A Comparison of Podoplanin Expression in Oral Leukoplakia and Oral Squamous Cell Carcinoma: An Immunohistochemical Study.

INTRODUCTION: Oral squamous cell carcinoma (OSCC) accounts for about 90% to 95% of all malignancies of the oral cavity.The majority of OSCCs are preceded by oral potentially malignant disorders (OPMDs). Podoplanin (PDPN) is a mucin-like small transmembrane glycoprotein. Alterations in PDPN immunoexpression have been reported in OPMDs and OSCCs. OBJECTIVE: The objectives of this study were to evaluate the role of PDPN immunoexpression in oral leukoplakia (OL) and different histological grades of OSCC and to assess the role of PDPN as a potential biomarker for predicting the risk of malignant transformation. MATERIALS AND METHODOLOGY: Immunohistochemical analysis for PDPN was performed in 45 histologically confirmed cases of formalin-fixed, paraffin-embedded specimens of different grades of OSCCs and 15 cases of OLs with 15 cases of the normal oral mucosa (NOM) as controls. The expression and distribution of this marker were analyzed in these lesions. RESULTS: The immunoexpression of PDPN showed a significant increase in the expression of the percentage of positive cells, staining intensity, location of staining in the epithelium, tumor islands, and within the cells, as well as the mean lymphatic micro vessel density between NOMs, OLs, and different grades of OSCCs. CONCLUSION: Upregulation of PDPN can be related to the malignant transformation of OLs and biological aggressiveness of OSCCs. The enhanced immunoexpression of PDPN signifies that this immunomarker can have a role in tumor cell differentiation and the neoplastic progression of OSCCs. Increased density of lymphatic vessels suggested an important role of lymphangiogenesis in tumor progression and also as a prognostic factor for lymph nodal metastasis.

Characterization of perineural invasion in different histological grades and variants of oral squamous cell carcinoma.

BACKGROUND: Oral squamous cell carcinoma (OSCC) accounts for 3% of all malignant neoplasms and is the fifth most frequent cancer in the world. They usually spread by hematogenous or lymphatic spread, and perineural invasion (PNI) is considered an alternate method of tumor spread where it is described as the tumor affinity toward a neural tissue. AIM AND OBJECTIVES: The present study aims to evaluate the biological behavior of OSCC with respect to PNI and to evaluate the importance of PNI with respect to different histopathological grades and variants, tumor stage and lymph node status of OSCC. PNI was also assessed with respect to its frequency, patterns, types and number in various grades of OSCC. MATERIALS AND METHODS: This retrospective, double-blind study was conducted on 148 histopathologically proven cases of different histopathological grades and variants of OSCC. The tissue sections were examined for PNI and its patterns and were further compared with habit history, site of the lesion, tumor staging, grading and lymph node status. RESULTS: A Chi-square test was performed. A percentage positivity of 45.27% (67 cases) among 148 cases was found. PNI positivity of 63.6% and 50% was observed in T4 and T3 tumor stages, respectively, with high significance. Seventy percent of cases belonging to poorly differentiated squamous cell carcinoma showed positivity for PNI, which was statistically significant. PNI positivity with respect to lymph node status is nonsignificant. CONCLUSION: The present study showed that there is a direct proportionality between PNI and different grades and stages of OSCC. Given this context, a histopathologist ought to examine for PNI and make it mandatory to report the same to the clinician for better treatment and follow-up of the patient.

Stereomicroscope as an aid in grossing and histopathological diagnosis: A prospective study.

BACKGROUND: Routinely, naked eye and a magnified glass are used to observe the specimens during grossing procedure. Stereomicroscope is a significant adjuvant to examine a variety of specimens and it enables us to examine the surface details of the specimen efficiently. AIMS AND OBJECTIVES: To assess the role of stereomicroscope in macroscopic examination and its effectiveness in the study of surface details of the specimen, thereby evaluating its role as an effective tool in grossing and histopathological diagnosis. MATERIALS AND METHODS: The study sample consisted of routine specimens received by the Department of Oral and Maxillofacial Pathology, Government Dental College and Hospital, Hyderabad, between July 15, 2018, and September 15, 2018. All the specimens were photographed under direct daylight ad later examined under stereomicroscope. The images were compared and grossing was carried out. The grossed specimen were processed using standard procedure and histopathological diagnosis was made. RESULTS: Compared to naked eye, the stereomicroscopic observation of specimens showed better details which helped in proper orientation of the specimen. CONCLUSION: Stereomicroscope aids as an adjuvant for proper orientation of the specimen which helps in arriving at an accurate final diagnosis.

