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IntroductionB cells, which have long been thought to be minor players in the development of anti-tumor responses, have been implicated as key players in lung cancer pathogenesis and response to checkpoint blockade in patients with lung cancer. Enrichment of late-stage plasma and memory cells in the tumor microenvironment has been shown in lung cancer, with the plasma cell repertoire existing on a functional spectrum with suppressive phenotypes correlating with outcome. B cell dynamics may be influenced by the inflammatory microenvironment observed in smokers and between LUAD and LUSC.MethodsHere, we show through high-dimensional deep phenotyping using mass cytometry (CyTOF), next generation RNA sequencing and multispectral immunofluorescence imaging (VECTRA Polaris) that key differences exist in the B cell repertoire between tumor and circulation in paired specimens from lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC).ResultsIn addition to the current literature, this study provides insight into the in-depth description of the B cell contexture in Non-Small Cell Lung Cancer (NSCLC) with reference to broad clinico-pathological parameters based on our analysis of 56 patients. Our findings reinforce the phenomenon of B-cell trafficking from distant circulatory compartments into the tumour microenvironment (TME). The circulatory repertoire shows a predilection toward plasma and memory phenotypes in LUAD however no major differences exist between LUAD and LUSC at the level of the TME. B cell repertoire, amongst other factors, may be influenced by the inflammatory burden in the TME and circulation, that is, smokers and non-smokers. We have further clearly demonstrated that the plasma cell repertoire exists on a functional spectrum in lung cancer, and that the suppressive regulatory arm of this axis may play a significant role in determining postoperative outcomes as well as following checkpoint blockade. This will require further long-term functional correlation.ConclusionB and Plasma cell repertoire is very diverse and heterogeneous across different tissue compartments in lung cancer. Smoking status associates with key differences in the immune milieu and the consequent inflammatory microenvironment is likely responsible for the functional and phenotypic spectrum we have seen in the plasma cell and B cell repertoire in this condition.

Abstract Background Primary squamous cell carcinoma of the breast is an extremely rare malignancy constituting less than 0.1% of all breast cancers with very few cases reported in literature. It is an aggressive, triple‐hormone negative tumor, and its appropriate management is still debated. It is diagnostically challenging on both histopathology as well as radiology. Different diagnostic criteria are established for its definite diagnosis. As squamous cells are not found normally in the breast, various theories have been proposed regarding its origin. But the exact pathogenesis is still unclear. We report one such case encountered. Case A 54‐year‐old female presented with gradually progressive painless lump in the right breast for 3 months with no other clinical features. There was neither any history of chronic or malignant disease in the patient nor in her family. On clinical examination, there was well‐defined, firm and nontender swelling in upper inner quadrant measuring 3 × 2 cm with overlying skin being normal. There was no swelling in the contralateral breast as well as in the bilateral axillary region. A suspicion of malignancy was raised on initial core needle biopsy and, on repeat biopsy, was diagnosed as metaplastic carcinoma with squamous differentiation. Later, on final resection, specimen was reported as primary squamous cell carcinoma of the breast without any nodal metastasis. All the metastatic causes were ruled out through proper clinical, radiological, and histopathological correlation. Conclusion Primary squamous cell carcinoma of the breast is an aggressive tumor with its treatment protocol being still unclear, owing to its rarity. It is important to rule out the metastatic causes. It is relatively resistant to conventional chemotherapy, and its prognosis is also unpredictable. Hence, this requires further studies in terms of management and prognosis.

Byline: Praveen. Birur, Sanjana. Patrick, Saman. Warnakulasuriya, Keerthi. Gurushanth, Shubhasini. Raghavan, Goura. Rath, Pankaj. Chaturvedi, Vijay. Chandru, Babu. Mathew, Kumar. Prabhash, Shubha. Gurudath, Nirza. Mukhia, Sumsum. Sunny, Ravi. Mehrotra, V. [...]

Primary gastric squamous cell carcinoma is a very rare presentation. Its pathogenesis is obscure, and the treatment strategy is largely unknown and controversial. We report a case of primary squamous cell carcinoma of the stomach with liver metastases in a 66-year-old man. The patient presented with a 2-month history of abdominal pain, vomiting, hematemesis, and weight loss. Endoscopic examination revealed large ulceroproliferative growth in body of stomach. Integrated PET CT (positron emission tomography computed tomography) scan revealed metabolically active nodular wall thickening involving body of stomach with liver metastases. Multiple biopsies of the lesions revealed squamous cell carcinoma of the stomach. The patient was started on palliative chemotherapy and is presently in partial response to treatment. He is tolerating treatment with no major side effects.

