Prognosis of Pediatric Patients With Mucoepidermoid Carcinoma of the Parotid Gland.

OBJECTIVE: To summarize the prognosis of pediatric patients with mucoepidermoid carcinoma (MEC) of the parotid gland. METHODS: Pediatric patients with MEC of parotid gland who were surgically treated at the Capital Medical University School of Stomatology from 2000 to 2014 were retrospectively analyzed. Clinical characteristics, pathology reports, and operation records were reviewed and analyzed. RESULTS: In total, 33 patients with an average age of 13.2 years were enrolled. The 5-year overall survival and disease-free survival were 95.8% and 84.4%, respectively. The disease-free survival and overall survival rates were lower in the under-10 age group (75.0 versus 87.7% and 83.3% versus 100%), though no statistically significant difference was found (P = 0.279 and P = 0.075). The patients who underwent complete resection all had a good prognosis without any recurrence or death regardless of whether the cut margin was 1.0 cm, 0.5 cm, or only extracapsular. One patient experienced 3 recurrences within 18 months and eventually died of disease. CONCLUSION: Good outcomes were achieved in pediatric patients with MEC of the parotid gland. Radical resection ensured a good prognosis regardless of the extent of resection. Frequent recurrence in a short period was associated with a poor prognosis. TRIAL REGISTRATION: None.

Saliva CA125 and TPS levels in patients with oral squamous cell carcinoma.

OBJECTIVES: To determine the levels of carbohydrate antigen 125 (CA125) and tissue polypeptide-specific antigen (TPS) in saliva of patients with oral squamous cell carcinoma (OSCC) and patients with nonneoplastic disease of the oral cavity, and to investigate their diagnostic value and their relationship with pathological grade and clinical stage. METHODS: A total of 97 hospitalized patients with OSCC, 36 patients with nonneoplastic disease of the oral cavity and 50 healthy individuals were included in this investigation. Mixed saliva was collected from these patients and the healthy controls before treatment. Saliva samples were analyzed by enzyme-linked immunosorbent assay (ELISA). RESULTS: The saliva CA125 and TPS concentrations were significantly higher in patients with OSCC than in patients with nonneoplastic disease and healthy controls, but not significantly different between patients with nonneoplastic disease and controls. Neither the saliva CA125 nor the TPS level was correlated with pathological grade and clinical stage. The sensitivity, specificity and accuracy of saliva CA125 and TPS for the diagnosis of OSCC were 80.0%, 66.0%, 75.7%, and 82.1%, 74.0%, 79.3%, respectively. When CA125 and TPS were analyzed independently, there was no significant difference in sensitivity, specificity and accuracy between the two markers. When CA125 and TPS were analyzed in combination, there was no significant difference in sensitivity, specificity and accuracy between independent detection and combined detection. CONCLUSIONS: The saliva CA125 and TPS concentrations were elevated in patients with OSCC. CA125 and TPS may prove to be useful tumor markers in OSCC.

Serum SCCA, Cyfra 21-1, EGFR and Cyclin D1 levels in patients with oral squamous cell carcinoma.

OBJECTIVES: To determine the concentrations of SCCA, Cyfra 21-1, EGFR and Cyclin D1 in serum of patients with oral squamous cell carcinoma, and investigate their diagnostic value and their relationship with clinical stage, histological differentiation and lymph node metastasis. METHODS: Seventy hospitalized patients with oral squamous cell carcinoma and 72 healthy individuals were included in the study. Venous blood was collected from all study participants, in the oral carcinoma patients before tumor resection. One week after surgery, venous blood was collected again from 20 patients. Serum marker levels were determined by enzymelinked immunosorbent assay (ELISA). RESULTS: The serum SCCA, EGFR and Cyclin D1 concentrations were significantly higher in patients with oral squamous cell carcinoma than in healthy controls, while there was no significant difference in Cyfra 21-1 levels between patients and controls. The serum SCCA concentration decreased after surgery, but there was no significant difference in the serum Cyfra 21-1, EGFR and Cyclin D1 concentrations before and after surgery. Serum SCCA, Cyfra 21-1, EGFR and Cyclin D1 concentrations were not correlated with clinical stage, histological differentiation and lymph node metastasis. When SCCA, EGFR and Cyclin D1 were measured separately, EGFR had the highest diagnostic sensitivity and accuracy and Cyclin D1 had the highest specificity; when any two of the markers were tested in combination, the combined detection of EGFR and Cyclin D1 had the highest sensitivity, specificity and accuracy. CONCLUSIONS: SCCA, EGFR and Cyclin D1 may prove to be useful tumor markers in oral squamous cell carcinoma. The combined determination of EGFR and Cyclin D1 may be of value in the diagnosis of oral squamous cell carcinoma. Serum SCCA may be used as an adjunct in monitoring treatment response.

