Web-based prognostic tools for oral tongue cancer: An analysis of online predictors.

BACKGROUND: Oral tongue squamous cell carcinoma (OTSCC) often presents with aggressive clinical behaviour that may require multimodality treatment based on reliable prognostication. We aimed to evaluate the prognostic ability of five online web-based tools to predict the clinical behaviour of OTSCC resection and biopsy samples. METHODS: A total of 135 OTSCC resection cases and 33 OTSCC biopsies were included to predict recurrence and survival. Area under the receiver operating characteristic curves (AUC), χ2 tests, and calibration plots constructed to estimate the prognostic power of each tool. RESULTS: The tool entitled 'Prediction of risk of Locoregional Recurrences in Early OTSCC' presented an accuracy of 82%. The tool, 'Head & Neck Cancer Outcome Calculator' for 10-year cancer-related mortality had an accuracy 77% and AUC 0.858. The other tool entitled 'Cancer Survival Rates' for 5-year mortality showed an accuracy of 74% and AUC of 0.723. For biopsy samples, 'Cancer Survival Prediction Calculators' predicted the recurrence free survival with an accuracy of 70%. CONCLUSIONS: Web-based tools can aid in clinical decision making of OTSCC. Three of five online web-based tools could predict recurrence risk and cancer-related mortality in resected OTSCC and one tool could help in clinical decision making for biopsy samples.

Oral squamous cell carcinoma: Effect of tobacco and alcohol on cancer location.

INTRODUCTION: The underlying factors of oral squamous cell cancers (OSCC) have been elucidated, but studies have focused little on etiological differences in affected oral cavity sites. The aim of this retrospective study was to clarify the role of carcinogen exposure in OSCC of different oral cavity areas. METHODS: A cross-sectional study of patients with primary OSCC was conducted retrospectively, based on patient records from Helsinki University Hospital, Finland, between January 2016 and December 2020. The patients' self-reported history of tobacco smoking and alcohol use was explained by tumor site, age, sex, tumor size, and lymph node status in a logistic regression model. The information on smoking and alcohol use was compiled from a patient background form. RESULTS: In 519 patients, tumors occurred most often in the tongue (51%), gingiva (21%), or floor of the mouth (FOM; 15%). FOM had 26-fold greater odds for a history of smoking and alcohol use than other tumor sites (OR=25.78; 95% CI: 8.02-82.95; p<0.001). Gingival and buccal sites were associated significantly less with smoking and alcohol use (OR=0.43, 95% CI: 0.28-0.67; p<0.001 and OR=0.47; 95% CI: 0.25-0.92; p<0.026, respectively). Patients of older age were less likely to have a history of smoking and alcohol use (AOR=0.95; 95% CI: 0.94-0.97; p<0.001) than younger patients. Tumor size (T3-4) and FOM increased the odds for history of smoking and alcohol use (AOR=1.73; 95% CI: 1.15-2.60; p=0.009 and AOR=26.15; 95% CI: 8.01-84.84; p<0.001, respectively). CONCLUSIONS: OSCC of oral cavity sites has notable differences in etiology. FOM seems to be related almost exclusively to conventional smoking and heavy alcohol use.

Strengthening neurosurgical training programs in Sub-saharan Africa: a medical student's perspective.

This article provides a nuanced exploration of the state and exigencies of neurosurgical training in sub-Saharan Africa (SSA), viewed through the discerning lens of a medical student. The region has a pronounced scarcity of neurosurgical services, further compounded by sociocultural intricacies and infrastructural inadequacies, resulting in elevated mortality and morbidity rates. The insufficiency of neurosurgeons, facilities, and training centers, particularly in remote areas, exacerbates this predicament. The imperative to fortify neurosurgical training programs is underscored, necessitating a multifaceted approach inclusive of international collaborations and innovative strategies. The challenges impeding neurosurgical training program implementation range from constrained infrastructure to faculty shortages and financial constraints. Recommendations encompass infrastructural investments, faculty development initiatives, and augmented community engagement. An exploration of neurosurgical training programs across diverse African regions reveals commendable strides and imminent deficits, warranting heightened international collaboration. Furthermore, technological innovations, including virtual reality, robotics, and artificial intelligence, are posited as transformative conduits for augmenting neurosurgical training in SSA. The article concludes with a sagacious compendium of recommendations, encompassing standardized curricula, mentorship paradigms, and stringent evaluation mechanisms, all combining efficaciously fortifying neurosurgical insight in SSA and producing transformative improvements in healthcare outcomes.

