Human Papillomavirus-Attributable Head and Neck Cancers in India-A Systematic Review and Meta-Analysis.

PURPOSE: Head and neck cancer accounts for about one third of the global burden in India. Mucosal high-risk human papillomavirus (HPV) has been hypothesized as a contributory risk factor for head and neck cancer (HNC) but its prevalence in Indian patients is not well established. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of HPV in HNC in India and their attributable fraction by considering the biomarkers of carcinogenesis, p16, and HPV E6/E7 mRNA. METHODS: A systematic literature search was done in Medline via PubMed, Embase, Scopus, ScienceDirect, ProQuest, and Cochrane to identify studies on HPV and HNC in the Indian population, published between January 1990 and October 2022. Fifty-four eligible studies were identified and relevant clinical information was collected. Meta-analysis was conducted to estimate the pooled prevalence of HPV DNA, p16INK4a, and E6/E7 mRNA percent positivity by random-effect logistic regression model using Metapreg, STATA 18. RESULTS: Thirty-four high-quality studies were taken for meta-analysis. The pooled prevalence of HPV in HNC was 20% (95% CI, 12 to 32) with a high level of heterogeneity (I2 = 90.79%). The proportion of HPV in oropharyngeal cancer (OPC; 22% [95% CI, 13 to 34]) and laryngeal cancer (LC; 29% [95% CI, 17 to 46]) was higher than in oral cancer (OC; 16% [95% CI, 8 to 30]). The HPV-attributable fraction of OPC, considering the E6/E7 mRNA and p16 positivity, was 12.54% and 9.68%, respectively, almost similar to LC (11.6% and 9.57%), while it was much lower in OC (3.36% and 4%). CONCLUSION: The HPV-attributable fraction is considerably lower for OC, suggesting a negligible causative role of HPV in OC. A significant proportion of OPC and LC are attributed to HPV; however, their exact causative role is unclear because of the presence of other known risk factors.

Prognostic Implication of Survivin Expression in Oral Squamous Cell Carcinoma-An Immunohistochemical Study.

AIM: Immunohistochemical expression of survivin was analyzed among the three histological grades (well differentiated, moderately differentiated, and poorly differentiated) of oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: The study material consisted of 60 formalin-fixed paraffin-embedded tissue samples: 15 cases each of well, moderate, and poorly differentiated OSCC and normal oral mucosal (NOM) tissues as the control. Survivin expression was evaluated immunohistochemically and statistical analysis of data was performed using Fisher's Chi-square and analysis of variance (ANOVA) tests. RESULTS: Survivin was expressed in all grades of OSCC, but absent in normal oral tissue samples. Poorly differentiated OSCC exhibited 51 to 75% immunopositivity (53.3%) and severe staining intensity (46.7%) for survivin, predominantly in nuclear areas. While moderately differentiated OSCC had 26 to 50% immunopositivity (40%) and moderate staining intensity (80%), 5 to 25% immunopositivity (40%) with moderate staining intensity (86.7%) was observed in well-differentiated OSCC. Overall, there was a statistically significant difference among the three grades of OSCC in relation to survivin immunopositivity and immunoreactivity (p < 0.01). CONCLUSION: This study supports the use of survivin as a potent diagnostic and prognostic marker for OSCC. CLINICAL SIGNIFICANCE: Increased survivin expression and its nuclear localization appeared to correlate with a higher grade of malignancy suggesting unfavorable prognosis.

Retrospective analysis of benign orofacial tumors at a tertiary referral center in Saudi Arabia.

AIM: The aim of the present study was to analyze the prevalence of benign tumors of the orofacial region at a tertiary referral center in the south-western region of Saudi Arabia. METHODS: Cases from 2009 to 2014 were retrieved from October 2014 to June 2015 from the archives of the histopathology department of the center. Demographic and clinical details of the patients were recorded. RESULTS: Of the 714 oral and maxillofacial biopsy specimens, 78 (10.9%) were benign tumors. The mean age and range were 34.6±19.8 and 3-85 year, respectively. Sex distribution was equal. Most tumors were mesenchymal (34.6%), followed by epithelial (26.9%), odontogenic (20.5%), and salivary gland tumors (17.9%). Squamous cell papilloma (20.5%) was the most common, followed by pleomorphic adenoma (15.4%) and fibrous tumors (15.4%). CONCLUSIONS: The low prevalence of benign orofacial tumors found in this study indicates a lack of awareness of the importance of taking biopsy for such lesions. The information reported here emphasizes the need for biopsy investigation for all oral lesions to ascertain appropriate diagnosis.

Analysis of sugars and pH in commercially available soft drinks in Saudi Arabia with a brief review on their dental implications.

OBJECTIVE: To determine the amount of sugar and pH in commercially available soft drinks in Jazan, Saudi Arabia. This was further compared with their labeled values in order to inform the regulations. The effects of these drinks on teeth is reviewed. MATERIALS AND METHODS: Ten brands of popular soft drinks including 6 regular carbonated drinks and 4 energy drinks were obtained from the local markets. Their pH was determined using a pH meter. The amount of total sugar, glucose, fructose, and sucrose was estimated using high performance liquid chromatography (using Dionex ICS 5000 ion chromatography) at the Saudi Food and Drug Authority. Descriptive statistics was done to obtain the mean and standard deviation. Intergroup comparison was performed using independent t-test, and the labeled and estimated values within the group were compared with paired t-test. RESULTS: The labeled and estimated sugar in energy drinks (14.3 ± 0.48 and 15.6 ± 2.3, respectively) were higher than the carbonated drinks (11.2 ± 0.46 and 12.8 ± 0.99), which was statistically significant. In addition, there was a significant difference in the concentration of glucose in energy drinks (5.7 ± 1.7) compared to carbonated drinks (4.1 ± 1.4). The pH of these drinks ranged from 2.4 to 3.2. The differences between the estimated and labeled sugar in carbonated drinks showed statistical significance. Mild variation was observed in total sugar, glucose, fructose, and sucrose levels among different bottles of the same brand of these drinks. CONCLUSION: The low pH and high sugar content in these drinks are detrimental to dental health. Comparison of the estimated sugar with their labeled values showed variation in most of the brands. Preventive strategies should be implemented to reduce the health risks posed by these soft drinks.

Myoepithelial carcinoma of palate: case report.

Myoepithelial carcinoma is an uncommon malignant salivary gland neoplasm with a predilection for parotid gland. However, its occurrence in minor salivary glands is considerably less with only 28 cases being reported in the literature. We report a case of myoepithelial carcinoma of palate in a 50-year-old woman. Computed tomography and magnetic resonance imaging revealed an extensive lesion in the palate. Microscopically, the tumor exhibited a wide spectrum of cytomorphologic features that overlap with other salivary gland tumors. Immunohistochemistry served as an adjunct in the diagnosis of the lesion. Clinical, radiographic, and histopathologic correlation along with immunohistochemical profile enabled to arrive at a diagnosis of myoepithelial carcinoma.

Cystic granular cell ameloblastoma.

Ameloblastoma is a locally aggressive benign epithelial odontogenic tumor, while unicystic ameloblastoma is a relatively less aggressive variant. Although rare in unicystic or cystic ameloblastoma, granular cell change in ameloblastoma is a recognized phenomenon. The purpose of the present article is to report a case of cystic granular cell ameloblastoma in 34-year old female.