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Background: Oral cancer encompasses all malignancies that originate in the oral tissues and remains a major public health problem throughout the world as an important case of poor health and illness. Head and neck cancer accounts for 9.8% of the estimated 6,44,600 incidental cancer cases in India. Oral Squamous Cell Carcinoma (SCC) is a serious and developing concern globally, accounting for more than 90% of malignant cancers of the oral cavity. Salivary diagnostics have been demonstrated to have potential in the detection and screening of oral pre-cancer and cancer in a variety of research settings. The continual and close contact between saliva and the mucosa, where cancer develops, is the foundation of this diagnostic capability. Materials and Methods: This research utilized spectrophotometry to quantify Lactate Dehydrogenase levels in serum and saliva of 30 healthy people which consisted the control group and 31 Oral Potentially Malignant people which constituted the study group. Results: On estimation and comparison, the mean Lactate Dehydrogenase levels in serum (397.4968+71.6392 IU/L) and saliva (675.4935+139.3352 IU/L) among patients with Oral Potentially malignant lesions/conditions were higher than the mean Lactate Dehydrogenase levels in serum (390.8667+71.0953 IU/L) and saliva (201.3700+89.1439 IU/L) among controls. Conclusion: Higher serum and salivary LDH levels in Oral Potentially malignant lesions/conditions than in control groups signifies the importance of assessing salivary LDH levels, in the prognosis of the same. Further prospective longitudinal studies are required to assess the salivary LDH levels among the patients with malignant transformation of Oral Potentially malignant lesions/conditions to oral cancers. [ABSTRACT FROM AUTHOR]

Background: Oral squamous cell carcinoma (OSCC) remains the most common cancer among Indian men. OSCC involving the tongue and bucco alveolar complex (BAC) behaves differently. Nevertheless, the differences in clinical features and symptoms between the two subsites and their relation to pathology remain largely unexplored. Study Design: The study compared various clinical parameters and pathological factors between tongue cancer patients and patients with BAC cancer. Results: Among 474 patients, 232 had tongue cancer and 242 had BAC cancer. Except for the ulcer, 30% of patients with OSCC were asymptomatic at presentation. Compared to tongue cancers, lesions confined to BAC present at an advanced stage (P = 0.006). Multivariate analysis showed that dysphagia in tongue cancer (P = 0.020) and external swelling or lesion in BAC cancers (P = 0.002) were significant predictors of an advanced stage of the disease. On histopathology, perineural invasion (PNI) was significantly associated with tongue (P = 0.008) compared to BAC cancers (P = 0.015). Cancers of the tongue with pain and referred otalgia had a significantly higher depth of invasion (DOI), compared to those without pain (DOI – no pain 6.9 mm, pain 9.9 mm, and referred otalgia 11.4 mm). Conclusions: Patients with OSCC present late and in an advanced stage of the disease. Among tongue cancers, clinical history of pain was significantly associated with DOI and PNI, the significance of which needs to be prospectively analyzed. Clinical history in OSCC can be used as predicting factor for an advanced pathological stage of the disease. It also had an influence on various pathological characters, which is subsite specific. [ABSTRACT FROM AUTHOR]

Oral cancer is usually preceded by oral potentially malignant disorders (OPMDs) and early detection can downstage the disease. The majority of OPMDs are asymptomatic in early stages and can be detected on routine oral examination. Though only a proportion of OPMDs may transform to oral squamous cell carcinoma (OSCC), they may serve as a surrogate clinical lesion to identify individuals at risk of developing OSCC. Currently, there is a scarcity of scientific evidence on specific interventions and management of OPMDs and there is no consensus regarding their management. A consensus meeting with a panel of experts was convened to frame guidelines for clinical practices and recommendations for management strategies for OPMDs. A review of literature from medical databases was conducted to provide the best possible evidence and provide recommendations in management of OPMDs. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) is associated with the etiology of oropharyngeal squamous cell carcinomas. Despite the high proportion of oral squamous cell carcinomas (OSCC) in India, there only a few studies on the HPV status. The present study evaluated the HPV status of OSCC and its association with age, site, and tobacco habits. Methods: A total of 60 formalin-fixed paraffin-embedded tissues were included in the study, of which 30 were cases with OSCC and 30 formed the control group. The study group consisted of 30 subjects with primary, untreated, histologically confirmed cases of OSCC. The tissues were evaluated for the presence of HPV DNA using conventional polymerase chain reaction. Tissues which tested positive for HPV were further tested for HPV 16 and HPV 18. Results: In the study group, 83% were males and 17% were females with an average age of 58 years. The commonest sites of OSCC were the alveolus, alveologingival sulcus, and tongue. All subjects except one had tobacco habit. Among OSCC cases, 16.7% tested positive for HPV and controls were positive in 3.3% samples. HPV 16 was the most common HPV type detected in 60% of HPV-positive OSCC cases, while HPV 18 was present in 20%. Tobacco habits were present in 80% of the HPV-positive cases, while no habit history was reported in 20% of cases. Conclusion: Tobacco habits such as smoking and use of smokeless tobacco are found predominantly in OSCC and are the most common etiological factors. The present study found a prevalence of 16.7% of HPV-associated OSCC, with most cases also having tobacco habits. Thus, HPV as an etiological factor in OSCC is confounded by the presence of tobacco-associated risk factors. [ABSTRACT FROM AUTHOR]