Asymptomatic bacteriuria in patients with type 2 diabetes mellitus in rural southwestern Nigeria: a cross-sectional study.

OBJECTIVES: We aimed to identify the prevalence, bacterial isolates, antimicrobial susceptibility profile, and factors associated with asymptomatic bacteriuria (ASB) in patients with type 2 diabetes mellitus (T2DM) in rural southwestern Nigeria. METHODS: We performed a hospital-based cross-sectional study of patients with T2DM and ASB. Demographic and clinical data were collected using questionnaires. Urine samples were cultured using standard laboratory procedures, and bacterial colonies were isolated and antimicrobial sensitivity was performed using the disc diffusion technique. Relationships between variables were assessed using adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS: Of the 280 participants, 73 (26.1%) had ASB (95% CI: 20.9%-31.2%). The most commonly identified isolate was E. coli (45/73; 61.7%), 100.0% of which were sensitive to cefuroxime but resistant to ciprofloxacin. Female sex (AOR, 6.132; 95% CI: 2.327-16.157), living below the poverty line (AOR, 2.066; 95% CI: 1.059-4.029), uncontrolled blood glucose (AOR, 2.097; 95% CI: 1.000-4.404), and a history of indwelling urethral catheterization (AOR, 14.521; 95% CI: 4.914-42.908) were associated with ASB. CONCLUSION: The findings suggest that cefuroxime should be used as an empirical treatment, pending urine culture and sensitivity, and that efforts should be made to prevent ASB in rural southwestern Nigeria.

Pediatric odontogenic keratocyst and early diagnosis of Gorlin syndrome: Clinicopathological aids.

Odontogenic keratocysts (OKCs) are a common presentation in almost all patients with nevoid basal cell carcinoma syndrome (NBCCS) or Gorlin syndrome, irrespective of race. In most patients with NBCCS, OKC presents as multiple lesions affecting the jaws which makes it a signpost for the investigation of patients with the syndrome. In approximately 40% of pediatric patients, the initial presentation is that of a single OKC, which may often result in missing the diagnosis of NBCCS. This is particularly common in patients without clinically apparent NBCCS-related manifestations. This review examines the clinicopathological features that clinicians and oral pathologists may look for in pediatric patient with OKC and OKC surgical specimens that may serve as indicators for the diagnosis of NBCCS. Although these features do not diagnose NBCCS by themselves, they may significantly help in initiating the diagnostic process at an early stage with an obvious benefit to the child and relatives.

From complexity to clarity: unravelling tumor heterogeneity through the lens of tumor microenvironment for innovative cancer therapy.

Despite the tremendous clinical successes recorded in the landscape of cancer therapy, tumor heterogeneity remains a formidable challenge to successful cancer treatment. In recent years, the emergence of high-throughput technologies has advanced our understanding of the variables influencing tumor heterogeneity beyond intrinsic tumor characteristics. Emerging knowledge shows that drivers of tumor heterogeneity are not only intrinsic to cancer cells but can also emanate from their microenvironment, which significantly favors tumor progression and impairs therapeutic response. Although much has been explored to understand the fundamentals of the influence of innate tumor factors on cancer diversity, the roles of the tumor microenvironment (TME) are often undervalued. It is therefore imperative that a clear understanding of the interactions between the TME and other tumor intrinsic factors underlying the plastic molecular behaviors of cancers be identified to develop patient-specific treatment strategies. This review highlights the roles of the TME as an emerging factor in tumor heterogeneity. More particularly, we discuss the role of the TME in the context of tumor heterogeneity and explore the cutting-edge diagnostic and therapeutic approaches that could be used to resolve this recurring clinical conundrum. We conclude by speculating on exciting research questions that can advance our understanding of tumor heterogeneity with the goal of developing customized therapeutic solutions.

Expression Patterns of ER, PR, HER-2/neu and p53 in Association with Nottingham Tumour Grade in Breast Cancer Patients.

