Publications by authors named "Roopa S Rao"

87 Publications

A Histopathology-based Assessment of Biological Behavior in Oral Hyalinizing Odontogenic Tumors and Bone Lesions by Differential Stains.

J Contemp Dent Pract 2021 Jun 1;22(6):691-702. Epub 2021 Jun 1.

Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India.

Aim: Odontogenic tumors (OTs) and bone lesions of the oral cavity present diverse histological features and varying clinical behavior that makes predicting their biologic behavior difficult. The research undertaken in the current study aims to predict the biological behavior of oral hyalinizing odontogenic and bone lesions (OHO-BL) for the first time by employing four differential stains with clinicopathologic correlation.

Materials And Methods: The study was performed on retrospectively diagnosed formalin-fixed paraffin-embedded cases of OTs (n = 53) and bone lesions (n = 10). The severity of hyalinization (SOH) was assessed from stained tissue sections. Polarizing microscopy was used to analyze hyalinization in tissues stained with differential special stains, namely periodic acid-Schiff (PAS), Safranin-O, Alcian Blue, and Picrosirius red. SOH was also analyzed for possible correlation with recurrence and clinicopathologic correlation in OHO-BL.

Results: Intense staining was observed with PAS, Alcian Blue, and Safranin-O in OTs with increased SOH with a statistical significance. Polarizing greenish yellow color correlated significantly with the recurrence potential of the OT group. Recurrence in individual lesions of the OT group showed a statistically significant association with SOH. Such individual correlation was not observed in bone diseases.

Conclusion: PAS, Alcian Blue, Safranin-O, and Picrosirius red are reliable stains to assess hyalinization in OHO-BL. Picrosirius red-polarizing microscopy is a dependable tool for identifying recurrent odontogenic lesions.

Clinical Significance: SOH can be considered a histological predictor of aggressive biologic behavior in oral hyalinizing odontogenic lesions that can enable the surgeon to arrive at an appropriate management protocol.
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June 2021

Natural stain () formulated by the extract of and slaked lime in histostaining of oral tissues: An observational study.

J Oral Maxillofac Pathol 2021 Jan-Apr;25(1):88-96. Epub 2021 May 14.

Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India.

Background: The pharmacological actions of (wild turmeric) such as anti-inflammatory, antitumor, antifungal, antimicrobial and wound healing have been recognized since ages. However, its role as a natural histological stain has not been explored till date.

Aim: To evaluate the efficacy of natural substance- prepared from the extract of and slaked lime in staining the biopsied oral tissues.

Materials And Methods: A cohort study that used 60 formalin fixed paraffin embedded soft and hard tissue specimens from institutional archives were subjected to sectioning and stained using and hematoxylin and eosin (H and E). The slides were evaluated for their staining efficacy and results were statistically analyzed using Wilcoxon signed-rank test and Independent 't' test.

Results: The mean of the overall parameters assessed for staining efficacy did not show statistically significant difference between the study groups in normal and pathological specimens for tooth ( = 0.410 and 0.484), bone ( = 0.133 and 0.157) and soft tissues ( = 0.186 and 0.113), respectively. This suggests that staining efficacy is equivalent to that of routine H and E for oral tissues. Structures such as dentinoenamel junction, dentinal tubules, incremental lines of cementum, reversal and resting lines, osteocytic canaliculi, mature and immature bone could be appreciated better in stained slides, thereby rendering a special staining property to stain.

Conclusion: To our knowledge, this study is the first of its kind to have used stain obtained from for the differentiation of the components of tooth, bone and soft tissue structures in histostaining of oral tissues. The naturally prepared stain possesses dual staining property both in routine and differential staining. This facilitates diagnosis of fibro-osseous lesions, bony, collagen and muscular pathologies. The natural stain also finds application in forensic odontology for age estimation.
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http://dx.doi.org/10.4103/jomfp.JOMFP_90_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272479PMC
May 2021

Lipid metabolism in cancer: A systematic review.

J Carcinog 2021 6;20. Epub 2021 May 6.

Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India.

Preclinical studies and clinical trials have emphasized the decisive role of lipid metabolism in tumor proliferation and metastasis. This systematic review aimed to explore the existing literature to evaluate the role and significance of the genes and pathways most commonly involved in the regulation of lipid metabolism in cancer. The literature search was performed as per Preferred Reporting Items for Systematic Reviews and Meta-analyses. Approximately 2396 research articles were initially selected, of which 215 were identified as potentially relevant for abstract review. Upon further scrutiny, 62 of the 215 studies were reviews, seminars, or presentations, and 44 were original study articles and were thus included in the systematic review. The predominant gene involved in lipid metabolism in cancer was stearoyl-coenzyme A desaturase 1 (SCD1), followed by fatty acid synthase (FASN). The pathway most commonly involved in lipid metabolism in cancer was the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) signaling pathway, followed by the mitogen activated protein kinase (MAPK) pathway. SCD1 and FASN play significant roles in the initiation and progression of cancer and represent attractive targets for potentially effective anti-cancer treatment strategies. The regulation of cancer metabolism by the Akt kinases will be an interesting topic of future study.
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http://dx.doi.org/10.4103/jcar.JCar_15_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312377PMC
May 2021

P-Cadherin and WNT5A expression in assessment of lymph node metastasis in oral squamous cell carcinoma.

Clin Oral Investig 2021 Jul 3. Epub 2021 Jul 3.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Background: Oral cancer progression is a multi-step process in which adhesion molecules play a pivotal role in the development of recurrent, invasive, and distant metastasis. The aim of this study was to adopt prognostic biomarkers to assess the lymph node metastasis of OSCC that will facilitate in deciding the treatment modality by the surgeons.

Objectives: The objectives of the study were to assess the biological behaviour of OSCC by correlating the expression levels of P-Cadherin and WNT5A immunohistochemically.

Methods: A total of 60 selected OSCCs cases (lymph node metastasis n = 30, non-metastatic n = 30) and 10 normal healthy controls were quantitatively and qualitatively analysed by immunohistochemistry for P-Cadherin and WNT5A. A survival analysis was also performed.