Aim: To determine the preponderance and the distribution of pathological lesions in oral and maxillofacial region reported in and around the Madurai city. Study Design: Retrospective study on the oral and maxillofacial biopsies taken during 11 years period from 2007 to 2018 in a CSI Dental College, Madurai, Tamilnadu. A total of 1000 cases were analyzed and 904 were selected. The parameters recorded were age, sex, area, and the histopathological report obtained. Descriptive statistics was used for analysis. Result: The most common soft tissue lesion was traumatic fibroma (16.1%) and the prevalent hard tissue lesion was periapical cyst (12.7%). The more common oral malignant tumour observed was squamous cell carcinoma (7.3%) and benign tumor was ameloblastoma (5.3%). The frequently affected sites were mandible (36.1%) and buccal mucosa (19.8%). There was more predilection among male than females. The frequency of lesion is common in age group of 31-60 years. A considerable similarity was observed between age, type of lesion and its location. Conclusions: This study evaluated chronic periapical lesions were the most common hard tissue lesions and fibromas in soft tissue category. The idea of this histopathological study concludes on the requirement for biopsy to rule out type of the lesion and its severity to start up the earlier management. [ABSTRACT FROM AUTHOR]

Head and neck cancers (HNCs) are malignant tumors of the upper aerodigestive tract and are the sixth most common cancer worldwide. In India, around 30-40% of all cancers are HNCs. Even though there are global guidelines or recommendations for the management of HNCs, these may not be appropriate for Indian scenarios. In an effort to discuss current practices, latest developments and to come to a consensus to recommend management strategies for different anatomical subsites of HNCs for Indian patients, a group of experts (medical, surgical and radiation oncologists and dentists) was formed. A review of literature from medical databases was conducted to provide the best possible evidence base, which was reviewed by experts during a consensus group meeting (January, 2019) to provide recommendations. [ABSTRACT FROM AUTHOR]

The occurrence of intranodal salivary gland neoplasm is uncommon; squamous cell carcinoma (SCC) of the external auditory canal (EAC) is another rare occurrence. Clinically, SCC of EAC presents with symptoms similar to other benign otologic conditions. A case of Stage I SCC in EAC region is presented here in a 60-year-old male patient with incidental intranodal Warthin tumor along with the histological differential diagnosis. The patient is being followed up. There is no evidence of recurrence 1 year and 11 months after surgery. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to investigate the efficacy, toxicity, and impact of induction chemotherapy (IC) in locally advanced T4b oral cavity squamous cell cancers (OSCCs).Materials and Methods: Patients diagnosed with locally advanced T4b OSCC from January 2013 to October 2016 at our center, who received 2-3 cycles of IC and then assessed for resectability, were reviewed retrospectively. Patients' profile, response, and toxicity of IC, resectability status, and overall survival (OS) were evaluated. Statistical analyses were performed by SPSS software version 17.Results: A total of 116 patients received IC, and out of them 90 (77.6%) were males. Median age at diagnosis was 43 years (range 31-62 years). Nearly 103 (88.8%) of our patients received doublet chemotherapy and the rest of the patients received triplet regimen. Majority of the patients had buccal mucosa cancers (71.6%), followed by gingivobuccal complex (21.6%) and oral tongue (6.9%) primaries. After IC, partial response was achieved in 20 (17.3%) patients, stable disease in 68 (58.6%) patients, and disease progression was noted in 28 (24.1%) patients. Post-IC, resectability was achieved in 22 (19%) of 116 patients, but 6 of them did not undergo surgery due to logistic and personal reasons. The median OS of patients who underwent surgery followed by adjuvant local therapy (n = 16) was 19.7 months (95% confidence interval [CI]: 16.0-22.8 months) and for those treated with nonsurgical local therapy (n = 100) was 7.1 months (95% CI: 5.8-8.2 months) (log-rank P = 0.000).Conclusions: IC had a manageable toxicity profile and achieved resectability in 19% of our patients with T4b OSCC. Patients underwent resection had a significantly better median OS than those who received nonsurgical local treatment. [ABSTRACT FROM AUTHOR]