Objectives: Recent molecular studies show that breast cancer (BC) is a heterogeneous disease, and several molecular changes may accumulate over time to influence treatment response. As a result, employing reliable molecular biomarkers to monitor these modifications may help deliver personalised treatment. However, this may be unrealistic in the resource-limited parts of the world. Thus, this study aimed to investigate the expression pattern of hormone receptors and p53 tumour suppressor using immunohistochemistry (IHC) in BC compared to the traditional tumour grade. Methods: In total, 205 cases were investigated, and the Modified Bloom-Richardson score system was adopted in grading the tumours. The tissue sections of the cases were stained with specific primary antibodies at dilutions of 1:60 for oestrogen receptors (ER) and progesterone receptors (PR), 1:350 for the human epidermal growth factor (HER-2/neu) and 1:50 for p53. Results: Invasive ductal carcinoma of no-specific type (n = 190, 92.7%) was predominant and grade II tumour (n = 146, 71.2%) was the most frequent. Hormone receptors ER (n = 127) and PR (n = 145) had 62.0% and 70.7% positive cases, respectively; 34.1% (n = 70) were positive for HER-2/neu, while 76.1% (n = 156) were positive for p53. Significant associations between Nottingham grade and expression patterns of ER (P <0.01), PR (P <0.001), HER-2/neu (P <0.001) and p53 (P = 0.001) were observed. Conclusion: Nottingham grade had a high degree of concordance with the patterns of expression of hormone receptors, HER-2/neu and p53, suggesting that it may play an important role in connection with the predictive and prognostic biomarkers for BC.

Phytochemicals and bioactive compounds effective against acute myeloid leukemia: A systematic review.

This systematic review identified various bioactive compounds which have the potential to serve as novel drugs or leads against acute myeloid leukemia. Acute myeloid leukemia (AML) is a heterogeneous hematopoietic malignancy that arises from the dysregulation of cell differentiation, proliferation, and cell death. The risk factors associated with the onset of AML include long-term exposure to radiation and chemicals such as benzene, smoking, genetic disorders, blood disorders, advancement in age, and others. Although novel strategies to manage AML, including a refinement of the conventional chemotherapy regimens, hypomethylating agents, and molecular targeted drugs, have been developed in recent years, resistance and relapse remain the main clinical problems. In this study, three databases, PubMed/MEDLINE, ScienceDirect, and Google Scholar, were systematically searched to identify various bioactive compounds with antileukemic properties. A total of 518 articles were identified, out of which 59 were viewed as eligible for the current report. From the data extracted, over 60 bioactive compounds were identified and divided into five major groups: flavonoids, alkaloids, organosulfur compounds, terpenes, and terpenoids, and other known and emerging bioactive compounds. The mechanism of actions of the analyzed individual bioactive molecules differs remarkably and includes disrupting chromatin structure, upregulating the synthesis of certain DNA repair proteins, inducing cell cycle arrest and apoptosis, and inhibiting/regulating Hsp90 activities, DNA methyltransferase 1, and histone deacetylase 1.

Wnt/ß-catenin signaling pathway inhibitors, glycyrrhizic acid, solanine, polyphyllin I, crocin, hypericin, tubeimoside-1, diosmin, and rutin in medicinal plants have better binding affinities and anticancer properties: Molecular docking and ADMET study.

Wnt/ß-catenin signaling pathway plays a role in cancer development, organogenesis, and embryogenesis. The abnormal activation promotes cancer stem cell renewal, proliferation, and differentiation. In the present study, molecular docking simulation and ADMET studies were carried out on selected bioactive compounds in search of ß-catenin protein inhibitors for drug discovery against cancer. Blind docking simulation was performed using PyRx software on Autodock Vina. ß-catenin protein (PDB ID: 1jdh) and 313 bioactive compounds (from PubChem database) with selected standard anticancer drugs were used for molecular docking. The ADMET properties of the best-performing compounds were calculated using SwissADME and pkCMS web servers. The results obtained from the molecular docking study showed that glycyrrhizic acid, solanine, polyphyllin I, crocin, hypericin, tubeimoside-1, diosmin, and rutin had the best binding interactions with ß-catenin protein based on their binding affinities. Glycyrrhizic acid and solanine had the same and lowest binding energy of -8.5 kcal/mol. This was followed by polyphyllin I with -8.4 kcal/mol, and crocin, hypericin, and tubeimoside-1 which all had a binding energy of 8.1 kcal/mol. Other top-performing compounds include diosmin and rutin with binding energy of -8.0 kcal/mol. The ADMET study revealed that the following compounds glycyrrhizic acid, solanine, polyphyllin I, crocin, hypericin, tubeimoside-1, diosmin, rutin, and baicalin all violated Lipinski's rule of 5 which implies poor oral bioavailability. However, based on the binding energy score, it was suggested that these pharmacologically active compounds are potential molecules to be tested against cancer.

