Online ISSN: 2515-8260

Keywords : Oral Squamous Cell Carcinoma


Expression of proinflammatory cytokine INTERLEUKIN 6 in oral submucous fibrosis and oral squamous cell carcinoma: Immunohistochemical study

Dr. Shruthi Rangaswamy; Dr. Rajkumar G C; Dr. Sharada P

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 5823-5832

Introduction: Interleukin 6 is a proinflammatory cytokine indicated in many types of cancer.
Increased cytokine levels are found in oral submucous fibrosis which is a premalignant
condition. Immunohistochemical evaluation of interleukin 6 will help in better understanding
of progression of OSF and OSCC
Materials and methods: Formalin fixed, paraffin embedded oral submucous fibrosis tissue
blocks were obtained from departmental archives. 40 samples each of early, moderately
advanced and severe OSF were randomly selected. 20 samples of normal mucosa and 20
samples of OSCC were selected. Immunohistochemistry was performed, quantitatively and
qualitatively assessed for expression of IL 6.
Results: The test results demonstrated a significant difference in the percentage of expression
in the IL-6 expression between 3 groups ( P<0.001).. Higher intensity and percentage of
expression was found in OSCC and the expression was cytoplasmic. Despite having an
increasing trend in the expression of IL-6 based on tumour grade, there was no statistically
significant difference noted. OSF group showed higher mean Q scores as compared to control
group but the difference was not statistically significant. Despite having an increasing trend in
the expression of IL-6 based on tumour grade, there was no statistically significant difference
noted.
Conclusion: Interleukin 6 is consistently expressed in oral squamous cell carcinoma but not in
OSF tissues. Immunohistochemical marking of interleukin-6 in surgically excised oral
squamous cell carcinoma specimen may help in understanding prognosis.

Oral squamous cell carcinoma: review of incidence and risk factors

Muhammad Azeem Yaqoob; Wan Muhamad Amir W Ahmad; Nor Azlida Alenng; Sami Aljahmi; Sayed Farooq Jalal; Ashfaq Ur Rahim

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 7967-7978

Globally, oral cancer is the sixth most common cancer and it is associated with a mortality
rate up to 50%. Oral cancer usually encompasses tumours derived from the lips, anterior
two-thirds of the tongue, buccal mucosa, hard palate, the floor of mouth, upper and lower
alveolar ridges, retromolar trigone, and sublingual area. An approximate age-standardized
to world population (ASR (W) for oral cavity and lip cancer according to the World Health
Organization (WHO) the topmost is South East Asia with incidence of 6.4 per 100000,
followed by Europe and East Mediterranean (4.6 cases per 100000), America (4.1 per
100000), Africa (2.7 per 100000), and Western Pacific area (2.0 per 100000).Oral
squamous cell carcinoma has multifactorial pathogenesis which includes smoking, alcohol
consumption, and HPV and others. Oral cancer has multifactorial etiology, mainly
smoking, tobacco, alcohol consumption, betel quid chewing and high-risk human
papillomavirus (HPV). Worldwide, the prevalence of HPV infection is 3% in oral cavity
cancer and has a significant role in the management of oral squamous cell carcinoma
(OSCC) as HPV-related oral cancers have shown better prognosis.
The risks of oral cancer in many developing countries had increased mainly by the habits
of using betel quid chewing, tobacco and alcohol consumption.Human papillomavirus is a
major concern and a public burden in a clinical setting all over the world. The sites
frequently involved in HPV related cancers are tonsils and base of the tongue.

“INCIDENCE OF METASTATIC INVOLVEMENT OF CAROTID SHEATH IN ORAL SQUAMOUS CELL CARCINOMA”-A Cross Sectional type of study.

