RESUMO
BACKGROUND: Xylene is one of the most commonly used solvents in industrial and medical technologies. Several health hazards of xylene have been documented in literature. Workers in certain forces appear to have the greatest potential for exposure to high concentrations of xylene - histopathology technicians and painters are two such groups. This study was undertaken with the aim to determine the level of xylene exposure and the various systemic health effects among these groups. METHODOLOGY: The study was performed by analyzing the urine samples of the participants for methylhippuric acid, the established biomarker of xylene with the aid of high-performance liquid chromatography. RESULTS AND CONCLUSION: The work hours per week of the occupationally exposed participants were statistically analyzed with that of the excretory values of the metabolites of xylene, and the P value was found to be highly significant. Various side effects of xylene including respiratory, dermatological, neurological and gastrointestinal symptoms were observed among the study groups.
RESUMO
BACKGROUND: It is a well-established fact that in squamous cell carcinoma cases, the presence of lymph node metastases decreased the 5-year survival rate by 50% and also caused the recurrence of the primary tumor with development of distant metastases. Till date, the predictive factors for occult cervical lymph nodes metastases in cases of tongue squamous cell carcinoma remain inconclusive. Therefore, it is imperative to identify patients who are at the greatest risk for occult cervical metastases. This study was thus performed with the aim to identify various histopathologic parameters of the primary tumor that predict occult nodal metastases. MATERIALS AND METHODS: The clinicopathologic features of 56 cases of lateral tongue squamous cell carcinoma with cT1NoMo/cT2NoMo as the stage and without prior radiotherapy or chemotherapy were considered. The surgical excision of primary tumor was followed by elective neck dissection. The glossectomy specimen along with the neck nodes were fixed in formalin and 5 urn thick sections were obtained. The hematoxylin & eosin stained sections were then subjected to microscopic examination. The primary tumor characteristics that were analyzed include tumor grade, invading front, depth of tumor, lymphovascular invasion, perineural invasion and inflammatory response. The nodes were examined for possible metastases using hematoxylin & eosin followed by cytokeratin immunohistochemistry. RESULT: A total of 12 cases were found with positive occult nodal metastases. On performing univariate analysis, the histopathologic parameters that were found to be statistically significant were lymphovascular invasion (p = 0.004) and perineural invasion (p = 0.003) along with a cut-off depth of infiltration more than 5 mm (p = 0.01). CONCLUSION: Histopathologic assessment of the primary tumor specimen therefore continues to provide information that is central to guide clinical management, particularly in cases of occult nodal metastases. Clinical significance The study highlights the importance of extensive histopathological screening, which holds the key for establishing occult metastases. Pathological upgrading of tumors is possible following histopathological studies similar to the present one. Presence of occult metastases justify neck dissection in these clinically N0 cases. In an Indian setting, histopathological evaluation assumes a bigger role than other expensive and advanced techniques.