Serum hyaluronan levels in oral cancer patients.

BACKGROUND: Hyaluronan (HA) is most likely associated with tumor invasion and metastasis. Studies have shown that HA levels are often increased in serum of patients with various malignant tumors. The purpose of this study was to determine the levels of serum hyaluronan in patients with oral cancer and evaluate the value of serum HA in adjuvant diagnosis, staging and monitoring treatment response in these patients. METHODS: Eighty-four hospitalized patients with oral cancer, 65 patients with benign tumors in the oral and maxillofacial region and 67 healthy individuals were included in this investigation. Venous blood was collected from these patients and the healthy individuals before therapy. One week after therapy, venous blood was collected once again in 43 patients with oral cancer. Serum samples were obtained and serum HA levels examined. RESULTS: The serum HA concentration was significantly higher in oral cancer patients than in patients with benign tumors and in healthy controls (P<0.05). The serum HA level in patients with stages III and IV disease was higher than in patients with stages I and II disease, but there was no significant difference in the HA level between stages I and II nor between stages III and IV (P>0.05). After a complete treatment the HA levels in patients with oral cancer became lower than before treatment, but the difference was not significant (P>0.05). CONCLUSIONS: The results of this study suggest that the determination of HA levels may provide additional information in diagnosis of oral cancer, but its usefulness as an adjunct in clinical staging and in monitoring treatment response was limited.

[Fibular flap combined with lateral crural flap for reconstruction of oral and maxillofacial defect].

OBJECTIVE: To investigate the therapeutic effect of fibular flap combined with lateral crural flap for reconstruction of oral and maxillofacial defect. METHODS: Based on the peroneal vascular system, fibular flap combined with lateral crural flap were used for reconstruction of oral and maxillofacial defect. The fibular flap was used for bone defect, and the lateral crural flap was for the reconstruction of soft tissue defect of the oral cavity and pharynx. RESULTS: During the period of Mar. 2005 to Mar. 2007, 26 cases were treated, including 25 cases of defects after tumor resection and 1 case of bilateral maxillary defect. The flaps were harvested without any injury to the peroneal vascular system and perforator. All the flaps were survived. One case of arterial insufficiency and one case of venous thrombosis occurred 12 hours and 24 hours after operation, but the flaps were salvaged after urgent re-operation. All the patients were followed up for 6 months to 2 years. The patients acquired satisfactory appearance with normal social life. CONCLUSIONS: For complicated oral and maxillofacial reconstruction, fibular flap combined with lateral crural flap can achieve good reconstruction results and could be selected as the first line treatment.

[Cytokeratin 18 and their gene expression in jaw odontogenic keratocyst epithelial lining].

OBJECTIVE: To examine cytokeratin 18(CK18) and it's gene in jaw odontogenic keratocyst (OKC) epithelial lining. METHODS: The epithelial linings of 32 cases were subject to monoclonal antibody immunohistochemical staining for CK18, CK8 and CK19. RT-PCR and in situ hybridization for CK18 mRNA were conducted in 12 of 32 cases in keratocyst epithelial cell linings. RESULTS: In 17 cases, CK18 were observed in keratinized surface layers, though weakly positive. In 27 cases, CK18 were positive in the granular cell layers. CK18 were also positive in the spinous cell layers in 14 cases. In all cases, CK18 was negative in basal cell layers. By RT-PCR, 4 cases expressed CK18 strongly, 8 cases weakly. By in situ hybridization, 8 cases expressed CK18 mRNA positively in both spinous and granular cell layers, and 4 cases positively in basal and keratinized cell layers. CK8 were expressed in basal cell layers of keratocyst epithelial linings. In 23 cases, CK19 were expressed in surface cell layers of keratocyst epithelial linings. CONCLUSION: The expression of CK18 in keratocyst epithelial linings transfers from basal cell layer to spinous layer. The expression of CK18 immunohistochemical staining and CK18 mRNA in situ hybridization are different, which shows CK18 might be related to proliferation of OKC epithelial linings. That suggests the existence of regulation of CK18 and CK18 mRNA expression.

