[Multidisciplinary team model for patients with oral cancer and systemic diseases: an expert consensus].

Large general hospitals currently play an increasingly important role in the diagnosis and treatment for acute critical patients and difficult diseases because of the development of dual referral system and hierarchical diagnosis, as well as the formation of medical treatment alliance. Patients with oral cancers are often associated with systemic diseases, which increases the complexity of the condition. Thus, meeting the demand through the traditional single medical model is difficult. As such, a multidisciplinary team (MDT) model has been proposed and has achieved a good clinical effect. To standardize the application of this model, we organized an event in which relevant experts discussed and formulated a consensus to provide standardized suggestions on the MDT process and the diagnosis and treatment of common systemic diseases as reference for clinical practice.

Preventing Early-Stage Graft Bone Resorption by Simultaneous Innervation: Innervated Iliac Bone Flap for Mandibular Reconstruction.

BACKGROUND: Postoperative resorption of vascularized bone grafts jeopardizes the success of dental implant(s) and functional rehabilitation of the jaw. Recent evidence supports the crucial role of innervation in bone regeneration and turnover. METHODS: This study reports a new technique for simultaneous innervation of vascularized iliac flaps in mandibular reconstruction, through neurorrhaphy between ilioinguinal nerves, which innervate iliac bone, and inferior alveolar nerves or great auricular nerves. Twenty-two patients (aged 50 to 69 years) with postoncologic continuity defects of the mandible underwent mandibular reconstruction (10 innervated flaps and 12 control flaps). Graft bone resorption was analyzed by computed tomographic scans at 6 and 12 months postoperatively, and bone quality was evaluated for dental implantation, with histologic and histomorphometric analyses for graft samples. RESULTS: At 12-month follow-up, graft bone density loss in the control group was significantly higher than in the innervated group (p < 0.05). Bone quality evaluation indicated a suitable condition for dental implantation in all patients in the innervated group but in 41.7 percent of patients in the control group. Histologic and histomorphometric analyses showed successful innervation in the innervated group but not in the control group. Osteoclast activity was significantly higher in the control group than in the innervated group (p < 0.05). CONCLUSIONS: Innervated iliac flaps may effectively prevent bone resorption of grafts in mandible reconstruction that otherwise jeopardize the success of dental implants. This new strategy of innervation of bone flaps appears clinically valuable and provides insights into the homeostasis of grafts for functional reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

p12CDK2-AP1 interacts with CD82 to regulate the proliferation and survival of human oral squamous cell carcinoma cells.

p12 cyclin-dependent kinase 2 (CDK2)-associating protein 1 (p12CDK2-AP1) has been demonstrated to negatively regulate the activity of CDK2. However, the underlying molecular mechanism remains largely unknown. We aimed to determine the potential binding proteins of p12CDK2-AP1 and to elucidate the role of p12CDK2-AP1 in the regulation of the proliferation, invasion, apoptosis, and in vivo growth of human oral squamous cell carcinoma cells. The protein-protein interaction was predicted using computational decision templates. The predicted p12CDK2­AP1 interacting proteins were overexpressed in human oral squamous cell carcinoma OSCC-15 cells, and the protein binding was examined using co-precipitation (Co-IP). Cell proliferation and invasion were determined via MTT assay and Transwell system, respectively. Cell apoptosis was evaluated using Annexin V-FITC/PI double staining followed by flow cytometric analysis. The in vivo growth of OSCC-15 cells was examined in nude mouse tumor xenografts. We found that overexpression of either p12CDK2-AP1 or CD82 significantly suppressed the proliferation and invasion but promoted the apoptosis of OSCC-15 cells (P<0.05). Importantly, combined overexpression of p12CDK2-AP1 and CD82 showed synergistic antitumor activity compared with the overexpression of a single protein alone (P<0.05). Additionally, the simultaneous overexpression of p12CDK2-AP1 and CD82 significantly suppressed the in vivo tumor growth of OSCC-15 cells in nude mice compared with the negative control (P<0.05). Our findings indicate that p12CDK2-AP1 interacts with CD82 to play a functional role in suppressing the in vitro and in vivo growth of OSCC-15 cells.