Results: The expression levels of P-Cadherin and WNT5A in OSCC groups were statistically significant between metastatic and non-metastatic groups (p < 0.001). P-Cadherin and WNT5A expression in metastatic (lymph node metastasis) and non-metastatic cases showed a significant correlation coefficient of 0.753 at (p < 0.01). The present study also found that the aberrant expression (high) of P-Cadherin was associated with diminished survival of patients with metastatic OSCC.

Conclusion: The present study demonstrated the aberrant expression of P-Cadherin and WNT5A could serve as important prognosticator in OSCC.

Clinical Relevance: P-Cadherin and WNT5A could be used as significant predictors of disease outcome.
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http://dx.doi.org/10.1007/s00784-021-03996-4DOI Listing
July 2021

Proliferative Verrucous Leukoplakia Revisited: A Retrospective Clinicopathological Study.

Clin Pract 2021 Jun 1;11(2):337-346. Epub 2021 Jun 1.

Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, 00185 Rome, Italy.

(1) Objective: To review the criteria proposed by Cerero-Lapiedra et al. and to retrospectively identify the under-diagnosed disease in patients diagnosed with proliferative verrucous leukoplakia. (2) Materials and methods: In this study, we included patients who were diagnosed with leukoplakia (histological label consistent with the clinical diagnosis, = 95), and cases with a final diagnosis within the spectrum of proliferative verrucous leukoplakia ( = 110) as defined by Batsakis et al. We applied the criteria proposed by Cerero-Lepiedra et al. to screen for the possible cases of proliferative verrucous leukoplakia. (3) Results: Although many of our patients satisfied specific isolated criteria, only 11 cases satisfied specific combinations of the guidelines to satisfy a diagnosis of proliferative verrucous leukoplakia. However, due to the lack of follow-up data, the disease is not confirmed in these 11 cases. (4) Conclusion: A limited number of cases of proliferative verrucous leukoplakia were diagnosed using the criteria given by Cerero-Lapiedra et al. The true natural history of the disease could not be studied due to the lack of follow-up data. (5) Clinical relevance: Proliferative verrucous leukoplakia presenting as hyperkeratosis or mild epithelial dysplasia are often not followed up, and they subsequently transform into carcinoma. Thus, clinicians must be vigilant whenever they encounter leukoplakia, especially with multifocal presentations. In such cases, the follow-up data are the key to understanding the true nature of the disease entity.
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http://dx.doi.org/10.3390/clinpract11020048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293104PMC
June 2021

Hyalinization as a histomorphological risk predictor in oral pathological lesions.

J Oral Biol Craniofac Res 2021 Jul-Sep;11(3):415-422. Epub 2021 May 20.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Background: Hyalinization is a process of conversion of stromal connective tissue into a homogeneous, acellular translucent material. Nevertheless, hyalinization could provide insights into the biologic behaviour and prognosis of pathological lesions. Few studies with limited sample size have intended to assess the correlation of hyalinization and biologic behaviour in oral lesions.

Aim: The current review aims to comprehensively appraise the mechanism of hyalinization in pathological oral hyalinizing lesions (OHL) and its clinical implications with emphasis on differential stains employed.

Methods: An electronic search was performed in the PubMed database (from year 2000-2020) using the keywords "special stains in oral hyalinizing lesions", "significance of hyalinization in oral lesions" and "hyalinization and biologic behaviour". Original research articles analyzing the effect of hyalinization on biologic characteristics of the lesion were evaluated in this review. Narrative review articles that provided insights into the mechanism of hyalinization and maturity of collagen fibers were also considered for analysis.

Conclusion: The presence of hyalinization does seem to have a significant effect on the biologic behaviour of pathological lesions. There is substantial scope to further investigate the process of hyalinization on larger samples and its correlation with the aggressive behaviour of OHLs. Special stains and advanced investigations such as immunohistochemistry for stromal markers would define the nature of hyalinized material and validate the correlation.

Clinical Significance: The prediction of the biologic behaviour of a lesion established through assessment of hyalinization would prevent unwanted over or under treatment leading to a better prognosis.
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http://dx.doi.org/10.1016/j.jobcr.2021.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164036PMC
May 2021

Sub-epithelial hyalinization, incomplete cystic lining, and corrugated surface could be a predictor of recurrence in Odontogenic Keratocysts.

J Oral Biol Craniofac Res 2021 Jul-Sep;11(3):423-429. Epub 2021 May 12.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Background: Odontogenic Keratocysts (OKCs) are known for their rapid growth and tendency to invade the adjacent tissues. Its high recurrence rate (2.5%-62%) has attracted many kinds of research to identify new parameters to predict recurrence that would enable better treatment outcomes for such patients. The present study aims to correlate Sub-Epithelial Hyalinization (SEH) that has not been explored in an Asian population to date and other histopathologic features of OKC to its recurrence propensity.

Materials & Methods: A total of 60 OKCs were analyzed for histopathologic correlation of thickness of lining, complete/incomplete lining, corrugated surface, ortho/para keratinization, intercellular edema, reversed polarity, basilar hyperplasia, the palisading arrangement of basal cells, presence/absence of rete pegs, folding of the epithelium, epithelial/connective tissue separation, SEH, basal offshoots, daughter cysts and inflammation with recurrence to arrive at the most significant histologic feature predicting recurrence.

Results: The most significant histologic parameter differentiating recurrent and non-recurrent OKCs was the presence of SEH (p = 0.004), incomplete lining epithelium (p ​= ​0.023), and a corrugated surface (p ​= ​0.049). Several other histologic parameters evaluated did not statistically correlate with recurrence, this can be attributed to the smaller sample size considered in the present study.

Conclusion: SEH is a reliable histologic parameter to predict recurrence in OKCs. The presence of SEH is indicative of a higher recurrence potential in OKCs. Evaluation of histological parameters and their correlation with recurrence in OKCs on a larger sample size could validate the results of the current study undertaken and potentially unravel more insights on predicting recurrence.

Key Messages: Sub-epithelial hyalinization is a significant feature for predicting recurrence in OKC.
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http://dx.doi.org/10.1016/j.jobcr.2021.05.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144347PMC
May 2021

Pancytokeratin immunostained tumor buds and cytoplasmic pseudofragments are reliable early predictive variables for regional lymph node metastatic risk assessment of oral squamous cell carcinoma.