Evaluation of glucose transporter-1 expression in oral epithelial dysplasia and oral squamous cell carcinoma: An immunohistochemical study.

INTRODUCTION: Oral squamous cell carcinoma (OSCC) is the most common malignancy of oral cavity and is commonly preceded by oral potentially malignant disorders. Glucose transporter-1 (GLUT-1) protein expression is upregulated in malignant cells that show increased glucose uptake. Alterations in GLUT-1 expression have been reported in several potentially malignant and malignant lesions. AIMS AND OBJECTIVES: The aims and objectives of this study were to analyze and assess the role of GLUT-1 immunomarker in oral epithelial dysplasia (OED) and OSCC, to demonstrate and analyze the presence, location and intensity of GLUT-1 immunomarker in low-risk and high-risk OEDs and in different grades of OSCC and to correlate the expression of GLUT-1 immunomarker between normal oral mucosa (NOM), OED and different grades of OSCC. MATERIALS AND METHODOLOGY: A total of ninety paraffin-embedded tissue blocks, 15 each of NOM; low-risk and high-risk OED and well, moderately and poorly differentiated OSCC were stained with the immunomarker GLUT-1. RESULTS AND OBSERVATION: GLUT-1 immunoexpression was statistically significant in terms of number of positive cells, staining intensity, IRS score and level of staining within the epithelium and also within the cell between NOM, OED and OSCC. CONCLUSION: Increased GLUT-1 expression has a consistent role in the malignant transformation of OED and aggressiveness of OSCC.

Epidemiological profile and clinical characteristics of oral potentially malignant disorders and oral squamous cell carcinoma: A pilot study in Bidar and Gulbarga Districts, Karnataka, India.

BACKGROUND: Clinical scenarios of oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) vary between geographical districts within the same country. This could be attributed to common habits and other cultural factors, such as excessive consumption of tobacco products, leading to higher prevalence of tobacco-related lesions of the oral cavity. A better understanding of their pattern and behavior in each particular region may help in devising strategies for prevention and treatment. AIMS AND OBJECTIVES: The aim of the study is to assess the epidemiological profile and clinical characteristics of OPMD and OSCC among population in and around Bidar and Gulbarga districts of Karnataka, India. MATERIALS AND METHODS: This was a retrospective, chart review study in the districts of Bidar and Gulbarga, Karnataka, India. Medical records of patients with clinical and histopathological diagnosis of OPMD or OSCC who attended a private dental school in Bidar and 20 private dental clinics in the districts of Bidar and Gulbarga between 2010 and 2017 were included in the study. Collected data were analyzed using Statistical Package Social Sciences software, version 20.0. RESULTS: There were a total of 630 patients, with males representing 69.52% (n = 438; ratio of 2.28:1) of cases and mean age of 42.64 years. 375 (59.52%) patients had a diagnosis of OPMD with the most common subtype of oral submucous fibrosis (185/375; 49.33%) followed by leukoplakia (110/375; 29.33%) and lichen planus (80/375; 21.33%). Buccal mucosa was the most commonly affected site (33.01%). Of 630 patients, 255 (40.48%) had OSCC, with tongue being the most common site (36.86%). CONCLUSION: This study revealed for the first time that OPMD and OSCC are widespread in the districts of Bidar and Gulbarga. The available knowledge on the prevalence of these lesions could help in educating patients and implementing preventive measures by health-care providers to improve overall survival. Long-term follow-up studies are needed to better understand the disease pattern.

Olze et al. stages of radiographic visibility of root pulp and cameriere's third molar maturity index to estimate legal adult age in Hyderabad population.

CONTEXT: Predicting one's attainment of age of majority is a controversial issue and considered as important aspect in medicolegal cases. In India, individuals older than 18 years of age have full capacity regarding civil conduct and are tried as adults for criminal charges. AIMS AND OBJECTIVE: To compare the accuracy of Olze et al., stages of radiographic visibility of root pulp, and Cameriere's third molar maturity index (I 3M < 0.08) to estimate the age of majority. MATERIALS AND METHODS: A total of 615 digital orthopantomographs of children aged between 15 and 22 years. The lower left third molars were evaluated using ImageJ computer software. The effectiveness of both methods was evaluated using sensitivity, specificity, positive likelihood ratios (LR+), and LR negative (LR-). RESULTS: For I 3M < 0.08, the sensitivity, specificity, LR+, LR- were 0.76, 0.72, 2.79, 0.32 and 0.67, 0.76, 2.83, 0.43 in males and females respectively. For Stage 0, the sensitivity, specificity, LR+, LR- were 0.68, 0.86, 5.18, 0.36 and 0.72, 0.91, 8.63, 0.31, respectively. CONCLUSION: Stage 0 of Olze's radiographic root pulp visibility showed to be more accurate than cutoff value of I 3M< 0.08 in discriminating adults and minors of Hyderabad sample when a test of high sensitivity and specificity is required.