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]

Introduction: Head and neck malignancies are responsible for 30% of all cancers in India with a dramatic increase in numbers due to widespread tobacco consumption. This study aims to assess the epidemiological and histopathological spectrum of these tumors. Materials and Methods: A large retrospective review of 5469 biopsy-proven patients presenting between 2018 and 2022 with head and neck cancers was done. Tumors were analysed for distribution according to sites of presentations, gender, age and histopathological profiles. Results: With a male-to-female ratio of 4.2:1, men constituted 80.80% of the study population. Mean age of presentation in women was 53.5 years, whereas men presented at an earlier age of 47.2 years. Oral cavity was the commonest site involved (59.7% cases) followed by the oropharynx (23.8% cases). Buccal mucosa was the commonest subsite involved with 1112 cases followed by tongue lesions with 1088 cases. Larynx was responsible for 17.04% of cases. All subsites were more commonly affected in men with the highest Male: Female ratio of 8.29:1 seen in larynx. The lowest ratio of 1.02:1 was seen in lesions of the face and scalp. Squamous cell carcinoma (SCC) was the most common histopathological diagnosis encountered in 88.97% of cases followed by basal cell carcinoma which was seen in 2.10% lesions. Conclusion: Oral cavity lesions constitute the bulk of head and neck cancer presentations in India. The disease is more prevalent in men overall and men present at a younger age in comparison to women. SCC is the most prominent histopathology encountered in our study. [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]

Background and objective: To evaluate the rates of immediate locoregional response and acute toxicities associated with the reirradiation and oral capecitabine treatment of locoregionally recurring, unresectable squamous cell carcinomas of the head and neck. Method: Forty patients met the study's inclusion criteria and were randomly assigned to receive reirradiation for previously treated inoperable and/or irresectable tumours using conventional fractionation (2GY per fraction, 5 days a week, up to a total cumulative dose of 120GY, including the prior RT dose) and Capecitabine (500 mg once daily) during treatment. Result: The average time between the first and second radiation treatment sessions was 20 months. Our experiment showed an overall 90% response rate, with 20 patients showing a complete response, 16 showing a partial response, and 4 showing stable disease. Fifteen patients experienced grade 2 toxicity, and thirteen individuals experienced grade 3 toxicity in the pharynx. A median cumulative lifetime dosage of 116 GY was found. Conclusion: In this prospective single institutional trial, reirradiation and chemotherapy are being combined for the first time to treat recurrent SCCHN. We conclude that chemotherapy-assisted reirradiation up to a total dose of 60GY is feasible and efficient in carefully selected patients with manageable initial toxicities. [ABSTRACT FROM AUTHOR]

Background: Lesions of nasal cavity and paranasal sinuses are commonly encountered clinically and it is quite difficult to distinguish clinically the polyps arising from inflammatory conditions with those of neoplastic origin. Though malignant lesion of nasal and paranasal cavities account for less than 1% of all malignant lesions and less than 3% of head and neck region malignancies, they cause frequent local recurrence and relatively great morbidity. Even the advance imaging techniques help to reach presumptive diagnosis only, whereas the histopathological diagnosis remains the main stay in arriving at definitive diagnosis. Materials and Methods: The present study was done on 92 cases of neoplastic lesions received at department of pathology, Government ENT Hospital, Hyderabad from November 2019 to October 2021 as prospective observational study. Received biopsy specimens are routinely processed, section cutting done and stained with Hematoxylin and Eosin stain. All the neoplastic lesions of nasal cavity and paranasal sinuses of all age groups are included and inflammatory lesions, foreign body inclusions are excluded from the study. Results: Out of 92 neoplastic lesions, 58 cases are benign and 34 cases are malignant. Out of 92 cases, 61 patients are male and 31 patients are female. Majority of the cases are seen in 4th and 3rd decades. Among males most of the cases are seen in 4th and 5th decades whereas in females they are seen in 3rd decade. Out of 58 benign neoplastic lesions, most common cases are of lobular capillary hemangioma that represents 50% and are followed by Schneiderian papilloma representing about 29%. Out of 34 malignant neoplastic lesions, squamous cell carcinomas are the most common and represent about 41% incidence. Undifferentiated Carcinomas and Lymphoproliferative Disorders are second common with similar incidence of 12%. Conclusion: Lesions of nasal cavity and paranasal sinuses are commonly encountered in clinical practice and they give rise to a variety of histological patterns. The inflammatory and infectious conditions at these locations share overlapping features with benign and malignant lesions both clinically and radiologically, where only a presumptive diagnosis can be made. The histopathological examination remains the definitive diagnostic method for timely and accurate intervention in patient management. [ABSTRACT FROM AUTHOR]

