Malignant transformation of oral leukoplakia: a multicentric retrospective study in Brazilian population / Transformación maligna de la leucoplasia oral: un estudio retrospectivo multicéntrico en población brasileña

Background: Among the oral potentially malignant disorders, leukoplakia stands out as the most prevalent. Thepurpose of this study was to analyse the clinical-pathological features of oral leukoplakia in groups of patientsfrom three major pathology centers in two different regions of Brazil, in order to determine which factors wouldbe associated to the clinical risk of malignant transformation.Material and Methods: A total of 148 patients was analyzed, and data regarding gender, age, site, classification ofthe clinical subtype, harmful habits such as use of tobacco and alcohol, time of evolution and presence of dyspla-sia were collected. The association between risk factors and malignant transformation was investigated using thechi-square test and Fischer's exact test for correlation of variables. A significance level of 5% (p≤0.05) was used.Results: The mean age of the patients was 60 years, and 56% were female. Most of the lesions (34,5%) were lo-cated in the lateral and ventral regions of the tongue. Of the 148 patients, ninety had clinical follow-up. Malignanttransformation occurred in 13 patients (8.8%), with an average of 44 months of follow up.Conclusions: Non-smoker, nonhomogeneous clinical presentation, location at the tongue, and the presence of highdegree of dysplasia were statistically relevant factors associated with a higher risk of transformation transformation.(AU)

A bibliometric analysis of the top 100 most-cited articles in the Journal of Oral Pathology & Medicine (1972-2020).

OBJECTIVE: The steady and continued increase of the Journal of Oral Pathology & Medicine's (JOPM) popularity prompted a bibliometric analysis of the journal. The purpose was to assess the significance and effect of the published research articles in the Journal from 1972 and 2020, aiding the identification of landmark articles. We performed a bibliometric analysis using the top 100 cited papers in the Journal of Oral Pathology & Medicine. MATERIALS AND METHODS: An extensive review of the Web of Science was undertaken. Standard information such as author details, affiliated institutions, publication year and the country of origin was recorded. RESULTS: The top 100 cited articles in JOPM were assessed. The maximum and minimum number of citations in the top 100 articles was 1459 and 95, respectively. A total of 16 790 citations were recorded for these 100 articles. Authors were affiliated to 28 different countries, 17 research articles from the UK and 12 from the USA. Other countries furnished seven or fewer articles. CONCLUSION: This bibliometric analysis provides a synopsis of research published in the journal over a 48-year period. Recent interest in the journal shows a healthy increase in submissions and profile.

Circulating tumour cells in head and neck cancers: Biological insights.

Tumour metastasis is one of the leading cause of cancer-related mortality. Circulating tumour cells (CTCs) have been implicated in loco-regional and distant metastasis and its role is being extensively studied in various malignancies, including those from the head and neck region. The main challenge in understanding their significance lies in the rarity of these cells in the blood. However, newer technologies have attempted to overcome these pitfalls. This review explores the evolution of CTC research and other related areas, including its biological significance, sustainability within the circulating vascular environment and possible clinical implications.

Expression of cell cycle proteins according to HPV status in oral squamous cell carcinoma affecting young patients: a pilot study.

OBJECTIVE: Tobacco and alcohol consumption are considered the main risk factors for oral squamous cell carcinoma (OSCC); however, the role of these factors in patients younger than 40 years is controversial, so it has been suggested that genomic instability and high-risk human papillomavirus (HR-HPV) infection may be contributing factors to oral carcinogenesis at a young age. Therefore, the aim of this study was to evaluate the immunoexpression of cell cycle proteins according HPV status in OSCC affecting young patients. METHODS: A tissue microarray construction based on 34 OSCC samples from young patients (<40 years old) was subjected to immunohistochemical reactions for Ki67, cyclin D1, C-ErbB2, p21, Myc, epidermal growth factor receptor, p53, and p16 antibodies. RESULTS: The clinicopathologic features and the immunoexpression of all tested proteins were similar in both groups. Patients with HPV-related OSSC tended to have better cancer-specific survival (CSS; 39% vs 60% 5-y CSS), and overall survival (OS; 29.2% vs 60% 5-year OS). However, this difference was not statistically significant. CONCLUSION: No significant difference exists in the expression of cell cycle proteins studied between HR-HPV DNA-positive and HR-HPV DNA-negative OSCC affecting young patients.

Different patterns of expression of cell cycle control and local invasion-related proteins in oral squamous cell carcinoma affecting young patients.

OBJECTIVES: Oral squamous cell carcinoma (OSCC) predominantly affects males in the fifth decade of life; nevertheless, an increased incidence in young patients has been reported worldwide, and the clinical and behavioral characteristics of tumors in this group are controversial, and the literature shows divergent results. PURPOSE: To investigate the clinicopathological features and prognostic significance of the immunoexpression of cell cycle and local invasion proteins in OSCC affecting young patients (≤40 years old). METHODS: A tissue microarray was performed with 132 OSCC samples (61 cases of young patients vs 71 cases of elderly patients) and submitted to immunohistochemical reactions with Ki67, p53, p16, Bcl-2, Cyclin D1, C-ErbB2, p21, Myc, EGFR, MMP-9, SMA, Cathepsin K and FGF-2 antibodies. RESULTS: Clinicopathological features and survival rates were similar in both groups. Although overexpression of EGFR (P=.042) and MMP-9 (P=.001) was more frequent in young patients, only C-ErbB-2 (P=.048) and SMA (P=.048) expression correlated with lower disease-free survival (DFS) in this group of patients. CONCLUSION: Clinicopathological features and survival rates are similar between younger and older patients with OSCC. The different patterns of C-ErbB2, EGFR, MMP-9, and SMA expression between the groups merits further investigation to understand their role in the early tumor onset in young patients.