DR. HARDIK G. KARIA; DR ANENDD JADHAV; DR NITIN BHOLA; Dr. HARDIK G. KARIA

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 1185-1190

Background: Surgery is the most well established mode of initial definitive
treatment for a majority of oral cancers. Over the past few decades, the surgical technique
of neck dissection has evolved from Radical neck dissection to Modified radical neck
dissection and then to Selective Neck Dissection.
Objectives: The main purpose of this research is to evaluate the incidence of pathologic
incursion of the carotid sheath, when noticed grossly uninvolved while doing surgery in
the patients with neck dissection for head and neck squamous cell carcinoma (HNSCC).
Methods: 80 neck dissections will be performed. Carotid Sheath will be removed separately
and methodically evaluated by well experienced head and neck pathologists by performing
hematoxylin and Eosin staining and Immunohistochemistry Analysis with Markers like
Pancytokeratin and CD34 for tumour infiltration and the occurrence of lymphatic 
tissue. Hence, if found negative than it will strongly indicate that we can modify the neck
dissections limiting upto the level of carotid sheath.
Results: Carotid Sheath is not grossly involved, removal of Carotid Sheath is not
recommended. Histologically Carotid Sheath may harbour dilated lymphatic vessels,
lymphocytes aggregates and neutrophils. Carotid Sheath, however, would not harbour any
metastatic tumour emboli from primary Oral Squamous Cell Carcinoma.
Conclusion: Not only for surgical safety but also for the shield it provides post operatively
against adjuvant radiation therapy and any infection in neck and even trickling of saliva
down the neck postoperatively by protecting vital structures it encases like Common carotid
artery, Vagus Nerve and Internal jugular vein. So far there is paucity of data in presence
of metastatic involvement of carotid Sheath. This study will give basis for preservation of
Carotid sheath during neck dissection which will reduce postoperative morbidities in head
and neck squamous cell carcinoma patients.

Assessment Of The Association Between Oral Health And Hygiene Practices And Oral Cancer- A Hospital–Based Case–Control Study

Dr.ArunParkashSharma .; Dr. Akbar Naqvi; Dr.Nilima Sharma; Dr.Khushtar Haider

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 1206-1211

Background:Oral lesions and pathologies are increasingly affecting significant patient population due to inadequate dietary habits and adaptation of western culture (changing lifestyle conditions). Hence; the present study was undertake for assessing the association between oral health and hygiene practices and oral cancer.
Materials & methods:A total of 200 patients with confirmed histopathologic diagnosis of oral squamous cell carcinoma and 200 healthy controls were enrolled. Complete demographic details of all the patients were recorded separately. A questionnaire was made and detailed data in relation to subject’s oral hygiene practices was recorded. Mouth mirror and probe was used for assessing the oral health status. Periodontal index and plaque index were used for evaluating the periodontal status.
Results:Presence of gum bleeding and periodontal pathologies weresignificant risk factor for occurrence of OSCC. Seventy six patients of the OSCC group and 134 patients of the control group did mouth wash daily. Thirty four patients of the OSCC group and 147 patients of the control group had complete dental check up every six months.
Conclusion:A strong association exists between oral health and oral hygiene practices and occurrence of oral cancer.

Proteomics and Oral Cancer: The Road Less Travelled

Dr. Kumar Gaurav Chhabra; Nandini Hake; Sayali Limsay; Radhika Kulkarni; Dr. Gargi Nimbulkar; Dr. Amit Reche

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 1816-1825

The oral squamous cell carcinoma (OSCC) is evaluated as the eighth driving reason for malignant growth all inclusive. OSCC shows high predominance and grimness, with the death pace of 145,000 passing for every year universally. The result of the treatment and anticipation of oral cancerous growth relies for the most part upon early finding. For the high morbidity of the oral cancer, deferred identification is probably going to be an essential explanation and this backing the basic requirement for sensitive biomarkers to improve early recognition of oral malignant growths. Along these lines, early location and counteraction of oral cancerous growth is one of the destinations set by World Health Organization (WHO). Abnormal cellular products from malignant cells can be recognized and estimated in different body fluids, for example, blood, urine and saliva. Saliva can be utilized to identify biomarkers explicit for oral cancer as it is anything but difficult to acquire and non-intrusive, additionally due to its immediate contact with oral cancer, salivary assessment for discovery of oral cancer can show the best benefit. Biomarkers are utilized for patient assessment in various clinical settings. They are likewise utilized for assessing disease risk, screening for mysterious primary cancers, differentiating benign from malignant findings/one sort of malignancy from another, determining prognosis, acting as indicators/screening, and observing disease status. Salivary biomarkers can possibly recognize normal biological, pathological as well as pharmacological response to treatment. Huge endeavours from scientists and clinicians are significant so as to transform salivary diagnostics into clinical and commercial reality and in this way helping in battling oral disease. This article gives survey of salivary proteomic biomarkers, strategies for examination of salivary proteomic biomarkers and their clinical significance in early discovery of oral cancers.