Objective: To check the toxicity and efficacy profile of hypo fractionated palliative irradiation (the "Christie Regimen") and standard palliative radiation in patients with HNSCC (head and neck squamous cell carcinoma). Methods: This was a prospective randomized study carried out at Department of Radiation Oncology, Kamineni Academy of Medical Sciences and Research Centre, L.B. Nagar, Hyderabad, Telangana, India between June 2021 to May 2022. In two arms, approximately 40 cases of locally advanced Head and Neck malignancies were analyzed. Results: The loco regional control in Arm A and Arm B was characterized by complete response (CR) (50% and 60%), partial response (PR) (40% and 30%), and static response (SD) (10% and 10%), but this difference was not statistically significant (P = 0.220056). In both limbs, there were more Grade II skin reactions. In Arms A and B, grade III skin reactions to radiation were 10% and 10%, respectively. Additionally, arms A and B had a higher incidence of Grade I and Grade II mucosal reactions. Both groups had grade III mucosal responses to radiation, which is statistically insignificant. Frequent Grade III and Grade II reactions occur in the oesophagus, larynx, and salivary ducts of both groups. The patients were observed for a minimum of nine months. The quality of life of Arm A and Arm B had improved in terms of pain, performance status and weight loss after 9 months. Conclusion: Thus, it may be stated that, despite the fact that Response rates were not significantly different, QOL improvement favored Christie regimen regimens with acceptable toxicities. The hypo fractionated irradiation regimen required less time overall, and this radiobiological superiority is helpful for facilities like ours where the patient load is significantly higher than the radiation facility's capacity. To confirm the long-term effects of this regime, additional research with extended follow-up will be required. [ABSTRACT FROM AUTHOR]

Byline: Kumar. Prabhash, Govind. Babu, Pankaj. Chaturvedi, Moni. Kuriakose, Praveen. Birur, Anil. Anand, Ashish. Kaushal, Abhishek. Mahajan, Judita. Syiemlieh, Manish. Singhal, Munish. Gairola, Prakash. Ramachandra, Sumit. Goyal, Subashini. John, Rohit. [...]

Byline: Kumar. Prabhash, Govind. Babu, Pankaj. Chaturvedi, Moni. Kuriakose, Praveen. Birur, Anil. Anand, Ashish. Kaushal, Abhishek. Mahajan, Judita. Syiemlieh, Manish. Singhal, Munish. Gairola, Prakash. Ramachandra, Sumit. Goyal, Subashini. John, Rohit. [...]

Introduction: B cells, which have long been thought to be minor players in the development of anti-tumor responses, have been implicated as key players in lung cancer pathogenesis and response to checkpoint blockade in patients with lung cancer. Enrichment of late-stage plasma and memory cells in the tumor microenvironment has been shown in lung cancer, with the plasma cell repertoire existing on a functional spectrum with suppressive phenotypes correlating with outcome. B cell dynamics may be influenced by the inflammatory microenvironment observed in smokers and between LUAD and LUSC. Methods: Here, we show through high-dimensional deep phenotyping using mass cytometry (CyTOF), next generation RNA sequencing and multispectral immunofluorescence imaging (VECTRA Polaris) that key differences exist in the B cell repertoire between tumor and circulation in paired specimens from lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC). Results: In addition to the current literature, this study provides insight into the in-depth description of the B cell contexture in Non-Small Cell Lung Cancer (NSCLC) with reference to broad clinico-pathological parameters based on our analysis of 56 patients. Our findings reinforce the phenomenon of B-cell trafficking from distant circulatory compartments into the tumour microenvironment (TME). The circulatory repertoire shows a predilection toward plasma and memory phenotypes in LUAD however no major differences exist between LUAD and LUSC at the level of the TME. B cell repertoire, amongst other factors, may be influenced by the inflammatory burden in the TME and circulation, that is, smokers and non-smokers. We have further clearly demonstrated that the plasma cell repertoire exists on a functional spectrum in lung cancer, and that the suppressive regulatory arm of this axis may play a significant role in determining postoperative outcomes as well as following checkpoint blockade. This will require further long-term functional correlation. Conclusion: B and Plasma cell repertoire is very diverse and heterogeneous across different tissue compartments in lung cancer. Smoking status associates with key differences in the immune milieu and the consequent inflammatory microenvironment is likely responsible for the functional and phenotypic spectrum we have seen in the plasma cell and B cell repertoire in this condition. [ABSTRACT FROM AUTHOR]