Indian J Dent Res 2020 Nov-Dec;31(6):904-910

Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka, India.

Context: The 5-year survival rate in patients with cervical lymph node metastasis is reported to be 20-36% post surgery as compared to 63-86% in patients without nodal involvement. This necessitates assessing the metastatic potential of OSCC patients.

Objectives: To evaluate the role of Pancytokeratin immunostained tumour buds and cytoplasmic pseudofragments with other histopathological and immunohistochemical variables in predicting metastatic risk of Oral Squamous Cell Carcinoma (OSCC).

Settings And Design: Retrospective study on archival tissues of OSCC available from the Department of Oral Pathology and Microbiology.

Methodology: Totally.

40 samples of 117 histopathologically diagnosed OSCC samples were selected that displayed metastatic risk variables like invasive tumour front pattern, lymphovascular invasion, tumour buds and cytoplasmic pseudofragmentation and were grouped into 20 each of metastatic and non-metastatic OSCC. 5 normal oral mucosa samples were included in the control group. The 45 tissues were stained with congo red to assess tumour - associated tissue eosinophilia (TATE) and immunohistochemically evaluated for tumour budding and cytoplasmic pseudofragmentation using pancytokeratin, proliferation (Ki-67), microvessel density (MVD)(CD31) and lymphatic vessel density (LVD)( LYVE-1).

Statistical Analysis: Pearson's Chi square test and Man Whitney U test were used and analysed by Statistical Package for the Social Sciences (SPSS) software version 20.0.

Results: Metastatic OSCC showed significantly high number of tumour buds (p = 0.001), cytoplasmic pseudofragments (p = 0.008), higher tumour grade (p = 0.038), lymphovascular invasion (p = 0.008) and LVD (p = 0.013), aggressive invasive tumour front pattern (p = 0.001) compared to non-metastatic OSCC.

Conclusion: Pancytokeratin immunostained tumour buds, cytoplasmic pseudofragments and higher LYVE-1 expression may be used as independent predictors for OSCC metastasis.

This study highlights the importance of recognizing the early metastatic risk variables that navigates the surgeon in planning appropriate therapy for OSCC.
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http://dx.doi.org/10.4103/ijdr.IJDR_101_19DOI Listing
March 2021

Sulforaphane in broccoli: The green chemoprevention!! Role in cancer prevention and therapy.

J Oral Maxillofac Pathol 2020 May-Aug;24(2):405. Epub 2020 Sep 9.

Department of Oral and Maxillofacial Surgery, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India.

Isothicyanates present in cruciferous vegetables are known to exhibit chemoprevention by various mechanisms. Presently, there is growing evidence that a phytochemical compound known as sulforaphane in these green leafy vegetables is found to be effective in preventing and treating various cancers such as prostate cancer, breast cancer, colon cancer, skin, urinary bladder and oral cancers. This component is naturally present in the broccoli sprouts, kale, cabbage, cauliflower and garden cress and is available as a commercial supplementary pill called Broccoli extract. Availability of many bioactive substances such as vitamins, polyphenols, sulfides, glucosinolates and antioxidants makes broccoli consumption important in daily diet regularly. Researchers have named it as "Green chemoprevention." It is easily affordable and more cost-effective than the traditional chemopreventive drugs. Results from the epidemiological and experimental studies have emphasized the role of sulforophane as a complementary or alternative chemopreventive agent.
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http://dx.doi.org/10.4103/jomfp.JOMFP_126_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802872PMC
September 2020

Oral lipoma with HPV-16 associated koilocytic epithelium: Expect the unexpected.

Indian J Pathol Microbiol 2021 Jan-Mar;64(1):197-199

Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru, Karnataka, India.

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http://dx.doi.org/10.4103/IJPM.IJPM_511_20DOI Listing
July 2021

Immunohistochemical expression of Tazarotene-induced Gene 3 in oral squamous cell carcinoma.

J Oral Pathol Med 2021 Apr 13;50(4):403-409. Epub 2020 Dec 13.

Department of Oral Pathology & Microbiology, Faculty of Dental Sciences, M S Ramaiah University of Applied Sciences, Bangalore, India.

Background: The prognosis of hyperproliferative skin lesions, such as psoriasis, basal cell carcinoma, and non-melanoma skin cancers, is significantly benefited from the levels of tazarotene-induced gene-1 (TIG3) expression and subsequent treatment with tazarotene. Such observations suggest that TIG3 could be used as a biomarker for apoptosis, differentiation, and proliferation. The current study aimed to evaluate the expression of TIG3 in normal oral mucosa (NOM) and oral squamous cell carcinoma (OSCC) compared with normal skin (NS) and skin squamous cell carcinoma (SSCC) using immunohistochemistry.

Methods: Seventeen cases each of SSCC, OSCC, NOM, and NS were evaluated. Each section was immunohistochemically stained with a rabbit polyclonal TIG3 antibody. The entire procedure was blinded and evaluated by 5 observers. Statistical analysis was performed using the chi-square test.

Results: There was a significant decrease in TIG3 protein expression in OSCC and SSCC compared with that in NOM and NS (P = 0.008). The progressive loss of expression was observed as the grade of both malignancies increased. However, there was no significant difference in the expression among the normal tissue groups and within SCC groups of similar grades.

Conclusion: The present study suggests that the loss of TIG3 is an important event in carcinogenesis. TIG3 acts as a regulator of keratinocyte proliferation and terminal differentiation. Therefore, TIG3 could be a potential biomarker to differentiate aggressive and non-aggressive neoplasms.
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http://dx.doi.org/10.1111/jop.13144DOI Listing
April 2021

Socket preservation with demineralized freeze-dried bone allograft and platelet-rich fibrin for implant site development: A randomized controlled trial.

J Indian Prosthodont Soc 2020 Jul-Sep;20(3):304-311. Epub 2020 Jul 17.

Department of Oral and Maxillofacial Pathology, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India.

Aim: This study compared clinical, histological, and radiological differences in bone formation in human extraction sockets grafted with demineralized freeze-dried bone allograft (DFDBA) and platelet-rich fibrin (PRF), with nongrafted sockets and bone-implant contact (BIC) at 3 and 6 months after implant placement.