Three-dimensional collagen scaffold enhances the human adenoid cystic carcinoma cancer stem cell and epithelial-mesenchymal transition properties.

Three-dimensional (3D) cell culture may provide the architectures similar to the in vivo natural extracellular matrix condition for in vitro cultured cells. In this work, a 3D collagen scaffold was used to culture the adenoid cystic carcinoma (ACC) cells. The results showed that the 3D scaffold not only induced the diversification of cell morphologies but also increased the cell proliferation. The transcription of matrix metalloproteinase and epithelial-mesenchymal transition were significantly increased in the cells cultured in 3D collagen scaffolds. In addition, the expression of cancer stem cell (CSC) markers of Sox2 and Oct4 were higher than that in 2D cultured cells. The 3D cultured ACC-83 cells showed more resistance to chemotherapeutic drugs. Thus, the 3D collagen scaffold could provide a useful model for CSCs study and anticancer therapeutics research in vitro.

Surgical treatment of a giant neurofibroma.

Neurofibromatosis type 1, an autosomal dominant inherited disease, presents pathologic symptoms of multiple systems, including neurofibromatosis, skeletal dysplasia, café-au-lait spots in skins, and so on. A 45-year-old man with neurofibromatosis type 1 was reported in this article. The patient presented a giant neurofibroma in his head and neck, dysplasia of skull, facial bones and spinal columns, and multiple café-au-lait spots in systematic skins. Satisfactory curative effects were obtained in this case after tumor resection and prosthesis implantation.

Gene expression profile of salivary adenoid cystic carcinoma associated with perineural invasion.

Adenoid cystic carcinoma (ACC) is a common salivary gland malignancy characterized by slow but progressive clinical course, proclivity for hematogenous spread and perineural invasion (PNI) that exhibits inherent resistance to complete surgical resection, systemic chemotherapy and conventional radiotherapy. The molecular alterations that underlie its PNI are poorly characterized. We report the combined use of laser capture microdissection (LCM) and high-throughput cDNA microarray to monitor in vivo gene expression profile of salivary ACC and to correlate the profile with PNI. Consecutive section staining with hematoxylin & eosin was applied to 15 cancerous tissues, among which 6 were judged as PNI. Pure cancer cells adjacent to the nerve tracts from 6 cancerous tissues judged as PNI were laser captured, and pure cancer cells from the same 6 tumors distant from the nerve tracts were also procured. Total RNA was extracted, amplified and subjected to cDNA microarray-based expression analysis. The patterns of gene expression were verified by quantitative real-time PCR and immunohistochemistry. As to the result of 6 arrays, a total of 53 genes were identified as being 2-fold or more differentially expressed in PNI cancer cell group as compared to non-PNI cancer cell control. Out of the 53 genes found consistently differentially expressed, 38 were up-regulated and 15 down-regulated. The combined use of LCM and cDNA microarray analysis provides a powerful new approach to monitor the in vivo molecular events of PNI in salivary ACC. These identified novel genes deserve further investigations to elucidate their clinicopathological significance.

[Coexpression of Schwann cell marker GFAP and myoepithelial cell marker alpha-SMA in salivary adenoid cystic carcinoma].

OBJECTIVE: To observe the expression of Schwann cell marker GFAP and myoepithelial cell marker alpha-SMA in salivary adenoid cystic carcinoma (ACC), and to evaluate the relationship of GFAP, alpha-SMA and perineural invasion in ACC. METHODS: Immunohistochemical SABC method, double-label immunofluorescence and CLSM were used to detect the expression of GFAP and alpha-SMA proteins in salivary ACC tissue samples. RESULTS: In salivary ACC tissue samples, both GFAP and alpha-SMA proteins were positive, which were coexpressed in cytoplasm of the same onco-myoepithelial cells. CONCLUSIONS: There may be Schwann cell differentiation in onco-myoepithelial cell of salivary ACC, and it may be the pathological base of perineural invasion in salivary ACC.