To find if an association could be established between Human Papilloma Virus (HPV) infection and oropharyngeal cancers (OPCs) in a group of patients known to be regular users of tobacco, and to determine the impact of HPV status on clinical outcomes.Case records of 212 patients with AJCC-7 (The American Joint Committee on Cancer 7th edition) stages II–IVB non metastatic squamous cell carcinoma of the oropharynx treated using radical radiotherapy with or without chemotherapy during the years 2015–2018 were retrieved. Formalin-fixed, paraffin-embedded blocks from oropharyngeal biopsies were available for 177 patients and were evaluated for p16 expression by immunohistochemical (IHC) staining. More than 50% nuclear staining with or without cytoplasmic staining was considered HPV+. The association between tobacco use and HPV, as well as the influence of HPV status on survival outcomes were assessed. p16 expression was found to be positive in 23(13%) patients. Significant association was found between chewable tobacco usage and HPV positivity (p = 0.051). The median follow up was 20.5 months (range: 3–80). 5-year Overall Survival was 43.4% and 29.8% (p = 0.044) in HPV+ and HPV− patients, respectively. Local control was significantly better in HPV+ patients (38.6% vs. 25.3%, p = 0.049). There was also a trend towards improved Disease-free Survival in HPV+ patients (31 months vs. 15 months, p = 0.078). Though less in prevalence among the Indian population, improved outcomes in HPV+ OPC patients and widely available IHC HPV assays signifies the routine implementation of p16 testing in day-to-day clinical practice. [ABSTRACT FROM AUTHOR]

Oral carcinogenesis is also dependent on the balance of the oral microbiota. Candida albicans is a member oral microbiota that acts as an opportunistic pathogen along with changes in the epithelium that can predispose to premalignancy and/or malignancy. This systematic review uses the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to analyze the role of Candida albicans in the process of oral carcinogenesis. Eleven articles qualified inclusion criteria, matched keywords, and provided adequate information about the carcinogenesis parameters of Candida albicans in oral cancer. Candida albicans in oral carcinogenesis can be seen as significant virulent factors for patients with oral squamous cell carcinoma (OSCC) or potentially malignant disorder (OPMD) with normal adjacent mucosa. Candida albicans have a role in the process of oral carcinogenesis concerning morphological phenotype changes in cell structure and genotype and contribute to the formation of carcinogenic substances that can affect cell development towards malignancy. [ABSTRACT FROM AUTHOR]

Although the overall prognosis for patients with non-small cell lung cancer (NSCLC) has improved over the past several decades, there are still survival differences that are not accurately defined by clinicopathological factors. Thus, there is an unmet clinical need to develop novel approaches to enhance prognostic accuracy for these patients. Keratin 17 (K17) is a negative prognostic biomarker in a wide range of cancer types, including pancreatic ductal adenocarcinoma, head and neck squamous cell carcinoma, and pulmonary adenocarcinoma (LUAD), but has yet to be investigated as a prognostic biomarker in primary lung squamous cell carcinoma (LSCC). Based on TCGA RNA-seq data, alpha-2-macroglobulin like 1 (A2ML1), a protease inhibitor, is highly correlated with K17 in other solid tumors, including pancreatic ductal adenocarcinoma and is also a prognostic biomarker for LSCC, although the prognostic accuracy of A2ML1 for LUAD has not been tested. Thus, we hypothesized that A2ML1 expression correlates with K17 expression and that K17/A2ML1 co-testing could provide complementary prognostic data for NSCLC. The aims of this study were to explore K17 and A2ML1 as dual prognostic biomarkers, using publicly available gene expression databases [The Cancer Genome Atlas (TCGA)] LSCC (n=266), LUAD (n=271)] and multiplexed immunohistochemistry (mIHC) on representative sections of LSCC (n=104) and LUAD (n=107) from two major academic medical centers. Our results suggest that using either mRNA or mIHC-based methods, combined K17 and A2ML1 testing provides information, independent of other clinicopathologic variables, that could impact treatment decisions for patients with NSCLC. [ABSTRACT FROM AUTHOR]

Verrucous carcinoma of oral cavity is a highly well differentiated variant of squamous cell carcinoma with a low potential for invasion and metastasis. It is prevalent in the tobacco quid chewing population in our region. In this observational study, we reviewed the medical case records of 58 patients treated for oral verrucous carcinoma staged T2 to T4a. All patients underwent wide excision of tumour which included marginal mandibulectomy in 22 and hemimandibulectomy in 23 patients along with neck dissection saving the accessory nerve and internal jugular vein. 5 patients were found to have bone involvement along the alveolar sockets. 11 patients had other associated premalignant lesions in oral cavity. Only 2 patients had lymph node metastasis without extra nodal spread in submandibular region. With a mean follow up of 6 years and minimum follow up of 1 year, 3 patients had local recurrence. All these 3 patients had bone involvement and 2 of them had lymph node metastasis on histopathological examination. 3 patients who had associated premalignant lesions developed second primary in oral cavity after 3 years. In our experience, verrucous carcinoma has good prognosis when treated by surgery. Bone involvement along alveolar sockets and associated oral premalignant lesions adversely affect the outcome. There was no difference in the outcome between selective and modified radical neck dissection. Therefore selective neck dissection (supraomohyoid) would be adequate in treating these patients. Adjuvant radiotherapy can be reserved for T4a lesions or for positive margins. [ABSTRACT FROM AUTHOR]