Head and neck squamous cell carcinoma (HNSCC) is now the seventh most common cancer worldwide. The median overall survival for patients with recurrent and/or metastatic (R/M) HNSCC remains <1 year despite modern systemic chemotherapy and targeted agents. Palliative systemic therapy for patients with R/M HNSCC typically includes a platinum-based doublet, with an understanding that the increase in efficacy compared with single agents is primarily related to improved response rate, and not survival. Till date, the only systemic therapy regimen to demonstrate survival superiority over platinum-5-fluorouracil (5-FU) doublet is platinum, FU, and cetuximab. Epidermal growth factor receptor inhibitors, including monoclonal antibodies and tyrosine kinase inhibitors, have achieved only a modest success in R/M HNSCC. Immunotherapy represents an attractive treatment option for R/M HNSCC, with encouraging preliminary data from studies involving immune checkpoint inhibitors (e.g., pembrolizumab, nivolumab) and toll-like receptor agonists (e.g., motolimod). Given the poor prognosis of R/M HNSCC, enrollment of patients into clinical trials to investigate novel systemic agents, is necessary for further improvement of oncologic outcomes in this patient population. [ABSTRACT FROM AUTHOR]

Verruciform xanthoma (VX) is a rare benign mucocutaneous verrucopapillary lesion, which mainly involves masticatory mucosa and gingiva. Clinically, it presents as a solitary, sessile or pedunculated, white- or yellow-white-colored growth with a pebbled surface, hence often misdiagnosed as papilloma. The hallmark of histological diagnosis is the presence of foam cells or xanthoma cells confined to the connective tissue papillae. We present a case of VX on the maxillary gingiva in a 52-year-old male patient with oral submucous fibrosis (OSF) with a review on histopathology and concomitant oral lesions. The exact etiopathogenesis is not clearly delineated more so when it is associated with diverse local and systemic conditions. Its concomitant association with other conditions such as lichen planus, leukoplakia, oral squamous cell carcinoma and OSF is rare, with only three cases of VX associated with OSF reported earlier. [ABSTRACT FROM AUTHOR]

Background: The extent of involvement of cervical lymph nodes is known to be the most important prognosticator in oral squamous cell carcinoma (SCC) that significantly affects the survival rate of patients. The clinical, radiological and pathological factors that can predict cervical lymph node metastasis are yet to be ascertained clearly, which poses a challenge for the surgeon to determine the extent of neck dissection. Aim: This study aims to identify the clinical and histopathologic predictors of lymph node metastasis among patients with oral SCC and to devise a scoring system based on those predictors to aid in better clinical decision-making regarding the extent of neck dissection. Setting: Malabar Cancer Centre, a specialized tertiary cancer care center in Kerala, India. Methods: A retrospective review of 160 patient records and biopsy slides collected and preserved between June 2014 and May 2016. Conclusion: The clinicopathologic parameters such as site of cancer (P = 0.03), histologic differentiation (P = 0.03), shape of rete pegs (P = 0.002), pattern of invasion (P = 0.0001) and depth of invasion >3 mm (P = 0.016) were significantly associated with the risk of lymph node metastasis. The risk score devised based on these predictors serves as an efficient tool in aiding clinical decision-making regarding the extent of neck dissection. [ABSTRACT FROM AUTHOR]

Background: The B cell lymphoma-2 gene is a proto-oncogene whose protein product inhibits apoptosis. Its role is associated with keeping cells alive, but not by stimulating them to proliferation, as other proto-oncogenes do. Increased expression of protein product of Bcl-2 gene appears in the early phase of carcinogenesis leading to apoptosis impairment and in consequence to the progression of neoplastic changes.Objective: To evaluate and compare the expression of Bcl-2 protein in oral epithelial dysplasia and oral squamous cell carcinoma (OSCC).Materials and Methods: Sixty cases of formalin-fixed paraffin-embedded archival specimens comprising of 30 cases of leukoplakia with oral epithelial dysplasia and 30 cases of OSCC were taken for immunohistochemical analysis using monoclonal antibody against anti-human Bcl-2 oncoprotein.Results: Immunostaining for Bcl-2 protein was identified in basal and parabasal layers as granular cytoplasmic staining in oral epithelial dysplasia. In OSCC, Bcl-2 immunoreactivity was most prominent in the peripheral cells of the infiltrating tumor islands which diminished toward the center in well-differentiated and moderately differentiated OSCC, whereas stronger and more diffuse expression of Bcl-2 oncoprotein was seen in poorly differentiated OSCC. Overall positivity of 26.7% (8/30) was observed in oral epithelial dysplasia and 30% (9/30) in OSCC in this study.Interpretation and Conclusion: Altered expression of Bcl-2 oncoprotein may be an early molecular event which leads to prolonged cell survival, increased chances of accumulation of genetic alterations, and subsequent increase in malignant transformation potential. [ABSTRACT FROM AUTHOR]