[Glandular odontogenic cyst: report of two cases with cytokeratin 18 expression].

OBJECTIVE: To report two cases of glandular odontogenic cyst and examine its cytokeratin 18,19 expression. METHODS: Two cases of glandular odontogenic cyst were reported and studied. The cytokeratin 18, 19 expression in these two cases were also investigated using immuno-histochemical staining as well as in the situ hybridization of the cyst epithelium. RESULTS: Histo-pathological examination revealed that ciliated columnar cells, squamous cells and low-columnar cells were found in the superficial layer of the lining epithelium. Several minor salivary glands, mainly composed of seromucous cells were observed near the satellite cyst. CK18 were expressed in all layers of the lining epithelium of varying intensity. CK18 was negative in lining epithelium of the daughter cyst, but CK19 was positive. CK18-mRNA was expressed in all the layers of the lining epithelium, the salivary glands and daughter cysts. CONCLUSIONS: Histological features and CK18 expression may be indicative of the possibility of salivary glandular and odontogenic differentiation.

[Cytokeratin18, 13 and their gene expression in post-operative maxillary cyst linings with metaplastic epithelium].

OBJECTIVE: To study the cytokeratin 18 and 13 and their gene (CK) expression in post-operation maxillary cyst linings with metaplastic epithelium. METHODS: CK expressions were examined with immunohistochemistry in 46 post-operative maxillary cyst (POMC) which were lined with pseudostriated columnar cells only (13 cases), both kinds of columnar and squamous cells (30 cases) and squamous cells only (3 cases). RESULTS: The expressions of CK8, CK13 and CK18 were observed in 39, 9 and all of the 43 columnar epithelial linings, respectively. Metaplastic squamous epithelia expressed more CK13 and less CK18 and CK8. Of the 33 metaplastic linings, 24 expressed CK8, 23 CK13 and 26 linings expressed CK18. The expression of CK13- and CK18-mRNA was generally correlated with the protein expression level. By in situ hybridization, CK18-mRNA expression was observed not only in 26 metaplastic linings which were positive for CK18 protein but also in five of the seven metaplastic linings which did not express CK18 protein. In addition, RT-PCR revealed an expression of CK18-mRNA in all metaplastic squamous linings although the expression level was weaker than that in the columnar epithelial linings. The CK13-mRNA was expressed in a fashion inverse to the CK18-mRNA. CONCLUSIONS: These results indicate that CK18-mRNA is preserved through metaplasia although the protein expression decreases and metaplastic squamous cells differentiate with a decrease of CK18 and an increase of CK13 expression.

[Examination of serum hyaluronic acid level in patients with oral and maxillofacial malignancy].

OBJECTIVE: To determine the level of hyaluronic acid (HA) in serum of patients with oral and maxillofacial malignancy and to investigate the correlation between the levels of serum HA and stage of the malignant lesions and treatment response. METHODS: 44 patients with oral and maxillofacial malignancy were analyzed and 24 healthy individuals served as controls. Venous blood was collected from the patients before treatment and the healthy individuals. One week after therapy, venous blood were collected in 24 patients once again. Serum levels of HA were measured with quantitative radioimmunoassay (RIA). RESULTS: Before treatment, the serum HA concentration in patients with oral and maxillofacial malignancy was significantly higher than that of the controls (P < 0.05). Also, the serum HA concentration in patients with OSCC was significantly higher than that of the controls (P < 0.05). No difference was noted in serum HA concentration between patients with salivary ACC and the control group (P > 0.05). The serum HA concentration of patients in stage III and IV was significantly higher than that of patients in stage I and II (P < 0.05). Serum HA levels decreased in patients after a complete treatment, but the difference was not significant (P > 0.05). CONCLUSION: Serum levels of HA may be useful in diagnosis of OSCC and was associated with clinical stages in patients with oral and maxillofacial malignancy. However, it may not be contributory to monitoring treatment response in patients with oral and maxillofacial malignancy.