Occurrence of malignancy in the TG cyst has been rarely reported, though rare, and papillary carcinoma predominates the common type but squamous cell carcinomas, anaplastic carcinoma, and medullary have been reported rarely. Mucoepidermoid carcinomas are most commonly seen in salivary glands, and as per the available literature, there was only two cases reported in thyroglossal cyst. We are presenting a 67-year-old lady presented with a 6×8 cm hard swelling below symphysis menti with no thyromegaly and moving on protrusion of tongue, and on MRI, it was found to be thyroglossal cyst with infiltration of strap muscles. Cytological investigation revealed it to be a TG cyst malignancy. The patient underwent total thyroidectomy and radical Sistrunk's operation. Histopathological and immunohistochemistry revealed it to be a histological examination revealed a low-grade mucoepidermoid carcinoma consistent with origin in a thyroglossal duct remnant it invaded the hyoid bone and adjacent strap muscles. Various diagnostic and treatment dilemmas in the treatment of TG cyst malignancy are discussed with reference to mucoepidermoid carcinoma. We are reporting an usual histological surprise in a thyroglossal cyst malignancy being the only second reported case of TG cyst mucoepidermoid carcinoma this case highlights the importance of removal of thyroglossal duct cysts at an early stage and aggressive surgical approach in high-grade tumors. [ABSTRACT FROM AUTHOR]

Spindle cell neoplasm of the tonsil are rare (Minami et al. in Am J Otolaryngol 29(2):123–125, 2008) and can be difficult to diagnose due to their non-specific clinical presentation and histological characteristics (Su et al. in J Chin Med Assoc 69(10):478–483, 2006). Differential diagnoses include lymphoma and squamous cell carcinoma (Hyams in Clin Otolaryngol Allied Sci 3(2):117–126, 1978). Oropharyngeal spindle cell neoplasms were more likely to occur in the tongue base and tonsil (58%) (Gerry et al. in Ann Otol Rhinol Laryngol 123(8):576–583, 2014). In this article, we report a case of tonsillar spindle cell neoplasm which is extremely rare. [ABSTRACT FROM AUTHOR]

Background Uric acid is a result of the metabolic breakdown of purine digestion. Serum uric acid ensures against carcinogenesis by means of its cell reinforcement properties and forestalls the development of oxygen extremists. High blood groupings of uric acid can prompt gout and are related with diabetes and development of kidney stones. Serum uric acid fixation mirror the harmony between uric acid combination and discharge. Studies have indicated that high uric acid is a danger factor for hypertension, diabetes and Cardio Vascular illness. Squamous cell carcinoma is characterized as threatening epithelial neoplasm showing squamous separation as described by the development of keratin or the bury cell spans. It also includestheinitialpresenceofaprecancerous lesion. Moreover, specificmedical conditionscancontributetotheoral potentially malignant disordersprevalenceOral squamous cell carcinoma is the most well-known neoplasm speaking to over 80% of all oral malignancy cases. Serum uric acid has been proposed to be related with the danger of malignant growth and it was seen that raised degrees of serum uric acid was related with an expanded disease frequency contrasted with typical qualities. Aim and Objectives: The aim of this study is to evaluate the serum uric acid level in oral cancer patients, to find out the association between low serum uric acid level and risk of squamous cell carcinoma and to compare the serum uric acid levels in oral cancer patients with normal individuals. Materials and Methods: This is a hospital based study to find out the uric acid level in oral cancer patients. The participants were selected from the out patients, Department of Oral Pathology and Microbiology. The study included a total numbe of 28 persons. Out of the 28 persons 15 oral cancer patients were selected for the experimental group. The remaining 13 subjects were in the normal group. Results: In this study, mean uric acid level in this stroke population with CAD is 6.37 mgs/dl and in those without CAD is 5.00 mgs/dl and thus establishes a statistically significant relationship ('p'0.0004). When males and females are considered, males have a significant association with a 'p' value of 0.0003. The buccal mucosa of the oral cavity was the most common involved site followed by the vestibule. Conclusion: The studies showed that serum uric acid level was significantly lower in oral cancer patients compared to the control group. Uric acid may prevent the formation of oxygen radicals and there by protect against carcinogenesis. In human's uric acid is the most abundant antioxidant and is an important intra cellular free radical scavenger. Early detection of oral cancer and Habit should be controlled to reduce mortality rates and help to provide successful cancer treatment. [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]