Objective: Immunohistochemical evaluation of the degree of expression of p16 and p27 in oral epithelial dysplasia and different histological grades oral squamous carcinoma. Materials and Methods: The study consisted of 5 cases of oral squamous cell carcinoma (OSCC), 5 cases of low-risk potentially malignant disorders (PMDs), 5 cases of high-risk PMDs and 5 cases of normal epithelium. Five micrometer thickness sections on a positively charged slide were subjected to immunohistochemical staining for the localization of p16 and p27. The expression of p16 and p27 was assessed in 10 random high-power fields (×40). Staining intensity was graded, and the data were subjected to statistical analysis. Results and Conclusion: OSCC and high-grade PMDs showed decreased intensity for both p16and P27. In our study, we concluded that p16 and p27 could be used as a diagnostic marker for predicting carcinogenesis in epithelial dysplasia. [ABSTRACT FROM AUTHOR]

Background: Nonsmall cell lung cancer (NSCLC) has varying epidemiological patterns in different countries and also in different regions of each country. In a country with a high prevalence of lung cancer such as India, regional variations in demography exist.Aim: A study of unique demographic trends of metastatic NSCLC patients presenting to our regional cancer center.Materials and Methods: We did a retrospective analysis of histologically confirmed metastatic NSCLC patients who presented to our Department of Medical Oncology between August 2012 and July 2014.Results: A total of 304 patients were analyzed. About 55.6% of the patients were in the age group of 41-60 years. About 79.6% of the patients were symptomatic for <6 months before presentation. About 63.5% of the patients were smokers presenting with a median age of 59 years whereas nonsmokers formed 36.51% of the patients presenting with a median age of 47 (P < 0.001). About 82.6% of the male patients and 4.1% of female patients were smokers. Equal number of all patients had adenocarcinoma (AC) and squamous cell carcinoma (SCC) histology. AC histology was more common in the nonsmoking group (62% of patients). SCC histology was seen in 54.3% of smokers. Metastasis to the contralateral lung and pleura was seen in 58.2% of patients.Conclusion: NSCLC presents at a young age. Smoking is a significant risk factor and it is common in the urban populations as in the rural areas. Both AC and SCC histologies presented in equal proportions. [ABSTRACT FROM AUTHOR]

Breast carcinoma in men is rare, and "intracystic papillary carcinoma (IPC)" of a male breast is an extremely rare entity accounting for <1% of all breast malignancies. It represents a small distinctive subgroup of noninvasive breast cancer. We discuss a case of a 70-year-old male presented with left breast lump of 6 months duration which rapidly increasing in size over 10-day period showed cystic mass with a mural nodule on ultrasonography. A diagnosis of papillary neoplasm was awarded (suspicious for malignancy-C4) on cytology. The patient underwent simple mastectomy, and a final diagnosis of "IPC" was confirmed on histopathology. IPC of the male breast is an extremely rare entity with favorable prognosis. Triple assessment (clinical examination and radiological and histological assessment) is necessary to diagnose IPC. Pathologic diagnosis can be difficult at classical histological examination; thus, the absence of myoepithelial cells layer by immunohistochemical study can be useful. [ABSTRACT FROM AUTHOR]

Biomarkers are broadly classified as genomic, proteomic, or metabolomic. Molecular biology and oncology research studies on oral cancer biomarkers focus on identifying key biological molecules or markers that could be linked to cancer development, risk assessment, screening, recurrence prediction, indicating prognosis, indicating invasion/metastasis and monitoring therapeutic responses of cancer. Cluster of differentiation factor 34 is a salivary biomarker that can identify recurrence potential of oral squamous cell carcinoma (OSCC). Integrin α3 and integrin β4 are genomic biomarkers that are helpful in estimating the risk of regional and hematogenous dissemination of malignant oral squamous cells. Other examples are vascular endothelial growth factor, B-cell lymphoma-2, claudin 4, yes-associated protein 1 and MET proto-oncogene, and receptor tyrosine kinase, which are genomic biomarkers that are used to predict radio-resistance in OSCC tissue. The present article reviews the clinical application, methodologies and steps in developing candidate biomarkers, protocols in reporting, evaluating candidate biomarkers, and challenges in biomarker research with a focus OSCC. [ABSTRACT FROM AUTHOR]