Trace elements (copper, zinc, selenium and molybdenum) as markers in oral sub mucous fibrosis and oral squamous cell carcinoma.

Oral cancer is a major cause of cancer morbidity and mortality worldwide and is prevalent in most areas where tobacco related practices are observed. Essential elements play a role in many biochemical reactions as a micro-source and there is growing evidence that their concentrations are altered on the onset and progress of malignant disease. In this study the levels of copper (Cu), zinc (Zn), selenium (Se) and molybdenum (Mo) in serum of patients with oral sub mucous fibrosis (OSMF) (n = 30) and oral squamous cell carcinoma (OSCC) (n = 30); were determined and the alterations of these critical parameters were analyzed in comparison with controls (n = 30) to identify predictors amongst these parameters for disease occurrence and progression. The serum Cu and Zn were established using Flame Atomic Absorption Spectrometry. Serum estimation of Se and Mo was done by graphite furnace atomic absorption spectrometry (GFAAS). Data analysis revealed a marked, progressive and significant increase in Cu levels in precancer (OSMF) and cancer (OSCC) groups as compared to the normal group. The level of Zn in serum was slightly elevated in OSMF and OSCC though not statistically significant. Cu/Zn ratio was slightly but not significantly elevated. Serum levels of Se and Mo were significantly decreased in the precancer and cancer groups as compared to the normals.

Cloud point extraction and electrothermal atomic absorption spectrometry of Se (IV)--3,3'-diaminobenzidine for the estimation of trace amounts of Se (IV) and Se (VI) in environmental water samples and total selenium in animal blood and fish tissue samples.

This paper presents a method based on the cloud point extraction for the separation and preconcentration of Se (IV) and Se (VI) in environmental water samples as well as total selenium in animal blood and tissue samples. 3,3'-Diaminobenzidine (DAB) is a selective and sensitive reagent and is known to form an intense yellow compound piazselenol with selenium (IV). When a system consisting of sample, DAB and surfactant Triton X-114 is warmed above the cloud point of the surfactant, it was seen that the DAB-Se (IV) complex gets extracted into the surfactant rich phase while the Se (VI) remains in the aqueous phase. Se (VI) in the sample was reduced to Se (IV) by microwave heating of solution in 4 mol L(-1) HCl and total Se was estimated by carrying out the CPE. The quantification of selenium was carried out using ETAAS. The analytical parameters for the quantitative cloud point extraction of the Se-DAB complex were investigated and optimized. The proposed procedure was validated by applying it to the determination of the content of Se in Certified Reference Material BND 701-02. (NPL, India). The detection limit of selenium in environmental water samples was 0.0025 microg L(-1) with an enrichment factor of 100. The relative standard deviation (RSD) for ten replicate measurements of 5 microg L(-1) was 3.6%. The proposed method was successfully applied to the determination of selenium (IV), (VI) in environmental water samples and determination of total selenium in human blood, SRM-IAEA-A-13 animal blood and SRM-IAEA-407 fish tissue.

Characterization of As (V), As (III) by selective reduction/adsorption on palladium nanoparticles in environmental water samples.

Hydrazine (HZ) and sodium borohydride (BH) are commonly used reagents for the production of palladium nanoparticles (PdNP) in aqueous solution and also for the reduction of arsenic from higher oxidation state to lower oxidation state. A methodology based on the quantitative adsorption of reduced arsenic species on PdNP generated in situ by BH and HZ is described to characterize As (V) and As (III) in environmental water samples. It was observed that PdNP obtained by BH gave quantitative recovery of As (V) and (III) and the PdNP obtained by HZ could account for As (III). The reduced palladium particles are collected and dissolved in minimum amount of nitric acid. The quantification of arsenic was carried out using GFAAS. Optimization of the experimental conditions and instrumental parameters were investigated in detail. The proposed procedure was validated by applying it for the determination of the content of total As in Certified Reference Material BND 301-02 (NPL, India). The detection limit of arsenic in environmental water samples was 0.029 microg L(-1) with an enrichment factor of 50. The relative standard deviation (R.S.D.) for 10 replicate measurements of 5 microg mL(-1) was 4.2%. The proposed method was successfully applied for the determination of sub ppm to ppm levels of arsenic (V), (III) in environmental water samples.