Shammah is a smokeless tobacco product often mixed with lime, ash, black pepper and flavorings. Exposure to shammah has been linked with dental diseases and oral squamous cell carcinoma. There is limited literature on the prevalence of shammah and its role in pathobiology of oral cancer. In this study, we developed a cellular model to understand the effect of chronic shammah exposure on oral keratinocytes. Chronic exposure to shammah resulted in increased proliferation and invasiveness of non-transformed oral keratinocytes. Quantitative proteomics of shammah treated cells compared to untreated cells led to quantification of 4712 proteins of which 402 were found to be significantly altered. In addition, phosphoproteomics analysis of shammah treated cells compared to untreated revealed hyperphosphorylation of 36 proteins and hypophosphorylation of 83 proteins (twofold, p-value ≤ 0.05). Bioinformatics analysis of significantly altered proteins showed enrichment of proteins involved in extracellular matrix interactions, necroptosis and peroxisome mediated fatty acid oxidation. Kinase-Substrate Enrichment Analysis showed significant increase in activity of kinases such as ROCK1, RAF1, PRKCE and HIPK2 in shammah treated cells. These results provide better understanding of how shammah transforms non-neoplastic cells and warrants additional studies that may assist in improved early diagnosis and treatment of shammah induced oral cancer. [ABSTRACT FROM AUTHOR]

Background: The inaccuracies in clinical examination have been well-documented while advanced imaging modalities including computed tomography (CT) and magnetic resonance imaging (MRI) have been shown to have superior diagnostic accuracy in detecting occult and nodal metastasis. The aim of the present study was to identify as well as evaluate the inaccuracies in clinical examination and of clinical diagnostic criteria in known cases of oral squamous cell carcinomas (OSCCs) with the help of MRI. Methodology: A total of 24 patients attending as outpatients were included in the study while clinically diagnosed and histopathologically proven cases of OSCC were examined clinically and then, subjected to advanced imaging with the help of MRI. Statistical Analysis Used: Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA) while paired t-test was performed for evaluating size of tumor and lymph node recorded on clinical and imaging findings. p<0.05 was considered statistically significant. Results: Detection of tumor size and lymph node metastasis were found to be higher in case of MRI than when accomplished by clinical staging alone while paired t-test values for difference in results were found to be statistically significant (p<0.05). Conclusions: The present study showed that clinical diagnostic criteria alone were not sufficient and reliable for detecting metastatic lymphadenopathy highlighting the significance of advanced imaging modalities like MRI for an efficient pre-operative diagnostic work-up as well as, as a tool for planning treatment in patients with OSCCs. [ABSTRACT FROM AUTHOR]

Though smoking remains one of the established risk factors of esophageal squamous cell carcinoma, there is limited data on molecular alterations associated with cigarette smoke exposure in esophageal cells. To investigate molecular alterations associated with chronic exposure to cigarette smoke, non-neoplastic human esophageal epithelial cells were treated with cigarette smoke condensate (CSC) for up to 8 months. Chronic treatment with CSC increased cell proliferation and invasive ability of non-neoplastic esophageal cells. Whole exome sequence analysis of CSC treated cells revealed several mutations and copy number variations. This included loss of high mobility group nucleosomal binding domain 2 (HMGN2) and a missense variant in mediator complex subunit 1 (MED1). Both these genes play an important role in DNA repair. Global proteomic and phosphoproteomic profiling of CSC treated cells lead to the identification of 38 differentially expressed and 171 differentially phosphorylated proteins. Bioinformatics analysis of differentially expressed proteins and phosphoproteins revealed that most of these proteins are associated with DNA damage response pathway. Proteomics data revealed decreased expression of HMGN2 and hypophosphorylation of MED1. Exogenous expression of HMGN2 and MED1 lead to decreased proliferative and invasive ability of smoke exposed cells. Immunohistochemical labeling of HMGN2 in primary ESCC tumor tissue sections (from smokers) showed no detectable expression while strong to moderate staining of HMGN2 was observed in normal esophageal tissues. Our data suggests that cigarette smoke perturbs expression of proteins associated with DNA damage response pathways which might play a vital role in development of ESCC. [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]