Background: Cervical Lymphadenopathy is one of the commonest and sometimes only clinical finding for a benign and malignant lesion. Fine needle aspiration cytology (FNAC) is a simple, safe, rapid and inexpensive method for establishing the diagnosis of lesions. Metastasis is more common in cervical lymph node and enlarged cervical nodes in an elderly patient must be considered as metastatic until proved otherwise. Methods: Retrospectively, 320 cases of left cervical lymph node FNAC were collected from five years record (May 2010 - June 2014) at Sri Devaraj Urs Medical College, Tamaka, Kolar . Review of all cytological reports were done according to standard guidelines and the morphological features of all non-neoplastic and neoplastic lesions were analysed. Results: Out of 320 cases 33% showed reactive lymphadenitis, 29% showed metastatic deposits, 14% showed features of granulomatous and necrotizing lymphadenitis, 9% were tuberculous lymphadenitis. In the present study, reactive lymphadenitis was the most common cause of enlarged lymph nodes followed by metastatic deposits. Squamous cell carcinoma is the most common metastatic lesions of lymphnode and comprise of 65% of the cases. Out of 62 cases of SCC 74% were keratinized, 16% were non keratinized, 29% cases showed granulomas. Non keratinization, presence of granuloma, plasma cells and eosinophils favours metastasis from nasopharyngeal carcinoma. Keratinization favours squamous cell carcinoma and absence of eosinophils and plasma cells in the background favors SCC metastasis from other sites. Conclusion: The present study highlight the usefulness of FNAC in left cervical lymphadenopathy where metastasis is common. Thus the knowledge about the cytological features and patterns will help the clinician to detect the respective cases early for investigations and treatment. [ABSTRACT FROM AUTHOR]

Background and Aim: The percentage of elderly people with head and neck cancers (HNC) is on the rise. This makes HNC in this group of patients an important issue for healthcare providers. The present study was planned to analyze the patterns of care given to the geriatric patients and to identify the factors influencing the decision making process.Materials and Methods: Data of all the elderly patients (≥65 years) registered in the year 2012, with histologically proven HNC (all sites, stages, histopathological types, except lymphoma, sarcoma and cervical metastasis of unknown origin) receiving treatment (definitive/palliative) were collected.Results: A total of 270 patients were included in this study. The median age was 72 years (range: 65-101), with predominant male population (70%, n = 190). Oral cavity squamous cell carcinoma (SCC) was the most common cancer (57%, n = 154). Eastern Co-Operative Oncology Group performance status (PS) of 0-2 was seen in 91% of the patients. Co-morbidities were present in 139 (51.5%) patients. 50% (n = 134) of the patients received palliative intent treatment, 45% (n = 123) definitive treatment, whereas in 5% (n = 13) the intent was not mentioned. Age, a clinical stage and PS significantly influenced the decision making on the intent of treatment. 208 (77%) patients completed their treatment irrespective of the intent. Age was the only factor influencing treatment completion irrespective of the intent.Conclusion: Geriatric HNC patients frequently present with advanced disease, having multiple co-morbidities. Hence, a multidisciplinary team management of these patients is essential, also taking into account of the social and financial support available to these patients. [ABSTRACT FROM AUTHOR]

Primary intraosseous carcinoma (PIOC) or Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare carcinoma, which arises within the jaws without connection to the oral mucosa and presumably develops from a remnant of odontogenic epithelium. It is a rare case which arises by direct transformation of odontogenic epithelial rests in the jawbone, including the epithelial rests found within the periodontal ligament and alveolar bone, remnants of the dental lamina, and the reduced enamel epithelium surrounding an unerupted/impacted tooth. Herein, we report a case of a 76-year-old male patient who came with a complaint of deviation of his jaws to one side which revealed resorption of total part of the condyle along with the condylar head and coronoid process on radiographic evaluation, which was histopathologically diagnosed as primary intraosseous carcinoma which is a very rare clinical entity. [ABSTRACT FROM AUTHOR]