―Comparison of Pectoralis Major Myocutaneous Flap with and without Lateral Axillary Incision in Reconstruction of Soft Tissue Defect in Head and Neck Region‖- A Pilot Study

Dr. Manan Gupta; Dr. Nitin Bhola

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2105-2115

Abstract: Background - Major ablative surgeries leads to soft and hard tissue defects which
require reconstruction which gives better functional and aesthetic outcomes. Pectoralis
major myocutaneous (PMMC) flap is a workhorse flap for soft tissue reconstruction owing
to its merits. The conventional technique of harvesting PMMC flap is associated with
donor site complications such as functional deformity and scar contracture. A modified
technique without lateral axillary incision for harvesting PMMC flap may provide better
results. Aim - To compare the two incision designs of harvesting PMMC flap (with lateral
axillary incision and without lateral axillary incision) in soft tissue defect reconstruction in
head and neck region. Methodology – A prospective pilot study will be performed on 16
patients diagnosed with OSCC requiring resection, neck dissection and reconstruction with
PMMC flap. These patients will be allocated to two groups by alternate randomization,
Group A PMMC flap harvest with lateral axillary incision and Group B PMMC flap
harvest without lateral axillary incision. The patients will be subjected to General
anaesthesia and surgery will be performed by single experienced surgeon. Parameters
assessed will be time taken for harvesting the flap, time required for closure of donor site,
flap survival, range of motion (ROM) of shoulder (Degree of endorotation and
exorotation), complications (hematoma, seroma, dehiscence, marginal necrosis, infection)
and scar formation. The obtained data will be filled in MS excel sheet and statistical
analysis will be done. Expected result – The modified technique would prove better in
terms of function and aesthetic with minimal complications and that it will provide new
insight in choosing the best approach with minimal complications for harvesting of PMMC
flap. Conclusion - The results if favours the modified technique with respect to time of
harvesting, time of closure of donor site and complications, will help in the reconstruction
of such defects with minimal donor site complications and improved outcomes.

Evaluation Of Serum Antioxidant Enzymes In Oral Submucous Fibrosis And Oral Squamous Cell Carcinoma- A Clinical And Biochemical Study

Dr. Rakesh G Oswal; Dr. Nandan Rao K.; Dr. Prashant Mall; Dr. Ishita Grover

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 3205-3209

Background: The present study evaluated serum antioxidant enzymes in oral submucous fibrosis and oral squamous cell carcinoma. Materials & Methods: 30 cases of OSMF and 25 cases of OSCC of both genders. 30 healthy subjects were also enrolled. 6 ml of blood samples were collected with a tourniquet applied 1½-2 inch above the antecubital fossa. The collected blood was centrifuged and the plasma separated was analyzed for vitamin E, beta carotene, MDA. Results: The mean vitamin E level was 7.19 in group I, 6.52 in group II and 9.12 in group III. Beta carotene level was 70.3 in group I, 62.3 in group II and 114.5 in group III. MDA level was 9.16 in group I, 13.4 in group II and 2.91 in group III. The difference was significant (P< 0.05). Conclusion: There was increased level of MDA and decreased level of vitamin E and beta carotene.in OSMF and OSCC patients.

KNOWLEDGE AWARENESS AND ATTITUDE TOWARDS ORAL MANIFESTATIONS OF VIRAL INFECTIONS AMONG DENTAL STUDENTS- A QUESTIONNAIRE BASED STUDY

Sneha Sree. S; Abilasha Ramasubramanian; Jayanth Kumar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 600-615

A virus is composed of nucleic acid either DNA or RNA, surrounded by a protein coat.It requires a living cell to multiply. A viral infection can lead to a spectrum of symptoms from asymptomatic to severe disease.Worldwide,5% of health-care-related infections are being transmitted. Dentists are considered being a high risk group for cross-infection.Therefore it is important that dental students have adequate knowledge and awareness of viral infections.The aim of the study is to evaluate the knowledge, awareness and attitude about oral manifestations of viral infections among dental students.A self explanatory questionnaire comprising 20 questions was presented to 205 students. The questionnaire enquired about oral manifestations of different viral infections and their precautionary infection control measures .Out of 205 students 86.34% were males and 13.66% were females,189 of them knew that the most common oral manifestation in HIV patients is candidiasis.92.6%agreed that a dentist could get Herpetic paronychia.When asked if treatment of patients with viral infections required special clinics 68.1% responded yes.Our study showed that the dental undergraduate students had adequate knowledge on oral manifestations of viral diseases but lacking knowledge about infection control protocol for the various diseases. Hence students should improve their attitude towards them in their dental practice.