[Analysis of postoperative survival rates of mucoepidermoid carcinoma in salivary gland].

OBJECTIVE: The pathologic slides and clinical data of 119 patients with mucoepidermoid carcinoma (MEC) of salivary glands were reviewed. All patients underwent surgical therapy in Department of Oral and Maxillofacial Surgery, College of Stomatology, Fourth Military Medical University. The postoperative overall observed survival rates and specific survival rates were statistically caculated, and the correlative clinicopathologic factors influencing the prognosis were evaluated. METHODS: Statistical analysis was performed using the SPSS 10.0 software. The survival rates were obtained by the Kaplan-Meier method. The clinicopathologic parameters were evaluated using log rank test (univariate analysis) and Cox proportional hazards regression model (multivariate analysis). RESULTS: The overall observed survival rates of this group were 92.53%, 87.52% and 85.39% at 5, 10 and 15 years respectively after surgical therapy. Univariate analysis demonstrated that the factors correlated with lower in survival rates were patient's age (> or = 40 years), advanced clinical stage (TNM III, IV stage) and the poorly differentiated tumors (P < 0.05). The survival rates of male patients with MEC in the major salivary glands were significantly lower than those of female patients (P = 0.008). The degree of differentiation, TNM stage and preoperative symptoms were three important prognostic factors that were selected into the Cox proportional hazards regression model. CONCLUSIONS: Most patients with highly differentiated MEC in salivary glands had a favorable outcome after receiving adequate surgical treatment. The degree of differentiation and the TNM stage of MEC in the salivary glands are two useful factors to evaluate the prognosis of these neoplasms.

[Influence of different temperatures on internalization of epidermal growth factor receptor complexes in Tca-8113 cells].

OBJECTIVE: To investigate the effect of different temperatures on internalization of epidermal growth factor receptor complexes in human tongue squamous carcinoma cells(Tca-8113). METHODS: Human epidermal growth factor r (hEGF) was labeled with 125I according to Chloramine-T method. The quantity of surface binding and internalization of 125I-hEGF in Tca-8113 cells at 4 degrees C and at 37 degrees C was compared respectively with radiobinding assay. RESULTS: At 37 degrees C, the amount of EGFR complexes internalization exceeded that of surface binding after 10 min. At 4 degrees C, the level of interlization maintained very low. CONCLUSION: The study indicated that the surface binding of 125I-hEGF at 4 degrees C was steadier than that at 37 degrees C. The study on phenomenon of EGFR complexes internalization provide the experimental basis for selecting anti-EGFR monoclonal antibody in clinic.

[Transforming the sintered ostrich cancellous bone to multiphasic calcium phosphate ceramic].

OBJECTIVE: To transform the sintered ostrich cancellous bone(ostrich true bone ceramic, OTBC) to multiphasic calcium phosphate ceramic and study its components and characterization. METHODS: The OTBC blocks were soaked in different concentration of sodium pyrophosphate (Na(4)P(2)O(7).H(2)O,NP) solution and heated to 1100 degrees C to transform its constitution from HAP into multiphasic calcium phosphate ceramics. Then the surface configuration of the material was observed by SEM and the following properties of the material:porosity,bending strength,mineral composition and element ratio were analyzed. RESULTS: The prepared material was a kind of porous calcium phosphate ceramic composed of beta-TCP, HAP and NaCaPO(4). With increase of the NP concentration,the content of HAP decreased while beta-TCP and NaCaPO(4) increased. The average bending strength of the material was (1.95+/-0.46)Mpa,the Ca/P element ratio was 1.511 and the average porosity was(60.71+/-6.9)%. The pore size was uneven. CONCLUSION: The OTBC could be transformed into beta-TCP /HAP /NaCaPO(4) multiphasic calcium phosphate ceramic by heating with NP. With characteristic porous structure, the prepared OTBC could become a new type of bone graft.