The abnormal growth of skin cells leads to skin cancer which occurs due to the unrepaired DNA impairment to the skin cells. Worldwide every year more than 1.23 lakhs of skin cancers are diagnosed, out of which Melanoma is the deadliest one. The aim of this research work is Recognition of Melanoma and skin lesion classification from the Dermoscopic images. Feature extraction of Dermoscopic images can be done by Shape, Color and Texture features. Texture features comprises of Gray Level Co-occurrence Matrix (GLCM) and statistical texture features calculated from the coefficients of the Multiresolution transforms such as Discrete Wavelet Transform (DWT), Curvelet, Tetrolet, and Spectral Graph Wavelet Transform (SGWT). The novelty in this work is using SGWT for extraction of texture features. The superiority of SGWT over conventional wavelet transform is its ability to work on irregular shaped images. Weighted graphs are the base for the SGWT which can be obtained in the form of meshes for irregular shapes. In the present work, skin lesions are obtained from the International Skin Imaging Collaboration (ISIC) 2016 archive. The features obtained from the Dermoscopic images are classified using Naïve Baye's, K-Nearest Neighbor (KNN) and Support Vector Machine (SVM) classifiers. The proposed method using Shape, Color and Texture based features for Melanoma Recognition with SGWT results in an Area Under the Curve (AUC) of 0.951 with Accuracy of 96.79%, Sensitivity of 88% and Specificity of 98.26%. Further, the AUC of skin lesion classification such as Melanoma vs Nevus, Seborrheic Keratosis vs Squamous Cell Carcinoma, Melanoma vs Seborrheic Keratosis, Melanoma vs Basal Cell Carcinoma and Nevus vs Basal Cell Carcinoma using SGWT is 0.895, 0.945, 0.9645, 0.945 and 0.98 respectively. [ABSTRACT FROM AUTHOR]

Background: Prognosis of oral squamous cell carcinoma (OSCC) can be predicted by evaluating both clinicopathological parameters and molecular markers. Understanding the reasons of recurrence is important to increase the morbidity and mortality of the patient. Aims and Objectives: The objectives are to study the immunoexpression of p53 and Ki-67 in recurrent and non recurrent OSCC. And correlate the clinicopathological parameters among non-recurrent and recurrent OSCC to predict the prognosis of OSCC. Materials and Methods: Clinicopathological and immunoexpression of p53 and Ki-67 at the histologically negative margin (HNM) and invasive tumor front (ITF) were assessed in 50 cases of non-recurrent and recurrent OSCC. Overall survival and disease free survival was estimated. Statistical tests like Mann Whitney U test, t Test, Pearson correlation coefficient, Kaplan Meier curve and Log Rank test were used. Results: The Labelling Index (LI) of p53 and Ki-67 was marginally higher in recurrent than in non-recurrent OSCC cases. When compared with clinicopathologic parameters, non-recurrent OSCC cases showed no significance with p53 LI in margin and ITF except for site, muscle invasion, pattern of invasion (POI) and muscle invasion, whereas in recurrent OSCC cases p53 LI in HNM and ITF did not show any statistical significance except for duration. In both groups, OS and DFS was higher in patients with lesser LI while higher in the greater LI but more number of deaths occurred in this category respectively. Conclusion: To conclude p53 and Ki-67 positivity in the HNM and ITF of non-recurrent and recurrent OSCC was seen and thus can be an important marker for identification of high and low risk individuals. [ABSTRACT FROM AUTHOR]

Introduction: Numerous studies have stated an association of spice consumption with lowered incidence of oral squamous cell carcinoma and other potentially malignant disorders of oral cavity. Anise seeds when consumed have the potential medicinal benefits including anticancer, anti-helminthic, hepato-protective and antioxidant activities. In this study we examined the anti-cancer activity of Anise seed extract (aqueous extract) on KB cancer cell lines. Aims: a) To determine the cytotoxic activity of Anise seed extract on KB cell line b) To determine the cytotoxic activity of CISPLATIN on KB cell line c) To compare the cytotoxic activity of Anise seed extract and CISPLATIN on KB cell line. Methods and Material: The study was conducted in Biogenix Research Centre, Thiruvananthapuram. The KB cancer cell lines were procured from NCCS, Pune. Anise seeds were purchased, dried and powdered using mortar and pestle. An extract was prepared in ascending concentrations and added to KB cell line in vitro under standardized environment. An extract of CISPLATIN at the same concentrations were prepared and added to KB cell line separately. Cytotoxic activity of the anise seed extract and CISPLATIN extract were assessed using MTT assay and cells were observed under an inverted phase contrast microscope, for any detectable changes in the cell morphology. Results: The results obtained showed that with ascending concentrations of anise seed extract there was significant cytotoxic changes observed with p value significant and obtained at 0.0052. Conclusion: Since anise seeds have been known to have a great potential as a chemotherapeutic agent, further focused studies of its anticancer properties and isolation of compounds from Pimpinella anisum are necessary to prove its worth in the cancer therapy. [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]

