Fibrous Dysplasia and Ossifying Fibroma-an advent in their diagnosis

Objectives: Fibro-osseous lesions of the craniofacial complex comprise of a diverse, interesting and challenging group of conditions that pose difficulties in classification and treatment. The two most confused benign fibro-osseous lesions are fibrous dysplasia and ossifying fibroma. Sometimes, the classic clinical, radiologic or pathologic features of fibrous dysplasia or ossifying fibroma may not be evident, but overlapping features of both may be seen. The dilemma in diagnosis of these lesions rests in the bony trabeculae as well as in the fibrous stroma. Cases of fibrous dysplasia showing lamellated bony trabeculae and osteoblastic rimming have been reported which may confound diagnosis because of resemblance with ossifying fibroma. In the present study, an attempt has been made to demonstrate the fibrous element of these two lesions using histochemical stains. Study design: The sections of fibrous dysplasia & ossifying fibroma were stained with Haematoxylin and Eosin, Trichrome stain and Peracetic acid-aldehyde fuschin-modified Halmi stain. Result: The study revealed that the oxytalan fibers were more numerous in ossifying fibroma (seen with both Trichrome and modified Halmi stains). Conclusion: Although the ultimate diagnosis of fibrous dysplasia and ossifying fibroma is arrived at by correlating clinical, radiographic and routine histopathologic examination, the differences in the configuration of the stroma using histochemical stains may help in the diagnosis of these two lesions

Overexpression of S100A4 as a biomarker of metastasis and recurrence in oral squamous cell carcinoma

S100A4, a biomarker of epithelial mesenchymal transition (EMT), plays an important role in invasion and metastasis by promoting cancer cell motility. In oral squamous cell carcinoma (OSCC), metastasis results in 90% of cancer associated mortality. Objective: To investigate the role of S100A4 expression as an important component of the epithelial mesenchymal transition (EMT) program in oral squamous cell carcinoma (OSCC). Material and Methods: S100A4 protein expression was assessed semi-quantitatively by immunohistochemistry in 47 histologically confirmed cases of oral squamous cell carcinoma (OSCC) and 10 normal oral mucosal biopsies. The association between the S100A4 overexpression and the aggressive features of OSCC were analyzed by X2 test. Results: Moderate to strong cytoplasmic expression of S100A4 was observed in 30 out of 47 specimens of OSCC (64%). Overexpression of S100A4 was significantly associated with the clinical stage, lymph node involvement, metastases, pattern of invasion and recurrence (

Quantification of colloid bodies in Oral Lichen Planus and Oral Lichenoid Reaction - A Histochemical Study

Aim: Oral lichen planus and oral lichenoid reaction are familiar keratotic lesions found on the oral mucosa. Colloid bodies can be microscopically appreciated in both these lesions. The aim of this study was to identify as well as examine the frequency of colloid bodies in oral lichen planus and oral lichenoid reaction by histochemical means. Method: The material for the study included 12 formalin-fixed paraffin-embedded tissue blocks (7 oral lichen planus and 5 oral lichenoid reaction), retrieved from the Department of Oral Pathology and Microbiology, MCODS, Manipal. Sections stained with hematoxylin-eosin (H&E) and periodic acid-Schiff (PAS) with diastase to identify, locate and examine the frequency of colloid bodies in oral lichen planus and oral lichenoid reaction. Results: It was observed that the colloid bodies in case of oral lichen planus were present in either epithelium or connective tissue but usually close to the epithelium-connective tissue junction. While in oral lichenoid reaction colloid bodies were mostly seen in lower spinous layer of epithelium. Conclusion: Colloid bodies can be used as one of the criteria to differentiate oral lichen planus from oral lichenoid reaction. However, further studies are required to permit more objective distinction between oral lichen planus and oral lichenoid reactio

