HPV-DNA Positive/p16 IHC Negative Oral Squamous Cell Carcinoma: A Case Report

Human Papillomavirus (HPV) is a DNA virus, belonging to papillomaviridae family. [...

Biomolecular alterations temporally anticipate microarchitectural modifications of collagen in oral tongue squamous cell carcinoma

High resolution analysis of collagen bundles could provide information on tumors onset and evolution. This study was focused on the microarchitecture and biomolecular organization of collagen bundles in Oral Tongue Squamous Cell Carcinoma (OTSCC). Thirty-five OTSCCs biopsy samples were analyzed by synchrotron-based Phase-Contrast MicroComputed Tomography (PhCmicroCT) and Fourier Transform Infrared Imaging (FTIRI) spectroscopy. PhC-microCT evidenced the presence of reduced and disorganized collagen in the tumor area compared to the extratumoral one. FTIRI also revealed a reduction of folded secondary structures in the tumor area, and highlighted differences in the peritumoral areas in relation with the OTSCC stage, whereby a significantly lower amount of collagen with less organized fibers was found in the peritumoral stroma of advanced-OTSCCs stages. Interestingly, no significant morphometrical mismatches were detected in the same region by PhC-microCT analysis. These results suggest that biomolecular alterations in the OTSCC stroma temporally anticipate structural modifications of collagen bundle microarchitecture. AB - High resolution analysis of collagen bundles could provide information on tumors onset and evolution. This study was focused on the microarchitecture and biomolecular organization of collagen bundles in Oral Tongue Squamous Cell Carcinoma (OTSCC). Thirty-five OTSCCs biopsy samples were analyzed by synchrotron-based Phase-Contrast MicroComputed Tomography (PhCmicroCT) and Fourier Transform Infrared Imaging (FTIRI) spectroscopy. PhC-microCT evidenced the presence of reduced and disorganized collagen in the tumor area compared to the extratumoral one. FTIRI also revealed a reduction of folded secondary structures in the tumor area, and highlighted differences in the peritumoral areas in relation with the OTSCC stage, whereby a significantly lower amount of collagen with less organized fibers was found in the peritumoral stroma of advanced-OTSCCs stages. Interestingly, no significant morphometrical mismatches were detected in the same region by PhC-microCT analysis. These results suggest that biomolecular alterations in the OTSCC stroma temporally anticipate structural modifications of collagen bundle microarchitecture

Addition of the tumour-stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma

Aims One of the objectives of current research is to customise the treatment of cancer patients. The achievement of this objective requires stratification of patients based on the most significant prognostic factors. The aims of this study were to evaluate the prognostic value of the tumour-stroma ratio (TSR), defined as the proportion of tumour cells relative to surrounding stroma, in patients with oral tongue squamous cell carcinoma (OTSCC), and to develop a prognostic nomogram based on the most significant clinicopathological features. Methods and results Clinicopathological data of 211 patients treated at 'Ospedali Riuniti' General Hospital (Ancona, Italy) for OTSCC were collected. One hundred and thirty-nine patients were restaged according to the 8th edition American Joint Committee on Cancer (AJCC) staging system. Evaluation of the TSR was performed on haematoxylin and eosin-stained slides, and correlation with survival outcomes was evaluated. In addition, with the aim of integrating the independent value of the TSR with the 8th edition AJCC staging system, a prognostic nomogram for OTSCC has been developed. OTSCC with a low TSR (i.e. a high proportion of stroma and a low proportion of tumour cells) was shown to have negative prognostic value in terms of disease-specific survival, with a hazard ratio (HR) of 1.883 and a 95% confidence interval (CI) of 1.033-3.432 (P = 0.039), and overall survival (HR = 1.747, 95% CI 0.967-3.154;P = 0.044), independently of other histological and clinical parameters. For the cohort of 139 patients restaged according to the 8th edition AJCC staging system, variables correlating with a poor prognosis were: the TSR, perineural invasion, and sex. The nomogram built on these parameters showed good predictive capacity, outperforming the 8th edition AJCC staging system in stratifying disease-specific survival in OTSCC patients. Conclusions Including the TSR in the predictive model could improve risk stratification of OTSCC patients and aid in making treatment decisions.Peer reviewe