AUDIT ON SUTURE TYPES USED FOR NECK DISSECTION WOUND CLOSURE IN ORAL SQUAMOUS CELL CARCINOMA PATIENTS

Jembulingam Sabarathinam; Kathiravan Selvarasu; Dr Madhulaxmi M

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 889-896

A suture is a device, either natural or synthetic, which is used for ligation of blood vessels and in wound closure following surgery. Its major functions are to hold tissues together following wound closure or surgery. Neck dissection procedures leave open wounds which need to be approximated for the process of wound healing and aesthetic considerations. Henceforth the aim of the current study is to assess the type of sutures used in surgical wound closure of neck in patients with oral squamous cell carcinoma following radial neck dissection in private institutional setup in chennai. Data was procured from the case sheets of patients undergoing radial neck dissection following surgical management of oral squamous cell carcinoma. The data was tabulated in MS-Excel and analysed by SPSS software (Version 20). The results were inferred. 60% of the external surgical wound closure were sutured using silk sutures while 40% where sutured using polyglactin and nylon sutures. 60% of the internal wound closures were closed using polyglactin while 40% was using polypropylene and nylon.Polyglactin 910 and silk were the most predominantly used suture materials for internal and external surgical wound closure in an private institutional set up in Chennai.

RADIOGRAPHIC ANALYSIS OF OSSEOUS CHANGES IN ORAL SQUAMOUS CELL CARCINOMA

Abarna jawahar; G.Maragathavalli .; Manjari Chaudhary

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1751-1761

Oral squamous cell carcinoma(OSCC) primarily affects the soft tissues,but involvement of jaw bones is seen in about 12–56% of patients.In these cases,radiographic analysis is essential inorder to observe the pattern of bone involvement.A retrospective study was conducted on patients who visited the department of oral medicine from march 2019 to march 2020.The clinical findings,histopathological diagnosis of OSCC patients who showed bone involvement in the digital panoramic radiographs were reviewed from electronic database.Descriptive statistics were used to analyse the radiographic findings.We observed that the majority of patients presenting with oral squamous cell carcinoma involving the jaw bone belonged to the age group 40-50 years with male predilection(76.9%).Mandible was most commonly involved with the right posterior alveolar region being the most commonly affected site.The radiographic changes observed predominantly in the lesions were smooth borders(53.85%) with an altered trabecular pattern (46.15%).The effect of the lesion
on the surrounding structures were spiked root appearance in 84.62% and floating tooth appearance in 69.23% of cases.Presence of saucerization was seen in 76.92%.Hence digital panoramic radiographs are valuable aids in diagnosing the involvement of jaw bones in oral malignancy and thereby help in devising the treatment plan.

Prognostic value of tumor budding in oral squamous cell carcinoma

Dr. Sandhya Sundar, Dr. Pratibha Ramani, Dr. Gheena S, Dr.Abilasha R

European Journal of Molecular & Clinical Medicine, 2019, Volume 6, Issue 1, Pages 81-90

Tumor budding is the histological phenomenon seen as a detached, discohesive small cluster
of cells in the invasive tumor front. Tumor buds may provide a histological means for the
assessment of epithelial-mesenchymal interaction and facilitate early prediction of
prognosis.The present study aims to assess the prognostic significance of the tumor budding in
oral squamous cell carcinoma(OSCC). Detailed Histopathological scoring of the oral
squamous cell carcinoma tissue and lymph nodes including the evaluation of tumor budding
was performed by two individual observers retrospectively. The association between various
clinicopathological parameters and the budding index was analyzed using chi-square test and
fisher’s exact tests. Tumor budding was demonstrated in the invasive tumor front of all OSCC
cases. High-intensity tumor budding was seen in stage 4 cancers with tumor size of > 4cms.
Histologically, they were related to deep and extensive tumors, having an invasive front with
infiltrative cells in groups or cords, dense stromal type in association with mild inflammation
invariably. All of the cases with lymph node metastases were tumor budding positive. Thus this
study emphasizes the importance of tumor budding evaluation in regular pathology practice in
the management of OSCC cases.