Background: Free radical damage to biologic molecules forms a basis for cancer development. Since DNA damage and methylation states are influenced by oxidative species catalyzed by myeloperoxidase (MPO), this enzyme is postulated to have a role in the occurrence of cancer. MPO has been studied in cancers such as those of the lung, ovary, and breast. However, serum and salivary studies of MPO in oral cancer are lacking. Aims: (1) To determine the MPO levels in the serum and saliva of patients with primary oral squamous cell carcinoma (OSCC). (2) To compare and correlate the serum and salivary MPO levels in patients with primary OSCC and healthy controls. Subjects and Methods: A total of 30 subjects were involved in this study, of which study group consisted of 15 subjects and control group consisted of 15 subjects. Study group included subjects with histologically proven primary OSCC. Serum and salivary samples were collected from all the subjects. Results: The results showed that the serum levels of MPO were slightly higher in the study group as compared to the control group; however, the difference was not significant. In saliva, levels of MPO were slightly lower in the study group as compared to the control group. The difference was not significant. Conclusions: This study could not find a significant correlation between serum and salivary MPO and OSCC. However, our study consisted of a limited number of samples and as such can be considered a pilot study. Studies with larger sample size are needed to give better insight into the role of MPO in OSCC. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to assess the efficacy and toxicity of 5-flurouracil (5-FU) and cisplatin (PF) versus taxane and cisplatin (TP) as induction chemotherapy in locally advanced head and neck squamous cell cancer.Materials and Methods: There were 50 patients in each arm, matched for age, performance state, site and stage of disease. PF arm (cisplatin - 100 mg/m2 D1, 5-FU - 1000 mg/m2 D1-D5) TP arm (docetaxel - 75 mg/m2 or paclitaxel - 175 mg/m2 on D1, cisplatin 75 mg/m2 on D2), received once in 3 weeks for 3 cycles. Patients without progressive disease underwent either surgery or chemoradiation. The primary end point was overall response rate (ORR) and secondary endpoint was toxicity.Results: In a total of 100 patients in our study, 44 in PF and 47 in TP arm were evaluable. ORR was 86.6% in PF arm and 82.9% in TP arm (P = 0.71).There were more Grade 3 or 4 events of neutropenia, mucositis (P ≤ 0.05) and myelosuppression diarrhea, febrile neutropenia (P ≥ 0.05) in PF arm compared with TP arm. Post-chemotherapy hospital admissions due to toxicity were more frequent in PF arm (38.6% vs. 19%), dropout rate due to toxicity (9% vs. 0%) and deaths (6.8% vs. 2.1%) were more common in PF arm compared with TP arm.Conclusion: TP induction chemotherapy better tolerated than PF, which has similar efficacy, further multicenter randomized controlled studies; involving a large sample size is needed to confirm our data. [ABSTRACT FROM AUTHOR]

Aims: To estimate serum lipid profile in oral squamous cell carcinoma and correlate the risk factors and lipid profile with oral squamous cell carcinoma. Materials and Methods: Lipid profile was done in agriculturists/laborers in the age group of 30-70 years; 56 subjects (cases = 28, control = 28) were included. Study was carried out for a duration of four months; statistical analyses applied were mean, standard deviation, and independent 't' test. P < 0.05 was considered statistically significant. Results: Eleven cases had buccal mucosa cancer, nine had tongue carcinoma, and eight had gingivobuccal sulcus carcinoma. Lipid profile such as total cholesterol, triglycerides, LDL cholesterol, non-high-density lipoprotein (non-HDL) cholesterol, and very-low-density lipoprotein (VLDL) were marginally and slightly elevated in cases compared to controls. HDL was grossly decreased in cases compared to controls. Conclusions: There was a significant association between HDL and squamous cell carcinoma; maximum number of SCC had a history of smoking in the range of 10-19 years, irrespective of other lipid parameters, constrained to the fact that lipids are genetically determined, have geographical variation, and are highly skewed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cancer chemotherapy has already been in practice by the use of toxins and some of the specific poisonous compounds of cyanide derivatives. Carbamate insecticides inhibit cellular metabolism including energy, protein, and nucleic acid metabolism, thereby, causing cell regression and death. AIM: Preliminary evaluation of three carbamate insecticides, namely, baygon, carbaryl, and carbofuran as chemotherapeutic agents for cancer is undertaken in the present study. MATERIALS AND METHODS: The toxicity of carbamates on squamous cell carcinoma was assessed in-vitro using dye binding tests. Cells were grown in microtitration ELISA plates, as adherent cultures, for six hours, and then exposed to the drugs for 2, 4, 8, and 12 hours, and finally stained with neutral red, to assess the viable cell number, and with methylene blue for the determination of protein in the monolayer. Optical density was read in an ELISA reader. STATISTICAL ANALYSIS: The data obtained during the experiment was subjected to statistical analysis by using the student 't' test. RESULTS: The results indicated that the percentage of the viable cell number reduced with an increase in the time of exposure of the drugs. Exposure of the tumor cells to the drugs for 12 hours detached them completely from the wells, and hence, all the cells were washed out. Exposure of the drugs prior to the establishment of the culture in-vitro resulted in the non-formation of the monolayer in the wells. CONCLUSIONS: Among the three drugs studied, the survival percent was least with carbaryl treatment followed by baygon, and with carbofuran treatment it was almost near to control group. [ABSTRACT FROM AUTHOR]