Settings And Design: Randomised controlled trial.

Materials And Methods: The study comprised thirty posterior teeth sockets in either arch in patients ranging from 25 to 60 years. The patients were divided into two equal groups - Group I: control group wherein no graft was placed and the extraction socket was left to heal normally and Group II: test group in which DFDBA and PRF were placed after extraction. 12-16 weeks after extraction, a trephine biopsy was done just prior to implant placement, followed by implant placement. Cone-beam computed tomography (CBCT) at 3 and 6 months after implant placement was done to assess BIC.

Statistical Analysis Used: Descriptive and Inferential statistical analysis was done. Parametric test: Independent -test was used for intergroup analysis and dependent -test for intra-group analysis.

Results: Lower buccal bone levels were seen in the control group versus test group at all intervals though moderately significant. Lingual bone levels significantly reduced at all the three intervals for the control group as compared to the test group. Ridge width in both groups reduced in a time span of 6-7 months without any significant difference. Better bone conversion was noted in the preserved sockets. The preserved sockets also showed better BIC 3 months after implant placement and loading.

Conclusion: Indigenously developed DFDBA material shows promising results as an osteoinductive material.
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http://dx.doi.org/10.4103/jips.jips_2_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7654195PMC
July 2020

Prediction of metastasis in oral squamous cell carcinoma through phenotypic evaluation and gene expression of E-cadherin, β-catenin, matrix metalloproteinase-2, and matrix metalloproteinase-9 biomarkers with clinical correlation.

J Carcinog 2020 6;19. Epub 2020 Aug 6.

Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India.

Context: Controversies prevail regarding the true predictive role of epithelial-mesenchymal transition (EMT) biomarkers in metastasis of oral squamous cell carcinoma (OSCC). There is also limited research carried on till date wherein the protein and gene expression of EMT biomarkers have been investigated simultaneously in the Indian population.

Aim: The aim of this study was to assess the gene expression and quantitative protein expression of EMT biomarkers using conventional method and MATLAB software and to determine if there is any difference in the expression between metastatic and nonmetastatic OSCCs with clinicopathologic correlation.

Settings And Design: Twenty metastatic and nonmetastatic OSCC tissue sections each were obtained from department archives. Gene expression and quantified protein expression of EMT markers were done and correlated with clinical parameters.

Subjects And Methods: Sections immunostained for EMT biomarkers were evaluated using semi-quantitative and quantitative (MATLAB) methods. Gene expression using semi-quantitative reverse transcriptase-polymerase chain reaction was done. These findings were correlated with clinical parameters.

Statistical Analysis Used: Pearson's Chi-square test, Student's -test, and univariate logistic regression analysis were performed using SPSS software.

Results: The low immunoexpression of E-cadherin and β-catenin and the high expression of matrix metalloproteinase (MMP)-2 and MMP-9 correlate with Stages III and IV showing high metastatic risk. Furthermore, the upregulated MMP-2 and MMP-9 gene expressions in advanced clinical stages of OSCC have high metastatic potential.

Conclusions: This study is the first of its kind to employ texture and color segmentation in MATLAB to objectively assess the protein expression of EMT biomarkers. This research is instrumental in studying the protein and gene expressions of EMT markers with clinical correlation.
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http://dx.doi.org/10.4103/jcar.JCar_8_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511891PMC
August 2020

Prognostic Significance of ALDH1, Bmi1, and OCT4 Expression in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma.

Cancer Control 2020 Jan-Dec;27(1):1073274820904959

Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Saudi Arabia.

Background: Increasing evidence suggests the involvement of cancer stem cells (CSCs) in both oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). Among the various CSC markers, aldehyde dehydrogenase (ALDH) 1, B cell-specific Moloney murine leukaemia virus integration site 1 (Bmi1), and octamer-binding protein 4 (OCT4) have been noted to increase in OSCC. The aim of the study was to analyze ALDH1, Bmi1, and OCT4 expression in OED and OSCC with clinicopathologic correlation and survival analysis.

Methods: A total of 40 cases each of OED and OSCC were retrieved from departmental archives. Expression of ALDH1, Bmi1, and OCT4 was analyzed using immunohistochemistry and was correlated with clinicopathological parameters. A follow-up ranging from 6 to 52 months was considered for Kaplan-Meier survival analysis. The log-rank test was performed to analyze significant difference in survival rates.

Results: The expression levels of ALDH1, Bmi1, and OCT4 increased significantly from OED through OSCC ( < .05). The expression of ALDH1 and OCT4 showed a significant correlation with lymph node metastasis. Positive cases of ALDH1 showed a significantly reduced survival rate compared to cases showing negative expression. Kaplan-Meier survival analysis showed a significant reduction of survival rate ( = .00) in patients showing a positive expression for all the 3 markers.

Conclusion: ALDH1 and OCT4 could be used as individual prognostic markers for assessing prognosis. ALDH1, Bmi1, and OCT4 could be used as a collective panel of markers to enable surgeons in predicting the prognosis of patients and thereby carry out prompt follow-up for such cases.
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http://dx.doi.org/10.1177/1073274820904959DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791458PMC
May 2021

Development of clinico-histopathological predictive model for the assessment of metastatic risk of oral squamous cell carcinoma.

J Carcinog 2020 18;19. Epub 2020 May 18.

Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India.

Context: Oral cancer metastasis is the leading cause of death globally. The decision-making on the mode of surgical treatment in clinically negative lymph nodes is challenging.

Aim: The aim of this study was to develop a predictive model using clinical and histopathologic parameters that may help in the assessment of the metastatic risk of oral squamous cell carcinoma (OSCC).

Settings And Design: Clinical data of histopathologically confirmed primary OSCC from 2014 to 2017 were retrieved from the archives. Histopathological parameters for metastasis that were considered for evaluation in the study were tumor buds, cytoplasmic pseudofragments, tumor grade, depth of invasion, invasive tumor front (ITF) pattern, and lymphovascular invasion (LVI).

Methods: Hematoxylin and eosin and pan-cytokeratin immunostained sections of metastatic and nonmetastatic OSCC were assessed for histopathological features and correlated with clinical parameters.

