Oral lichen planus: A retrospective study of 110 Brazilian patients

<p>Abstract</p> <p>Background</p> <p>Oral lichen planus (OLP) is a chronic autoimmune disease characterized by multiple clinical presentations and a relatively high prevalence in the population. This retrospective patient record study investigated the profile of OLP in a group of Brazilian patients seen between 1989 and 2009.</p> <p>Findings</p> <p>The clinical records were analyzed and data such as gender, age, race, clinical presentation of OLP, site affected, presence of symptoms and extraoral manifestations of the disease, smoking habit, and consumption of alcoholic beverages were obtained. Among the 1822 records of patients with oral mucosal lesions, OLP was identified in 6.03%. Of these, 76.36% were females, with a mean age of 54 years, and 85% were whites. The reticular form was the most frequent (81.81%). Extraoral lesions were observed in 32.72% of the patients and painful symptoms were reported by 50.90%. The cheek mucosa was the site most affected (92.72%) and multiple oral lesions were observed in 77.27% of the patients. Among patients with OLP, 18.18% reported a smoking habit and 29.09% the consumption of alcoholic beverages.</p> <p>Conclusions</p> <p>This retrospective study showed a relatively high prevalence of OLP in the population studied, with a predominance of the disease among middle-aged white women and bilateral involvement of the cheek mucosa. Reticular lesions were the most frequent, followed by the erosive form which is mainly associated with painful symptoms. No relationship with tobacco or alcohol consumption was observed.</p

Oral carcinoma after hematopoietic stem cell transplantation – a new classification based on a literature review over 30 years

BACKGROUND: Patients undergoing hematopoietic stem cell transplantation (HSCT) have a higher risk of developing secondary solid tumors, in particular squamous cell carcinoma, because of several risk factors, including full-body irradiation (TBI), chemotherapy, and chronic graft versus host disease (GVHD). Based on the review presented here, a classification of oral changes is suggested in order to provide a tool to detect high-risk patients. Methods and Results The literature over the last 30 years was reviewed for development of malignoma of the oral cavity after HSCT. Overall, 64 cases were found. In 16 out of 30 cases, the tongue was the primary location, followed by the salivary gland (10 out of 30); 56.4% appeared in a latency time of 5 to 9 years after HSCT. In 76.6%, GVHD was noticed before the occurrence of oral malignancy. Premalignant changes of the oral mucosa were mucositis, xerostomia, and lichenoid changes, developing into erosive form. CONCLUSION: All physicians involved in the treatment of post-HSCT patients should be aware of the increased risk, even after 5 years from the development of oral malignancy, in particular when oral graft versus host changes are visible. In order to develop evidence management and to detect and offer adequate therapy as early as possible in this patient group, multicenter studies, involving oncologists and head and neck surgeons, should be established

Prediction of recurrence using exfoliative cytology and melanoma-associated antigen-A mRNA analysis following wide excision of oral squamous cell carcinoma: short report

BACKGROUND: Oral squamous cell carcinoma (OSCC) is the sixth most common cancer. The local recurrence of OSSC might result from the existence of occult cancer cells around tumour margins. Exfoliative cytology has lately gained great importance as a method for obtaining RNA samples from suspicious oral mucosal lesions in order to carry out molecular diagnosis. In addition, melanoma associated-A antigens (MAGE-A) are expressed in various tumours and their detection is a highly accurate sign that cancer cells are present. OBJECTIVE: The prediction of a recurrence using MAGE-A mRNA expression analysis to follow-up OSCC cases using a newly established molecular diagnostic technique applied to cytological materials. METHODS: RNA was extracted from three recurrent OSCC cases and from 20 healthy volunteers as a control group using a cytobrush. The expression of MAGE-A3, A4, A6, A10 and A12 was investigated in these specimens using quantitative real-time (RT-PCR). RESULTS: There was no expression of MAGE-A in the specimens of normal oral mucosa. However, the expression analysis of five different MAGE-A genes indicated a high potential for malignant change in biopsy-proven recurrent OSCC cases. Except for MAGE-A10, the rest of the genes were expressed in different ratios by the three recurrent cases, which had been determined on histopathology to be OSCC or carcinoma in situ. CONCLUSION: It is suggested that analysis of MAGE-A expression may be used as a risk prediction method in the diagnosis of recurrence after wide excision of OSCC to enhance the accuracy of exfoliative cytology, which has limitations due to false negative and false positive results

A novel multiple-marker method for the early diagnosis of oral squamous cell carcinoma

Objective: Melanoma associated antigens-A (MAGE-A) expression is highly specific to cancer cells. Thus, they can be the most suitable targets for the diagnosis of malignancy. The aim of this study was to evaluate the sensitivity of multiple MAGE-A expression analysis for the diagnosis of oral squamous cell carcinoma (OSCC). Methods: Total of 70 OSSC and 20 normal oral mucosal (NOM) samples of otherwise healthy volunteers were examined for the expression of 10 different single antigens out of 12 different MAGE-A subtypes by highly sensitive reverse transcriptase polymerase chain reaction (RT-PCR) methods. The results were correlated to clinicopathological parameters of tumor samples. Results: Expression of MAGE-A was restricted to OSCC. The expression frequency of single antigen was between 10% and 55%. However, expression rate was increased up to 93% by the elevated number of genes examined. A significant correlation was found between the expression of MAGE-A and malignancy (p=0.0001). In addition, multiple MAGE-A detection has also correlated to the incidence of lymph node metastasis, grading and advanced clinical stages. Conclusions: Analysis of multiple MAGE-A expression is more sensitive than the analysis of a single MAGE-A for the diagnostic evaluation of OSCC. Multiple MAGE-A expression analysis may be a very sensitive method to be used for the diagnosis even in the early stage of OSCC. © 2009 - IOS Press and the authors. All rights reserved