Circulating tumor cells (CTCs) are those cells present in the blood and have antigenic and/or genetic characteristics of a specific tumor type. CTCs can be detected in the peripheral blood of cancer patients. Various techniques are available for detection of CTCs, which provide evidence for future metastasis. CTCs may provide new insight into the biology of cancer and process of metastasis in oral squamous cell carcinoma (OSCC). The detection of CTCs may represent a new diagnostic tool for predicting the occurrence of metastatic disease in OSCC and endow with the treatment strategies to efficiently treat and prevent cancer metastasis. This review gives an insight into the significance of CTCs and different techniques for detection of CTCs. [ABSTRACT FROM AUTHOR]

Skin cancers are rather uncommon malignancies comprising less than 1% of all the cancers in India. Saree cancer is a rare type of squamous cell carcinoma (SCC). Saree and dhoti are traditional male and female costumes respectively, which is unique to the Indian subcontinent. Constant wear of this clothing tightly around the waist results in changes in pigmentation and scaling of the skin, acanthosis, scar and ulceration and subsequent, gradual malignant changes. The process of repeated trauma over a long time and consequent interference with the healing process may rationalise the reason for malignant transformation. Few papers have been published on saree cancer, in main stream medical journals. We are presenting a rare case of saree cancer in a 68-year-old woman, with two distant bilateral ulceroproliferative growths in loin (Synchronous), along the waistline, which showed well-differentiated SCC on biopsy. Wide excision with rhomboid transposition flap was done bilaterally. [ABSTRACT FROM AUTHOR]

Background: Oral cancer is the third most common form of malignancies in India. In many cases it develops at the site of premalignant lesion. Transformation of normal tissue to premalignant lesion and further to oral cancer results in alteration in glycolytic pathway and hence the lactate dehydrogenase levels. Therefore, a study was carried out to determine the changes in the salivary alterations in lactate dehydrogenase (LD) levels oral leukoplakia (OL) and oral cancer (OC). Methods: Seventy-five patients reporting to department of oral medicine and radiology, were enrolled into the study which includes 25 patients each of oral leukoplakia, 25 of oral cancer and 25 healthy controls (HC). Unstimulated whole saliva measuring 1 mL will be collected from each of these patients by spit method in centrifuged and evaluated for LDH levels using the standard kit method. The data obtained were subjected to statistical analysis using the SPSS software version 17. Results: The mean salivary lactate dehydrogenase levels were higher in males in comparison to females in all three study groups OL, OC and HC. The salivary lactate dehydrogenase levels in the controls group, oral leukoplakia group and oral cancer were 79.50 ± 4.67 IU/L, 136.46 ± 3.36 IU/L and 148.77 ± 4.83 IU/L, respectively. There was a significant difference in the mean salivary levels of the above groups. Conclusion: Salivary lactate dehydrogenase levels are consistently higher in oral precancer and cancer hence it could be future marker [ABSTRACT FROM AUTHOR]

Background: Surgical excision is the mainstay of treatment for oral cavity squamous cell cancers (OSCCs). The median survival of locally advanced unresectable OSCCs (T4b and technically unresectable T4a) with various non-surgical treatment modalities is only 2-12 months. We hypothesized that induction chemotherapy (IC) in this subgroup of patients could improve the overall treatment outcome by reducing the tumor bulk and allowing definitive surgery. Methods: Patients diagnosed with locally advanced unresectable OSCCs (T4b and technically unresectable T4a) from January 2013 and May 2017 at our center, who received 2-3 cycles of IC and then assessed for resectability, were reviewed retrospectively. After IC, patients were reassessed clinico-radiologically and planned for either definitive surgery with adjuvant CTRT or non-surgical treatment including definitive CTRT, palliative RT or best supportive care (BSC). The inclusion criteria were: age ?18 years, pathologically proven OSCC, ECOG PS ?2; and adequate organ functions. Major exclusion criteria were: previous therapy for OSCC, congestive cardiac failure and evidence of metastatic disease. Patients received either TP (paclitaxel 175 mg/m2 on day 1, and cisplatin 75 mg/m2 on day 1) or TPF (paclitaxel 175 mg/m2 /docetaxel 75 mg/m2 on day 1, cisplatin 75 mg/m2 on day 1, and 5?FU 750 mg/m2/d on days 1 to 5) as IC, every 3 weeks along with primary G?CSF prophylaxis. Responses to IC were reported according to RECIST 1.1. Adverse events were classified based on CTCAE v 4.0. Statistical analyses were performed by SPSS version 17. Results: Total 206 patients received either TP (n=180) or TPF (n=26) as IC. The median age was 44 years (range, 35-62); 78.2% were males; ECOG PS 0?1/2, 100%/0%; site of primary tumor buccal mucosa/gingivo-buccal complex/oral tongue, 73.8%/21.4%/4.8%; primary tumor grade I/II/III, 53.4%/38.8%/7.8%. Responses to IC were as follows: partial response in 31 (15%) patients, stable disease in 140 (68%) patients and disease progression in 35 (17%) patients. All grade 3-4 toxicities were higher with TPF than TP regimen: neutropenia (30.8% vs. 12.2%), febrile neutropenia (19.2% vs. 4.4%), mucositis (15.4% vs. 6.1%) and diarrhea (11.5% vs. 2.8%). Post-IC, resectability was achieved in 35 (17%) patients (7 in TPF arm and 28 in TP arm); but 9 of them did not undergo surgery due to logistic reasons. The median survival of patients who underwent definitive surgery followed by adjuvant CTRT (n=26, 12.6%) was 19.4 months (95% CI: 16.4-22.3) and for those treated with non-surgical local therapy (n=180) was 7.6 months (95% CI: 6.2-8.8) (log-rank p = 0.000). Conclusions: This study suggests that IC is effective in converting locally advanced unresectable OSCCs to operable disease in a significant proportion of patients and has the potential to improve survival outcomes in that patient population, in comparison to non-surgical treatment. [ABSTRACT FROM AUTHOR]