Statistical Analysis Used: SPSS software (Statistical Package for Social Sciences for Windows, Version 22.0 (2013) (IBM Corp., Armonk, NY, USA)) was used for the statistical analysis. Pearson's Chi-square test was done to assess the grades of histopathological and clinical parameters between the study groups. Univariate analysis was performed to develop a clinicopathologic predictive model.

Results: The clinicopathologic model signifies that OSCC with clinical Stage IV, high grades of tumor buds and cytoplasmic pseudofragments, Type V ITF pattern, positive LVI, deeply invasive tumors, and poorly differentiated grades of OSCC have a high risk of developing nodal metastasis. These parameters may be used as early predictors for metastasis of OSCC both in incisional and excisional biopsy specimens.

Conclusions: The proposed predictive model is simple, cost-effective, and user-friendly for the early assessment of nodal metastatic risk in clinically negative lymph nodes.
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http://dx.doi.org/10.4103/jcar.JCar_16_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363157PMC
May 2020

Procedures and pitfalls in incisional biopsies of oral squamous cell carcinoma with respect to histopathological diagnosis.

Dis Mon 2020 Dec 1;66(12):101035. Epub 2020 Jul 1.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia. Electronic address:

This review has addressed the issues faced by a diagnostic pathologist during routine assessment of haematoxylin and eosin stained incisional biopsies from oral squamous cell carcinoma patients. Herein, the pragmatic means undertaken, has highlighted routinely faced problems & encounters determined at various levels as clinical, laboratory and diagnostic pitfalls, when possible, tips offered towards procedures and guidance. Also, dealt with subtypes of oral squamous cell carcinoma, differential diagnosis, and relevant prognostic indicators that can navigate the surgeon to take quick decisions. It speaks of the journey of biopsied material from the clinician to the laboratory until the generation of the final report. Although histopathological evaluation is a confirmatory tool for any clinically suspected lesion it mandates the co-operation of faculty from varied disciplines. The onus lies on a pathologist to establish standard protocols to oversee, audit the laboratory operating procedures from time and again. Technical errors and faults at the office desk doesn't come under the purview of this review.
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http://dx.doi.org/10.1016/j.disamonth.2020.101035DOI Listing
December 2020

Minimally invasive procedures for the recognition and diagnosis of oral precancer and cancer.

Dis Mon 2020 Dec 30;66(12):101033. Epub 2020 Jun 30.

College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah 84095, United States. Electronic address:

Oral cancer represents a blend of genetic and epigenetic instability. Many a times, oral cancer occurs in the background of oral potentially malignant disorders (OPMDs), which could be easily detected and diagnosed. Various diagnostic aids have been explored for early detection of oral cancer. Some of the minimally invasive (chair-side diagnostic) procedures such as vital staining and light-based systems are used widely in the clinical practice as well as in the hospital setting owing to their simple and easy operability. In addition, these chair-side diagnostic procedures offer relatively good sensitivity and specificity despite some of their limitations. These diagnostic tools could complement good clinical history and thorough examination of patients for early detection of oral precancer and cancer.
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http://dx.doi.org/10.1016/j.disamonth.2020.101033DOI Listing
December 2020

Novel therapies in the management of oral cancer: An update.

Dis Mon 2020 Dec 25;66(12):101036. Epub 2020 Jun 25.

College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, United States. Electronic address:

An estimated 4% of all cancers are of the oral cavity or oropharyngeal. Presently, management of the oral cancers mainly includes surgery, radiotherapy, and chemotherapy either alone or in combination depending on the individual case. Each of these techniques has their advantages and disadvantages. Surgery demands removal of cancerous tissue causing disfigurement and functional impairment. Radiotherapy has significant side effects like mucositis, myelosuppression, xerostomia and dental caries. With the advent of newer treatment methods like the targeted therapy, immune therapy and gene therapy, treatment outcomes are better with fewer side effects. This has generally improved survival rates and quality of life of cancer patients.
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http://dx.doi.org/10.1016/j.disamonth.2020.101036DOI Listing
December 2020

Advanced diagnostic aids for oral cancer.

Dis Mon 2020 Dec 25;66(12):101034. Epub 2020 Jun 25.

College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah 84095, United States. Electronic address:

Oral cancer, a universal malady, has become a stumbling block over the years due to its significant morbidity and mortality rates. The greater morbidity associated with this deadly disease is attributed to delay in its diagnosis / its presentation in advanced stage. Being multifactorial, Oral squamous cell carcinoma (OSCC) is the outcome of genetic and epigenetic instability. However, in many instances, oral cancer is preceded by precursor lesions named as oral potentially malignant disorders (OPMDs), the early detection of which makes it beneficial for patients with the possible increase in the productive longevity. Many diagnostic tools / aids have been explored with the aim of early detection of oral precancer and cancer. The basic chair-side procedures or relatively advanced aids come with a set of limitations along with subjectivity as one of the setbacks. The advent and exploitation of molecular techniques in the field of health diagnostics, is demanding the molecular typing of the OPMDs and also of oral cancer. The saga of various diagnostic aids for OSCC has witnessed the so-called latest trends such as lab-on-chip, microfluidics, nano diagnostics, liquid biopsy, omics technology and synthetic biology in early detection of oral precancer and cancer. Oral cancer being multifactorial in origin with the chief participation of altered genetics and epigenetics would demand high-end diagnostics for designing personalized therapy. Hence, the present paper highlights the role of various advanced diagnostic aids including 'omics' technology and synthetic biology in oral precancer and cancer.
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http://dx.doi.org/10.1016/j.disamonth.2020.101034DOI Listing
December 2020

Intra-observer and inter-observer variability in two grading systems for oral epithelial dysplasia: A multi-centre study in India.

J Oral Pathol Med 2020 Oct 9;49(9):948-955. Epub 2020 Jul 9.

Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, London, UK.

Background: The presence and grading of oral epithelial dysplasia (OED) are considered the gold standard for predicting the malignant risk of oral potentially malignant disorders. However, inter-observer and intra-observer agreement in the context of reporting on OED grading has been reputedly considered unreliable.

Methods: We undertook a multi-centre study of six Indian oral pathologists to assess variations in reporting OED using the World Health Organization (WHO; 2005) system and also the recently introduced binary system. The observer variability was assessed with the use of kappa statistics.