Skin cancer is one of the deadliest disease found in humans. These skin cancers are of various types like Basal Cell Carcinoma(BCC), Melanoma, Nevus, Seborrheic Keratosis (SK), Squamous Cell Carcinoma (SCC). Some of the skin cancers can be identified visually, but in order to diagnose a skin cancer patient should have to undergo for a biopsy test and it takes a long time to diagnose. To overcome this an automated skin lesion classification system has to be developed. In this work, a basic architecture of the Convolution Neural Network(CNN) model is used to classify different skin lesions. The proposed model achieved better accuracy for SCC Vs SK, BCC Vs SK, Melanoma Vs Nevus and Melanoma Vs SK are 0.9741, 0.9867, 0.9506 and 0.9734 respectively for 25 epochs when compared to the other related works. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to investigate the efficacy, toxicity, and impact of induction chemotherapy (IC) in technically unresectable T4a oral cavity squamous cell cancers (OSCCs). Materials and Methods: Patients diagnosed with technically unresectable locally advanced T4a OSCC from January 2013 and November 2016 at our center, who received 2-3 cycles of IC and then assessed for resectability, were reviewed retrospectively. Patients' profile, response rates and toxicity of IC, resectability status, and overall survival (OS) were evaluated. Statistical analyses were performed using SPSS version 17.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: Totally 80 patients received IC, and of them 58 (72.5%) were males. Median age at diagnosis was 44 years (range, 34-62 years). All our patients received IC with doublet regimen. Majority of the patients had buccal mucosa cancers (73.8%), followed by gingivobuccal complex (21.2%) and oral tongue (5%) primaries. After IC, partial response was achieved in 17 (21.3%) patients, stable disease in 49 (61.3%) patients and disease progression was noted in 14 (17.4%) patients. Post-IC, resectability was achieved in 19 (23.8%) of 80 patients, but 4 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 = 15) was 16.9 months (95% CI: 15.2-19.8 months) and for those treated with nonsurgical local therapy (n = 65) was 8.8 months (95% CI: 6.8-10.6 months) (log-rank P = 0.000). Conclusions: IC had a manageable toxicity profile and achieved resectability in 23.8% of our patients with technically unresectable T4a OSCC. Patients underwent resection had a significantly better median OS than those who received nonsurgical local treatment. [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]

Objectives: Secretory leukocyte protease inhibitor (SLPI) is a protein found in body fluids and implicated as a prognostic factor in many cancers. There is limited research regarding serum and salivary SLPI in oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC). Materials and Methods: A total of 90 participants were included in the study; of which 30 formed the control group, 30 included participants with OPMD, and 30 included participants with OSCC. Serum and salivary levels of SLPI were estimated using enzyme-linked immunosorbent assay. Results: Serum levels of SLPI showed progressive increase in potentially malignant disorders and SCC patients when compared with controls, while salivary levels were increased in both OPMD and OSCC groups as compared to controls. However, the difference between groups was not statistically significant (P < 0.05). Conclusion: The above results suggest that increase in SLPI levels in the serum may have a role in indicating progression of OPMD to OSCC. [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: Neck masses are found in all age groups from many causes, ranging from congenital to acquired pathology. There is paucity of data on neck masses in Tanzania and at Muhimbili National Hospital, prevalence of neck masses is not yet known. The aim of this study was thus to address this gap. Methods: Descriptive cross sectional study was done from July to December 2016 involving patients who were admitted in surgical wards. Structured questionnaires were filled after thorough head and neck evaluation of patients. Data analys is by SPSS version 20 and p-value<0.05 was considered to be statistically significant. Results: The overall prevalence of neck masses was found to be 14.1% and proportion of neck masses was found to increase as the age increase. Anterior triangle was the commonest anatomical site (53.8%). Most of the neck masses (65.7%) were malignant and the age group most involved was >60 years (P-value 0.000). Among the malignant neck masses squamous cell carcinoma was the leading variant (54.1%) and most of themalignant neck masses were metastatic nodes from primary cancers in the upper aerodigestive tract (67.21%). Conclusion: This study has unveiled neck masses at MNH to be prevalent and the proportion of neck masses increase age increase. Anterior triangle was the leading anatomical site. Most of the neck masses were malignant and majority of them were metastatic nodes from upper aerodigestive tract. Any neck mass especially in adults needs thorough evaluation including upper aerodigestive assessment to rule out the possibility of malignancy. [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]