Malaria infection and its association with socio-demographics, long lasting insecticide nets usage and hematological parameters among adolescent patients in rural Southwestern Nigeria.

BACKGROUND: There is increasing evidence suggesting that adolescents are contributing to the populations at risk of malaria. This study determined the prevalence of malaria infection among the adolescents and examined the associated determinants considering socio-demographic, Long Lasting Insecticide Nets (LLINs) usage, and hematological factors in rural Southwestern Nigeria. METHODS: A hospital-based cross-sectional study was conducted between July 2021 and September 2022 among 180 adolescents who were recruited at a tertiary health facility in rural Southwestern Nigeria. Interviewer administered questionnaire sought information on their socio-demographics and usage of LLINs. Venous blood samples were collected and processed for malaria parasite detection, ABO blood grouping, hemoglobin genotype, and packed cell volume. Data were analyzed using SPSS version 20. A p-value <0.05 was considered statistically significant. RESULTS: The prevalence of malaria infection was 71.1% (95% CI: 68.2%-73.8%). Lack of formal education (AOR = 2.094; 95% CI: 1.288-3.403), being a rural residence (AOR = 4.821; 95% CI: 2.805-8.287), not using LLINs (AOR = 1.950; 95% CI: 1.525-2.505), genotype AA (AOR = 3.420; 95% CI: 1.003-11.657), genotype AS (AOR = 3.574; 95%CI: 1.040-12.277), rhesus positive (AOR = 1.815; 95% CI:1.121-2.939), and severe anemia (AOR = 1.533; 95% CI: 1.273-1.846) were significantly associated with malaria infection. CONCLUSION: The study revealed the prevalence of malaria infection among the adolescents in rural Southwestern Nigeria. There may be need to pay greater attention to adolescent populations for malaria intervention and control programs.

Heterogeneity and versatility of the extracellular matrix during the transition from pleomorphic adenoma to carcinoma ex pleomorphic adenoma: cumulative findings from basic research and new insights.

Pleomorphic adenoma (PA) is the most common salivary gland tumor, accounting for 50%-60% of these neoplasms. If untreated, 6.2% of PA may undergo malignant transformation to carcinoma ex-pleomorphic adenoma (CXPA). CXPA is a rare and aggressive malignant tumor, whose prevalence represents approximately 3%-6% of all salivary gland tumors. Although the pathogenesis of the PA-CXPA transition remains unclear, CXPA development requires the participation of cellular components and the tumor microenvironment for its progression. The extracellular matrix (ECM) comprises a heterogeneous and versatile network of macromolecules synthesized and secreted by embryonic cells. In the PA-CXPA sequence, ECM is formed by a variety of components including collagen, elastin, fibronectin, laminins, glycosaminoglycans, proteoglycans, and other glycoproteins, mainly secreted by epithelial cells, myoepithelial cells, cancer-associated fibroblasts, immune cells, and endothelial cells. Like in other tumors including breast cancer, ECM changes play an important role in the PA-CXPA sequence. This review summarizes what is currently known about the role of ECM during CXPA development.

Trends in Biological Ammonia Production.

Food production heavily depends on ammonia-containing fertilizers to improve crop yield and profitability. However, ammonia production is challenged by huge energy demands and the release of ~2% of global CO2. To mitigate this challenge, many research efforts have been made to develop bioprocessing technologies to make biological ammonia. This review presents three different biological approaches that drive the biochemical mechanisms to convert nitrogen gas, bioresources, or waste to bio-ammonia. The use of advanced technologies-enzyme immobilization and microbial bioengineering-enhanced bio-ammonia production. This review also highlighted some challenges and research gaps that require researchers' attention for bio-ammonia to be industrially pragmatic.

Developing rumen mimicry process for biological ammonia synthesis.

The ruminant rumen houses hyper-ammonia-producing bacteria (HAB) that produce ammonia with minimal energy use. Here we developed a mimicry process to produce bio-ammonia, a solution of ammonia and ammonium. The rumen microbes were used to ferment soybean (SYB), soybean protein isolate (SPI), and pepsin-hydrolysate (HP) for bio-ammonia production. The maximum bio-ammonia produced from SYB, SPI, and HP were 0.65, 1.2, and 1.1 g/L, respectively. The presence of non-protein in SYB hindered bio-ammonia production and the processing of SYB to SPI and HP significantly (p < 0.05) increased bio-ammonia production. HP was converted to bio-ammonia quicker than SPI suggesting that enzymatic hydrolysis increases bioprocessing efficiency. Metagenomic analysis of a sample culture revealed that the HAB population is predominantly Klebsiella quasivariicola (73%), Escherichia coli (6%), and Enterobacter cloacae (6%). The bioprocessing steps developed would enable industrial ammonia production to achieve a low CO2 footprint.