Results: The weighted kappa intra-observer agreement scores improved (κ  = 0.5012) on grouping by two grades as no and mild dysplasia versus moderate and severe dysplasia compared to binary grading system (κ = 0.1563) and WHO grading system (κ  = 0.4297). Poor to fair inter-observer agreement scores were seen between the principal investigator (PI) and the other five observers using the WHO grading system (κ = 0.051-0.231; κ  = 0.145 to 0.361; 35% to 46%) and binary grading system (κ = 0.049 to 0.326; 50 to 65%).

Conclusions: There is considerable room for improvement in the assessment of OED using either system to help in standardised reporting. The professional pathology organisations in India should take steps to provide external quality assessment in reporting OED among oral and general pathologists who are engaged in routine reporting of head and neck specimens.
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http://dx.doi.org/10.1111/jop.13056DOI Listing
October 2020

PECAM-1 overexpression signifies aggressive biologic behavior of oral lichen planus - A pilot study.

Indian J Dent Res 2020 Mar-Apr;31(2):277-281

Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M S Ramaiah University of Applied Sciences, M S R Nagar, Bangalore, Karnataka, India.

Context: The etiopathogenesis of oral lichen planus (OLP) is still debatable. According to literature, many studies have illustrated OLP as a T-cell-mediated chronic autoimmune disease. Currently, there is increased evidence of chronic inflammation in OLP and its association with vascular adhesion molecules (VAMs).

Aim: The aim of this study was to evaluate the expression of VAM (PECAM-1) in OLP.

Setting And Design: Tissue samples involved 20 archival cases of histopathologically confirmed OLP (n = 15) and normal mucosa (n = 5) as controls.

Materials And Methods: The sections were subjected to immunohistochemical analysis using antibody to PECAM-1. Brown staining of the endothelial cells of blood vessels was considered positive. The expression of PECAM-1 in OLP was statistically analyzed using Wilcoxon sign-rank test.

Results: The expression of PECAM-1 in OLP was statistically significant when compared with normal mucosa (P < 0.05). A statistically significant difference was also observed in PECAM-1 expression between the reticular type and erosive type of OLP.

Conclusion: PECAM-1 was found to be overexpressed in OLP; difference in PECAM-1 expression was noted between the reticular and erosive types. The VAMs could be exploited as a possible therapeutic target in OLP to modulate the disease process thereby reducing the dependency on corticosteroids.
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http://dx.doi.org/10.4103/ijdr.IJDR_653_18DOI Listing
May 2020

Cocktail of Periodic Acid-Schiff and Papanicolaou: Novel staining technique for the identification of leukemic eosinophils - A pilot study.

J Oral Maxillofac Pathol 2019 Sep-Dec;23(3):476

Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India.

Background: Tissue eosinophilia may be caused due to reactive, neoplastic or idiopathic reasons. Reactive eosinophils in allergic and inflammatory conditions are transient and recruited from the circulation in response to various stimuli, whereas neoplastic eosinophils of leukemias and hematological malignancies are involved in the pathogenesis of the disease. The differentiation of reactive from neoplastic eosinophils has a serious implication on the treatment and prognosis of diseases. However, both these types of eosinophils display variation in morphology and staining characteristics in routine histopathology leading to a diagnostic dilemma.

Aim: The aim of this study is to evaluate the efficacy of special stains for the demonstration of eosinophils in normal/reactive lesions and leukemias.

Methodology: A retrospective study comprising twenty histologically diagnosed cases each of reactive oral lesions and leukemias were obtained from institutional archives. These tissue sections were subjected to staining with routine and special stains - Carbol chromotrope, Congo red, Leishman's stain, Periodic Acid-Schiff-papanicolaou (PAS-PAP) and PAS. Statistical analysis was performed using Pearson's Chi-square test to compare the various parameters in the evaluation of the staining efficacy.

Results: Carbol chromotrope and Congo red staining showed increased staining efficacy in normal/reactive eosinophils while PAS-PAP followed by PAS and Leishman's stain showed enhanced features such as homogenicity, specificity, increased staining intensity, enhanced nuclear and cytoplasmic details in leukemic eosinophils.

Conclusion: Combined PAS-PAP is a novel and cost-effective staining technique in differentiating reactive and leukemic eosinophils. It is significant in recognizing leukemic eosinophils of routine biopsies and alerts the clinician to rule out any underlying malignancies.
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http://dx.doi.org/10.4103/jomfp.JOMFP_8_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948061PMC
January 2020

Expression of hTERT in Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma - an Immunohistochemical Analysis.

Pathol Oncol Res 2020 Jul 5;26(3):1573-1582. Epub 2019 Sep 5.

Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, M S R Nagar, Bangalore, Karnataka, 560054, India.

Human telomerase reverse transcriptase enzyme, the catalytic subunit of telomerase are seen to be frequently reactivated in cancers including Oral squamous cell carcinoma (OSCC). Increased hTERT expression have been seen in potentially malignant conditions including Oral submucous fibrosis (OSMF). The aim of the study was to evaluate the expression levels in OSMF, OSCC in the background of OSMF and OSCC using immunohistochemistry and also to correlate hTERT expression with clinicopathologic parameters. A total of 50 histopathologically diagnosed cases of 20 OSMF, 20 OSCC wherein 5 were OSCC in the background of OSMF and 10 Normal oral mucosae were retrieved from the departmental archives and subjected to immunohistochemical analysis of hTERT. The expression of hTERT increased from normal, OSMF, to OSCC with statistically significant differences in mean labelling score (LS). We also found a shift in cellular localization of stain where, normal mucosal tissues showed a nuclear stain unlike OSMF, where combined nuclear and cytoplasmic staining as noted. The tumor cells in OSCC showed predominant cytoplasmic staining. There was no correlation between hTERT expression and clinicopathological parameters of OSMF. However, a significant increase of hTERT expression was seen with increasing histological grading of OSCC. These results suggest the role of hTERT in the early event of malignant transformation of OSMF. Telomerase could be used as a potent diagnostic marker to identify high-risk group of OSMF.
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http://dx.doi.org/10.1007/s12253-019-00700-6DOI Listing
July 2020

Interleukin-1beta and Caspase-3 expression serve as independent prognostic markers for metastasis and survival in oral squamous cell carcinoma.

