp.6081-6086
• /
• 2014

Background: To evaluate the effectiveness of Microlux/DL with and without toluidine blue in screening of potentially malignant and malignant oral lesions. Materials and Methods: In this diagnostic clinical trial clinical examination was carried out by two teams: 1) two oral medicine consultants, and 2) two general dentists. Participants were randomly and blindly allocated for each examining team. A total of 599 tobacco users were assessed through conventional oral examination (COE); the examination was then repeated using Microlux/DL device and toluidine blue. Biopsy of suspicious lesions was performed. Also clinicians opinions regarding the two tools were obtained. Results: The sensitivity and, specificity and positive predictive value (PVP) of Microlux/DL for visualization of suspicious premalignant lesions considering COE as a gold standard (i.e screening device) were 94.3%, 99.6% and 96.2% respectively, while they were 100%, 32.4% and 17.9% when considering biopsy as a gold standard. Moreover, Microlux/DL enhanced detection of the lesion and uncovered new lesions compared to COE, whereas it did not alter the provisional clinical diagnosis, or alter the biopsy site. On the other hand, adding toluidine blue dye did not improve the effectiveness of the Microlux/DL system. Conclusions: The Microlux/DL seems to be a promising adjunctive screening device.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.33 no.4
• /
• pp.368-372
• /
• 2011

Progressive transformation of germinal centers (PTGC) is mostly a disease of young adults and it presents as unexplained, asymptomatic, localized or generalized lymphadenopathy that is usually persistent or recurrent over a period of many years. PTGCs are larger than regular germinal centers and they contain a variable proportion of small mantle zone lymphocytes and so they become progressively transformed and they may result in the loss of clear demarcation between them and the mantle zone. PTGC may resemble the nodules of nodular lymphocyte predominant Hodgkin's disease (NLPHD) and it may be mistaken for NLPHD. Histological and immunohistochemical studies are helpful in differentiating these diseases. Because of the relatively frequent recurrences of PTGC, follow-up and repeat biopsy are indicated. Although PTGC is not considered to be a premalignant condition, PTGC may occur prior to, concurrent with or following NLPHD. This emphasizes the need for ongoing follow-up and repeat biopsy. Although PTGC is reported in 3.5% to 10% of the cases of chronic nonspecific lymphadenopathy, oral & maxillofacial surgeons are not widely aware of this condition and its clinical implications. Herein, we present a case of PTGC. A 24-year-old male without any history of immunodeficiency or autoimmune disease was admitted to the Department of Oral & Maxillofacial surgery at Ulsan University Hospital for evaluation of a right submandibular swelling. He had another mass on the right thigh that was noticed about 1 year ago. The submandibular lesion was completely resected and biopsied. The histological findings and immunohistochemical stains (CD3, CD15, CD20, CD30, CD57, BCL-2, EMA) were consistent with PTGC. He was followed up without any other complaints for 9 months.