Optimization of Soybean Protein Extraction with Ammonium Hydroxide (NH4OH) Using Response Surface Methodology.

Plants have been recognized as renewable and sustainable sources of proteins. However, plant protein extraction is challenged by the plant's recalcitrant cell wall. The conventional extraction methods make use of non-reusable strong alkali chemicals in protein-denaturing extraction conditions. In this study, soy protein was extracted using NH4OH, a weak, recoverable, and reusable alkali. The extraction conditions were optimized using response surface methodology (RSM). A central composite design (CCD) with four independent variables: temperature (25, 40, 55, 70, and 85 °C); NH4OH concentration (0.5, 1, and 1.5%); extraction time (6, 12, 18, and 24 h) and solvent ratio (1:5, 1:10, 1:15 and 1:20 w/v) were used to study the response variables (protein yield and amine concentration). Amine concentration indicates the extent of protein hydrolysis. The RSM model equation for the independent and response variables was computed and used to create the contour plots. A predicted yield of 64.89% protein and 0.19 mM amine revealed a multiple R-squared value of 0.83 and 0.78, respectively. The optimum conditions to obtain the maximum protein yield (65.66%) with the least amine concentration (0.14 Mm) were obtained with 0.5% NH4OH concentration, 12 h extraction time, and a 1:10 (w/v) solvent ratio at 52.5 °C. The findings suggest that NH4OH is suitable to extract soybean protein with little or no impact on protein denaturation.

Malaria among the elderly in five communities of Osun East district, Southwest Nigeria: Prevalence and association with non-communicable diseases.

Objective: The level of immunity against pathogens decreases with old age. As a result, the elderly may be regarded to be at increased risk of malaria morbidity and fatality. There is paucity of studies on malaria among the elderly population in Osun East district, Southwest Nigeria. This study aimed to determine the prevalence of malaria and its association with medical comorbidities among the elderly. Methods: A descriptive cross-sectional study was carried out, which involved 972 adult residents of five communities in Osun State, who were selected using a multistage random sampling technique. Data was collected with aid of a structured questionnaire. The medical history of respondents and anthropometric measures were obtained. The presence of malaria parasitaemia in the respondents was determined by rapid diagnostic test (RDT). Appropriate descriptive and inferential analyses were done. Results: Out of the 972 respondents, 504 (51.9%) were 60 years and above. The overall prevalence of malaria RDT positivity was 4%. The positivity rate was higher among the elderly (4.6%) compared to those less than 60 years (3.4%), albeit not statistically significant (p = 0.36). Among these elderlies, 52.6% and 16.1% used insecticide-treated nets and insecticide sprays, respectively. There was no association between the prevalence of malaria positivity and comorbid conditions, such as hypertension (p = 0.37), overweight/obesity (p = 0.77), or diabetes (p = 0.15). Malaria positivity rate was also not significantly associated with the use of insecticide-treated nets (p = 0.64) or insecticide sprays (p = 0.45). Conclusion: The malaria positivity rate was higher among the elderly in the study area, although not statistically significant. The prevalence was not associated with comorbid medical conditions.

Prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido-Ekiti, Southwestern Nigeria.

BACKGROUND: Asymptomatic malaria infections have received less attention than symptomatic malaria infections in major studies. Few epidemiological studies on asymptomatic malaria infections have often focused on pregnant women and children under-five years of age as the most vulnerable groups. However, there is limitation on data regarding asymptomatic infections among the old adult populations, particularly in the study area. Therefore, this study determined the prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido- Ekiti, Southwestern Nigeria. METHODS: A hospital-based cross-sectional study was conducted between July and September 2021 among 232 consenting apparently healthy individuals aged 40 years and above who were recruited during a free health screening program using a standardised interviewer-administered questionnaire. The questionnaire sought information on respondents' socio-demographics, presence and types of co-morbidity, and the prevention methods being adopted against malaria infection. Venous blood samples were collected and processed for asymptomatic infections using Giemsa-stained blood smear microscopy. Data were analysed using SPSS version 21. Multivariate logistic regression was used to identify factors associated with asymptomatic infections. RESULTS: Of the total 232 respondents, 19.0% (48/232) were confirmed to be infected with Plasmodium falciparum (95% confidence interval (CI): 14.1% - 24.6%). Lack of formal education (Adjusted odds ratio (AOR): 5.298, 95% (CI): 2.184-13.997), being diabetic (AOR: 4.681, 95% CI: 1.669-16.105), and not sleeping under Long Lasting Insecticide Net (LLINs) (AOR: 4.594, 95% CI: 1.194-14.091), were the determinants of asymptomatic Plasmodium falciparum infection. CONCLUSION: The prevalence of asymptomatic Plasmodium falciparum was 19%. Lack of formal education, being diabetic, and not sleeping under LLINs were the determinants of asymptomatic infections.