Cancer Biomark 2019 ;26(1):109-122

Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India.

Background: The Indian subcontinent has the highest incidence and prevalence of oral squamous cell carcinoma (OSCC). Inflammation and apoptosis are two emerging hall marks of cancer that might play a significant role in tumorigenesis and metastasis. Concurrent expression of proinflammatory cytokine (IL-1β) and executioner caspase (Caspase-3) in same OSCC tissue samples has not been reported in an Indian population.

Objectives: The present study aimed to evaluate the immunohistochemical expression of IL-1β and Caspase-3 in same OSCC tissue samples with clinicopathological correlation and survival analysis in Indian population.

Methods: A retrospective study was conducted utilizing 40 formalin fixed paraffin embedded histologically diagnosed cases of OSCC comprising of 20 metastatic OSCC and 20 non-metastatic OSCC.

Results: Increased expression of IL-1β and Caspase-3 were observed in metastatic OSCC. Correlation of expression of IL-1β and Caspase-3 with clinicopathological parameters revealed a significant association between these markers and staging, nodal status and site of the lesion.

Conclusion: Over expression of IL-1β and Caspase-3 was associated with advanced stage and poor survival of the patient. IL-1β overexpression showed significantly lower disease-free survival and disease specific survival as well. Overexpression of IL-1β and Caspase-3 in incisional OSCC biopsies could be considered for predicting metastasis and survival outcome.
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http://dx.doi.org/10.3233/CBM-190149DOI Listing
March 2020

Expression of Ki-67, p53, α-SMA and COX-2 in lichen planus and related lesions: A pilot study.

J Oral Biol Craniofac Res 2019 Apr-Jun;9(2):230-235. Epub 2018 Feb 19.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Background: Researchers have struggled to understand the natural history of lesions presenting with both lichenoid features and epithelial dysplasia. Thus the present study was designed to differentiate between OLP, OLP with dysplasia, epithelial dysplasia and epithelial dysplasia with lichenoid features based on the expressions of ki-67, p53, COX-2, and α-SMA.

Materials And Methods: Formalin-fixed paraffin-embedded archival specimens of OLP, OLP with dysplasia, epithelial dysplasia and epithelial dysplasia with lichenoid features were subjected to immunohistochemical staining with ki-67, p53, COX-2, and α-SMA.

Results: Ki-67 exhibited strong positivity in 100% (6/6) of epithelial dysplasia cases, 71.4% (5/7) of lichenoid dysplasia cases, 57.1% (4/7) of OLP cases and 60% (3/5) of OLP with dysplasia cases. Strong p53 staining was evident in more cases of lichenoid dysplasia [42.8% (3/7)], while moderate staining was more frequent in OLP cases [42.8% (3/7)] and OLP with dysplasia cases [42.8% (3/7)] and mild intensity was more frequent in epithelial dysplasia cases [50% (3/6)] followed by lichenoid dysplasia cases [42.8% (3/7)], OLP cases [28.5 (2/7)] and OLP with dysplasia cases [40% (2/5)]. COX-2 strong positivity was more frequent in cases of epithelial dysplasia cases [57.1% (4/7)] and OLP [50% (3/6)]. Strong α- SMA staining was noted more frequently in lichenoid dysplasia cases [71.4 (5/7)], followed by OLP cases [42.8% (3/7)] and OLP with dysplasia cases [60% (3/5)].

Conclusions: Ki-67, p53, α-SMA and COX-2 expression do not differentiate between OLP, LP with dysplasia and epithelial dysplasia with lichenoid features.
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http://dx.doi.org/10.1016/j.jobcr.2018.02.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6562184PMC
February 2018

cytotoxic and apoptotic induction effect of earthworm coelomic fluid of and on human oral squamous cell carcinoma-9 cell line.

Toxicol Rep 2019 19;6:347-357. Epub 2019 Apr 19.

Central Research Laboratory, Ramaiah Medical College, MSR Nagar, MSRIT Post, Bangalore, 560054, India.

The current protocol of cancer management includes surgery, radiotherapy and chemotherapy. However, these modalities have significant adverse effects and affect the quality of life. Further intensification of treatment is hindered as maximal toxicity levels are reached impeding improvement. Hence researchers are in the quest for adjunctive naturally available therapies that can alter tumor proliferation without causing significant adverse reactions. The present study aims to explore the cytotoxic potential of earthworm coelomic fluid (ECF) of (EE), (EF), and (PE) on oral cancer cell line SCC-9. The effect of ECF on cell cycle analysis and mechanism of cell death have also been investigated. All experiments reported in this paper were performed as 3 replicates per experiment. The results indicated that ECF of EE, EF and PE have potent variable cytotoxic effect on SCC-9 cells demonstrated through LDH, clonogenic and comet assay. An effective cell cycle arrest was observed at the G2M phase of cell cycle with apoptotic induction that was observed through an Annexin V - FITC/PI assay. ECF of EE was found to be superior in its cytotoxic action closely followed by ECF of PE. The present findings provide evidence for the first time that ECF of EE, EF and PE have potent cytotoxic effect on oral cancer cells . They significantly induce G2M cell cycle arrest and promote apoptosis in SCC-9 cell line. Gene expression studies have been planned to ascertain the pathways of cell death.
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http://dx.doi.org/10.1016/j.toxrep.2019.04.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488712PMC
April 2019

Molecular pathways of oral cancer that predict prognosis and survival: A systematic review.

J Carcinog 2018 31;17. Epub 2018 Dec 31.

Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India.