Background:. Squamous cell carcinoma of the breast (SCCB) is a rare entity with limited data pertaining to the clinicopathological profile and treatment outcome. These tumors are characterized by rapid progression and have a poor outcome. The optimal therapy for SCCB has not yet been standardized. Most SCCB are treated with the similar conventional chemotherapy regimens used in the ductal variant of breast cancer. Methods. This was a retrospective observational study of patients diagnosed with SCCB diagnosed from March 2013 to August 2015 at our institute. The medical records were reviewed and patients were contacted telephonically to study the clinicopathological profile and treatment outcome. Results. We identified 6 (0.43%) patients of SCCB out of 1396 breast cancer patients treated. The median age at presentation was 48 years. All tumor specimens showed macroscopic findings of a cystic lesion and central necrosis. After a median follow-up of 34 months, 4 (60%) were surviving whereas 2 (40%) patients succumbed to disease progression after recurrence. Conclusion. SCCB is a rare subtype of breast cancer with no standard treatment approach. These are associated with poor prognosis and larger studies are needed to investigate different treatment options. [ABSTRACT FROM AUTHOR]

Oral leukoplakia is one of the most common potentially malignant disorders. Right diagnosis of potentially malignant disorders may help to prevent these lesions from malignant transformation. Proper understanding, recognizing, identification and differentiating these lesions from normal mucosa are necessary for proper treatment. [ABSTRACT FROM AUTHOR]

MicroRNAs (miRNAs) are short non-coding RNAs, which regulate translation and degradation of target mRNAs. Single miRNA can target multiple mRNAs and thereby potentially affect several important cellular pathways involved in tumorigenic processes. They control many key functions of the cell which can lead to carcinogenesis and metastasis. Therefore, the signature patterns of representative miRNAs may hold meaningful diagnostic value or serve as predictors of therapeutic efficacy and prognosis in cancer. Some of miRNA are secreted into saliva by exocytosis. Specific salivary miRNA signatures which can be used to detect the OSCC and to predict the prognosis will be reviewed. [ABSTRACT FROM AUTHOR]

Background: Reactive hyperplastic lesions are the most frequently encountered lesions in the oral cavity. Mast cells have a main role in hypersensitive reactions. Many studies have shown the interaction of mast cells in various pathological conditions such as squamous cell carcinoma, oral submucous fibrosis, periapical granulomas etc; suggesting their role in the proliferation of fibroblasts, blood vessels and in the recruitment of inflammatory mediators. Information regarding the role of mast cells in the pathogenesis of oral reactive lesions was scant. So this study was designed to attempt the possible role of mast cells intheetiopathogenesisoforal reactive lesions. Aim and objectives: To compare the mast cell count in oral reactive lesions and to correlate with inflammation, fibrosis and blood vessel density. Materials and Methods: Thirty-five samples including 10 pyogenic granulomas, 10 irritational fibromas, five inflammatory fibrous hyperplasias, five peripheral cementossifying fibromas and five normal gingiva were selected and immunohistochemically assessed for the mast cells using mast cell tryptase antibody and the number of mast cells were counted in 10 random fields under 20X magnification. The samples were also analyzed for mast cell count with fibrosis, inflammatory component and blood vessel density. Results and Conclusion: An increase in mast cell number was observed in oral reactive lesions and the statistical significance of degranulated mast cells in irritational fibromas and inflammatory fibrous hyperplasia indicate a possible of role of mast cells in angiogenesis, recruitment of inflammatory cells and fibrosis. [ABSTRACT FROM AUTHOR]