An Overview on Current Non-invasive Diagnostic Devices in Oral Oncology

Oral squamous cell carcinoma (OSCC) is the most common head and neck malignancy, and despite advances in cancer therapies, the overall 5-year survival rate has remained below 50% over the past decades. OSCC is typically preceded by potentially malignant disorders (PMD), but distinguishing high-risk from low-risk PMD is challenging. In the last years, several diagnostic methods as light-based detection systems (LBDS) have been proposed to facilitate the detection of OSCC and PMD. Furthermore, the recent evolution of nanotechnology may provide new opportunities to detect PMD and OSCC at an early stage. Indeed, several preclinical studies showed the potential of nanotechnology to enhance diagnostic accuracy. For these reasons, it is fundamental to conduct studies to evaluate the efficacy of nanotechnology implementation in LBDS. The aim of this article is to review the current literature on LBDS and to provide a summary of the sensitivity and specificity of each technique, and possible future applications of nanotechnologies. The LBDS showed great potential for screening and monitoring oral lesions, but there are several factors that hinder an extensive use of these devices. These devices seem to be useful in assessing lesion margins that must be biopsied. However, to date, conventional oral examination, and tissue biopsy remain the gold standard for OSCC diagnosis. The use of nanotechnologies could be the next step in the evolution of LBDS, thus providing devices that can help clinicians to detect and better monitor oral lesions

Odontogenic Cysts: A 30-Year Retrospective Clinicopathological Study

Odontogenic cysts (OC) are one of the most frequent lesions. [...

Sviluppo di un modello prognostico morfologico per il carcinoma squamocellulare della lingua

Il carcinoma squamocellulare della lingua (OTSCC) è una neoplasia caratterizzata da un elevato tasso di recidive e da una mortalità stabile da oltre 20 anni. L’ottava edizione del sistema di stadiazione dell’AJCC ha migliorato la capacità di stratificare i pazienti affetti da OTSCC. Ciononostante, la capacità predittiva di tale sistema deve essere migliorata per poter discriminare quei pazienti affetti da una malattia più aggressiva, rendendo necessaria la ricerca di nuovi marcatori prognostici. Lo scopo di questo lavoro è stato quello di studiare le principali caratteristiche morfologiche del tessuto tumorale, sviluppando un modello prognostico e un nomogramma al fine di migliorare la stratificazione dei pazienti affetti da OTSCC. È stato condotto uno studio di coorte retrospettivo su 211 pazienti con OTSCC. Sono stati valutati vari parametri istopatologici sezioni seriali da 4 μm colorate con ematossilina-eosina: il pattern d’invasione tumorale, l’invasione perineurale (PNI), l’invasione linfovascolare (LVI), il budding tumorale (BT), l’eosinofilia associata al tumore (TATE), il tumor-stroma ratio (TSR) e l’immunofenotipo. Gli endpoint esaminati sono stati la sopravvivenza specifica da malattia (DSS) e la sopravvivenza libera da malattia (DFS). L’analisi univariata di Cox ha evidenziato una riduzione della DSS nei soggetti che presentavano lo Stadio avanzato (p<0,001), la PNI multifocale (p<0,001) e peritumorale (p=0,003), la LVI (p<0,001), il BT (p<0,001), la scarsa TATE (p<0,001), il TSR basso (p=0,001) e l’immunofenotipo deserto (p<0,001). L’analisi multivariata e la regressione stepwise hanno permesso di costruire un modello prognostico impiegando età, Stadio, BT, LVI e immunofenotipo; tale modello ha mostrato gli indici di performance migliori. I risultati ottenuti suggeriscono che questo modello prognostico è un sistema semplice, economico e pratico per la valutazione degli OTSCC. Tuttavia sono necessari ulteriori studi di validazione su coorti più ampie.The oral tongue squamous cell carcinoma (OTSCC) is characterized by a high rate of recurrence and a stable mortality rate in the last 20 years. The 8th edition of AJCC staging system has allowed for better stratification of patients with OTSCC. However, the predictive capability of this system still need to be improved in order to better stratify those patients with a more aggressive disease, searching for new prognostic markers. The aim of this study was to investigate the main morphological features of tumor tissue and to develop a prognostic model and a nomogram, in order to improve the stratification of OTSCC patients. A retrospective cohort study on 211 OTSCC patients has been conducted. Several histopathological parameters have been visually assessed on 4-μm hematoxylin-eosin stained sections: pattern of invasion (POI), perineural invasion (PNI), lymphovascular invasion (LVI), tumor budding (BT), tumor associated tissue eosinophilia (TATE), tumor stroma ratio (TSR), and the immune phenotype. The primary endpoints were the disease-specific survival (DSS) and the disease-free survival (DFS). Univariate Cox analysis highlighted significant associations between a reduced DSS and: advanced Stage (p<0,001), multifocal PNI (p<0,001), peritumoral PNI (p=0,003), LVI (p<0,001), BT (p<0,001), low TATE (p<0,001), low TSR (p<0,001) and desert immune phenotype (p<0,001). The multivariate analysis and the stepwise regression analysis were conducted in order to create a prognostic model and a nomogram for DSS evaluation. Age, Stage, BT, LVI, and immune phenotype were entered into the model, showing the best performance. The results obtained suggest that the prognostic model is simple, inexpensive, and practical system for the evaluation of OTSCC. However, further validation studies on larger cohorts are needed