Several genes and pathways associated with oral squamous cell carcinoma (OSCC) are significant in terms of early detection and prognosis. The objective of this literature review is to evaluate the current research on molecular pathways and genes involved in oral cancer. Articles on the genes involved in oral cancer pathways were evaluated to identify potential biomarkers that can predict survival. In total, 36 articles were retrieved from internet databases, including EBSCO Host, Google Scholar, PubMed, and Science Direct, using the keywords "biomarker of oral cancer," "pathways of oral cancer," "genes involved in oral cancer," and "oral cancer pathways." A total of 36 studies related to OSCC were chosen. Most of the studies used cell lines, while others used archival tissues, few studies followed up the cases. Three major interlinked pathways found were the nuclear factor kappa B (NF-kB), PI3K-AKT, and Wnt pathways. The commonly mutated genes were cyclin D1 (CCND1), Rb, p53, FLJ10540, and TC21. The NF-kB, PI3K-AKT, and Wnt pathways are most frequently involved in the molecular pathogenesis of oral cancer. However, the CCND1, Rb, p53, FLJ10540, and TC21 genes were found to be more accurate in determining patients' overall survival. Polymerase chain reaction, immunohistochemistry, and immunoblotting were the commonly used detection methods.
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http://dx.doi.org/10.4103/jcar.JCar_17_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334533PMC
December 2018

Stem Cell Markers SOX-2 and OCT-4 Enable to Resolve the Diagnostic Dilemma between Ameloblastic Carcinoma and Aggressive Solid Multicystic Ameloblastoma.

Adv Biomed Res 2018 28;7:149. Epub 2018 Nov 28.

Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India.

Background: Ameloblastic carcinoma (ACA) is a malignant neoplasm with overlapping histopathological features of benign aggressive solid multicystic ameloblastoma (SMA). This often leads to misdiagnosis with direct implication on the management protocol. The need of the hour is to adopt reliable tissue biomarkers to differentiate these lesions accurately that will help to implement an appropriate treatment modality. Few studies to differentiate ACA and SMA in literature with a limitation of a single marker and lack of availability of cases have prompted us to undertake this study. Thereby, this study is aimed at resolving the diagnostic dilemma in differentiating ACA and aggressive SMA using SOX-2, OCT-4 and CD44.

Materials And Methods: Tissue samples involved 40 archival cases of histopathologically confirmed cases of ACA ( = 20) and SMA ( = 20). The sections were subjected to immunohistochemical staining using antibodies to SOX-2, OCT-4 and CD44. Nuclear staining for SOX-2 and OCT-4 and membranous reactivity for CD44 was considered positive.

Results: The expression of SOX-2 and OCT-4 in ACA was statistically significant when compared to SMA ( < 0.001). CD44 showed an insignificant statistical value of <0.077 in differentiating ACA and SMA. SOX-2 and OCT-4 expression in ACA showed a significant correlation coefficient of 0.616 at < 0.004.

Conclusions: SOX-2 and OCT-4 could serve as independent novel markers in resolving the diagnostic dilemma between ACA and aggressive SMA.
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http://dx.doi.org/10.4103/abr.abr_135_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282489PMC
November 2018

Antiproliferative Effect of Earthworm Coelomic Fluid of , , and on Squamous Cell Carcinoma-9 Cell Line: A Pilot Study.

Pharmacognosy Res 2017 Dec;9(Suppl 1):S61-S66

Central Research Laboratory, M. S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India.

Introduction: The earthworm coelomic fluid (ECF) has shown proven antiproliferative effect against breast, liver, gastrointestinal, and brain cancer, but it is least explored in oral cancer. The present study is an attempt to investigate the antiproliferative activity of ECF on oral cancer cell line squamous cell carcinoma (SCC)-9.

Materials And Methods: ECF was collected from the species (EE), (EF), and (PE) stored at -80°C. Percentage inhibition of ECF on squamous cell carcinoma-9 cells was recorded at 24 h. Protein estimation was done using Bradford protein assay validated by the biuret method. Cytotoxicity was tested at 2.5, 5, 10, 20, 40, and 80 μg/ml concentrations by 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay in SCC-9 cells . GraphPad Prism 7.0 software was used to calculate the inhibitory concentration (IC). Chi-square test was used to analyze the difference between samples.

Results: The test samples EE, EF, and PE inhibited the growth of SCC-9 cells significantly in a dose-dependent manner, and the IC values were found to be 4.6, 44.69, and 5.27 μg/ml, respectively. The antiproliferative effect was found to be variable among the three earthworm species with EE showing the most promising effect followed by PE and EF.

Conclusion: Establishing the antiproliferative effect of ECF on oral cancer cells could be an initial step toward drug development and future anticancer research. The preliminary investigation has shown that ECF has a promising antiproliferative effect on oral cancer cells .

Summary: The present pilot study evaluated the antiproliferative effect of earthworm coelomic fluid (ECF) of (EE), (EF), and (PE) on squamous cell carcinoma-9 cell line. The ECF inhibitory activity was promising at inhibitory concentration values of 4.6, 44.69, and 5.27 μg/ml, respectively. Further studies pertaining to antiproliferative mechanism of EE, EF, and PE have been planned. ECF: Earthworm coelomic fluid, EE: , EF: , PE: , MTT: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, SCC: Squamous cell carcinoma, BSA: Bovine serum albumin, PBS: Phosphored buffered saline, ATCC: American Type Culture Collection.
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http://dx.doi.org/10.4103/pr.pr_52_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757329PMC
December 2017

Naturally Available Extracts Inhibiting Cancer Progression: A Systematic Review.

J Evid Based Complementary Altern Med 2017 Oct 11;22(4):870-878. Epub 2017 Dec 11.

4 Department of Maxillofacial Surgery and Diagnostic Science, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Aim: This systematic review is aimed at evaluating the literature on the efficacy of naturally available extracts that inhibit cancer.

Methods: A literature search was performed to strengthening the reporting of observational studies in epidemiology analysis. Approximately 3000 research articles were initially selected. Of these articles, 200 were included, and 2800 were excluded. On further scrutiny, 150 of the 200 studies were reviews, seminars, and presentations, and 50 were original study articles. Among these articles, 20 studies were selected for the systematic review.

Results: The predominant molecular pathways followed by natural extracts were nuclear factor kappa B ligand, suppression of the protein kinase B-Akt/P13K pathway (an intracellular signaling pathway important in regulating cell cycle), vascular endothelial growth factor downregulation, and tumor protein-P53 tumor suppressor upregulation.

Conclusions: It is evident that natural extracts have the ability to inhibit cancer progression. Continued research in this field could facilitate the use of natural extracts with currently available anticancer agents.
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http://dx.doi.org/10.1177/2156587217744914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871319PMC
October 2017
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