Biological Ammonia Production via Anaerobic Fermentation of Soy Meal Protein.

BACKGROUND: Conventional ammonia production methods, notably the energy-intensive Haber-Bosch process, are costly and contribute substantially to about 2% of the world's CO2 emissions. This study focuses on the biological approach to convert protein to ammonia via hyper-ammonia-producing bacteria (HAB) fermentation. METHODS: A consortium of ruminal microbes was employed in this work to ferment soybean meal protein under varying processing conditions. The parameters investigated included pH (7-11), inoculum concentrations (1-10%), substrate concentrations (5-20%), and fermentation time (0-168 h). RESULTS: Optimal conditions for microbial growth and biological ammonia production were observed at pH 7, fermentation duration of 72 h, inoculum concentration of 10%, and substrate concentration of 10%. ~8000 mg/L biological ammonia was produced following HAB fermentation. CONCLUSIONS: By leveraging the capabilities of rumen HAB, this study contributes to the ongoing efforts to develop environmentally friendly processes for ammonia production that will mitigate both economic and environmental concerns associated with traditional methods.

Factors Influencing the Booking Gestational Age Among Antenatal Clinic Attendees at Primary Health Centers in South West, Nigeria: A Cross-Sectional Study.

Background: Antenatal care (ANC) is a recognized factor for favorable pregnancy outcomes. Despite the benefits associated with early initiation of antenatal care, late booking still predominates in sub-Saharan Africa including Nigeria. Objective: This study aimed to assess the factors, including family dynamics, associated with the booking gestational age among women attending ANC clinics in a Local Government Area of Osun State, Nigeria. Methods: A descriptive cross-sectional study was conducted among 255 pregnant women attending ANC at the Primary Health Centres in Osun State, who were selected by stratified random sampling technique. Data were obtained with aid of a semi-structured questionnaire and subjected to descriptive and inferential analyses. Results: The mean age of respondents was 27.3 ± 5.1 years. Their mean booking gestational age was 23.0 ± 6.6 weeks, while the majority (85.3%) booked late for ANC. Most (122, 54.2%) of the respondents booked in the second trimester. The opinion of the husband influenced most women (54.2%) in the decision regarding the time of ANC booking. There was no association between the booking gestational age and each of respondents' age, education, parity, perceived family support, level of family functioning, and other sociodemographic characteristics. The booking GA was however significantly related to the previous booking GA at the last pregnancy (p = .004). Conclusion: Late initiation of antenatal care was high among pregnant women attending PHCs in the study area and it was not associated with measures of family dynamics. The predominant influence of husbands' opinion on time of booking suggests the need for strategic outreach to males through relevant reproductive health educational campaigns.

Tertiary lymphoid structures associate with improved survival in early oral tongue cancer.

BACKGROUND: The clinical significance of tertiary lymphoid structures (TLSs) is not well-documented in early oral tongue squamous cell carcinoma (OTSCC). METHODS: A total of 310 cases of early (cT1-2N0) OTSCC were included in this multicenter study. Assessment of TLSs was conducted on hematoxylin and eosin-stained sections. TLSs were assessed both in the central part of the tumor and at the invasive front area. RESULTS: The presence of TLSs associated with improved survival of early OTSCC as presented by Kaplan-Meier survival analyses for disease-specific survival (P = 0.01) and overall survival (P = 0.006). In multivariable analyses, which included conventional prognostic factors, the absence of TLSs associated with worse disease-specific survival with a hazard ratio (HR) of 1.96 (95% CI 1.09-3.54; P = 0.025) and poor overall survival (HR 1.66, 95% CI 1.11-2.48; P = 0.014). CONCLUSION: Histological evaluation of TLSs predicts survival in early OTSCC. TLSs showed superior prognostic power independent of routine WHO grading and TNM staging system.