Alendronate-associated osteonecrosis of the jaws: A review of the main topics

Bisphosphonates is a group of inorganic pyrophosphates analogues that suppress bone resorption by inducing osteoclast inactivation, being frequently used for management of diseases affecting bone metabolism, bone metastases and bone tumors. However, since 2003 many cases describing the presence of necrotic bone exposures in the jaws have been described in patients receiving these drugs, what represent a significant complication of bisphosphonates treatment. The overall incidence of bisphosphonate-related osteonecrosis of the jaws is low, ranging from 0.7% to 12%, mainly observed in those patients receiving intravenously treatment. Osteonecrosis of the jaws associated to oral bisphosphonate, particularly alendronate, has also been reported by a number of authors. Considering that alendronate is one of the most used drug worldwide, specially for treatment of osteoporosis, a better understanding of osteonecrosis of the jaws related to its use and how to manage these patients is extremely important. Therefore, in the current manuscript the authors aim to review the most important topics related to this pathological presentation

Nonendodontic lesions misdiagnosed as apical periodontitis lesions: series of case reports and review of literature.

INTRODUCTION: This study aimed to analyze cases referred from a reference service in oral pathology that were initially misdiagnosed as periapical lesions of endodontic origin and to perform a review of the literature regarding lesions located in the apical area of teeth with a nonendodontic source. METHODS: A survey was made of clinical cases derived from the service of oral pathology from 2002 to 2012. The pertinent literature was also reviewed using ScienceDirect and PubMed databases. The lesions were grouped into benign lesions mimicking endodontic periapical lesions (BLMEPLs), malignant lesions mimicking endodontic periapical lesions (MLMEPLs), and Stafne bone cavities. The clinical presentations were divided into lesions with swelling without pain, lesions with swelling and pain, and lesions without swelling but presenting with pain. RESULTS: The results showed that 66% (37/56) of cases represented benign lesions, 29% (16/56) malignant lesions, and 5% (3/56) Stafne bone cavities. The most commonly reported BLMEPLs were ameloblastomas (21%) followed by nasopalatine duct cysts (13.5%). The most frequently cited MLMEPLs were metastatic injuries (31.5%) followed by carcinomas (25%). The main clinical presentation of BLMEPLs was pain, whereas that of MLMEPLs was swelling associated with pain; Stafne bone cavities displayed particular clinical findings. CONCLUSIONS: Clinical and radiologic aspects as well as the analysis of the patients' medical history, pulp vitality tests, and aspiration are essential tools for developing a correct diagnosis of periapical lesions of endodontic origin. However, if the instruments mentioned earlier indicate a lesion of nonendodontic origin, a biopsy and subsequent histopathological analysis are mandatory.

Tissue microarray construction for salivary gland tumors study

Objective: To describe and discuss the design, building and usefulness of tissue microarray (TMA) blocks for the study of salivary gland tumors (SGTs). Study Design: Two hundred thirty-eight formalin-fixed, paraffin-embedded SGTs were arranged in blocks of TMA using a manual tissue arrayer. Three representative cores of 1.0, 2.0 or 3.0mm were taken from each original block and their characteristics were analyzed and described. Results: It was created 12 TMA blocks that presented highly representative neoplastic cylinders. However, those neoplasias rich in cystic spaces such as mucoepidermoid carcinoma and Warthin tumor presented more difficulties to be sampled, as the neoplastic tissue available was scarce. Tissue damage and loss during TMA construction was estimated as 3.7%. Conclusion: Representative areas of SGTs, with relatively small loss of tissue, can be obtained with the construction of TMA blocks for molecular studies. However, tumors rich in cystic spaces present more difficulties to be adequately sampled (AU)

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Tissue microarray construction for salivary gland tumors study.

OBJECTIVE: To describe and discuss the design, building and usefulness of tissue microarray (TMA) blocks for the study of salivary gland tumors (SGTs). STUDY DESIGN: Two hundred thirty-eight formalin-fixed, paraffin-embedded SGTs were arranged in blocks of TMA using a manual tissue arrayer. Three representative cores of 1.0, 2.0 or 3.0mm were taken from each original block and their characteristics were analyzed and described. RESULTS: It was created 12 TMA blocks that presented highly representative neoplastic cylinders. However, those neoplasias rich in cystic spaces such as mucoepidermoid carcinoma and Warthin tumor presented more difficulties to be sampled, as the neoplastic tissue available was scarce. Tissue damage and loss during TMA construction was estimated as 3.7%. CONCLUSION: Representative areas of SGTs, with relatively small loss of tissue, can be obtained with the construction of TMA blocks for molecular studies. However, tumors rich in cystic spaces present more difficulties to be adequately sampled.