Dentinogenic Ghost Cell Tumor of the Peripheral Variant Mimicking Epulis

Dentinogenic ghost cell tumor (DGCT) is an uncommon locally invasive odontogenic tumor regarded by many as a variant of calcifying odontogenic cyst. The peripheral variant of this clinical rarity appears as a well-circumscribed mass mimicking a nonspecific gingival enlargement. Microscopic appearance of odontogenic epithelium admixed with focal areas of dentinoid formation and sheets of ghost cells giving the definitive diagnosis of dentinogenic ghost cell tumor imply that microscopic examination is compulsory for any gingival mass. Van Gieson histochemical stain further confirmed the nature of dentinoid-like material. A complete workup of a case of peripheral dentinogenic ghost cell tumor is presented in this paper and the current concept as well as the appraisal of literature is presented

Sentinel lymph node biopsy in oral squamous cell carcinoma - Ensuing from elective to selective

The status of lymph node involvement holds prime importance in the prognosis and therapy of oral squamous cell carcinoma (OSCC). Clinically and radiologically negative neck lymph nodes in early OSCC frequently create difficulty in predicting prognosis and defining treatment, owing to the chances of occult metastasis. In case of the lymphatic spread of the carcinoma, lymphatic drain will first pass through sentinel lymph nodes. The sentinel lymph node (SLN) is defined as the lymph node on the direct drainage pathway from the primary tumor. Sentinel lymph node biopsy (SLNB) is a minimally invasive technique and can be used for staging of cN0 neck in early OSCC. It helps to identify “skip” metastases and unpredictable lymphatic drainage patterns. Elective lymph node dissection (ELND) is frequently used as an adjunctive therapy to improve the cure rates of patients with cN0 OSCC and has been applied for staging as well, but it holds a greater risk of morbidity as compared to SLNB. Sentinel lymph node biopsy (SLNB) poses to be a feasible, safe and reliable prognostic tool for cN0 OSCC. Here’s an attempt to understand the validity of SLNB over ELND

Salivary biomarkers associated with the progression of disease in people living with HIV: A scoping review protocol [version 2; peer review: 2 approved, 1 approved with reservations, 1 not approved]

Background: Biomarkers are measurable indicators of normal biological processes, which provide an objective assessment of the physiologic state of living systems. Saliva contains several biomarkers that serve as a diagnostic tool in health and disease. Evaluation of a multitude of salivary components could potentially predict the clinical outcome. This is especially critical in a chronic, potentially life-threatening condition like human immunodeficiency virus (HIV) infection. Scrupulous evaluation of relevant biomarkers could facilitate the early detection of HIV, determine the stage of infection and monitor the disease progression. Currently, there is a paucity of validated biomarkers in saliva predicting the disease progression in people living with HIV. In this scoping review, we aim to provide an overview of the available evidence on salivary markers associated with the progression of disease in people living with HIV. Methods: The authors shall develop a tailored search strategy for each database using relevant keywords. We will search for eligible studies indexed in the following databases: MEDLINE, EMBASE, and the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and gray literature. We will restrict the search to studies published in the English language. Following deduplication, all search results will be exported to the EPPI reviewer web, where two independent reviewers using a data extraction tool developed and pretested by the review authors will screen eligible studies. The result of this review will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist and reporting guidelines. Discussion: The proposed scoping review protocol will enable the identification and assessment of salivary biomarkers, which can predict disease progression in patients with HIV infection. The synthesis of evidence from this review will assist in improving our current understanding of biomarkers used to evaluate the progression of HIV infection

Integrated computational analysis reveals HOX genes cluster as oncogenic drivers in head and neck squamous cell carcinoma

Alterations in homeobox (HOX) gene expression are involved in the progression of several cancer types including head and neck squamous cell carcinoma (HNSCC). However, regulation of the entire HOX cluster in the pathophysiology of HNSCC is still elusive. By using different comprehensive databases, we have identified the significance of differentially expressed HOX genes (DEHGs) in stage stratification and HPV status in the cancer genome atlas (TCGA)-HNSCC datasets. The genetic and epigenetic alterations, druggable genes, their associated functional pathways and their possible association with cancer hallmarks were identified. We have performed extensive analysis to identify the target genes of DEHGs driving HNSCC. The differentially expressed HOX cluster-embedded microRNAs (DEHMs) in HNSCC and their association with HOX-target genes were evaluated to construct a regulatory network of the HOX cluster in HNSCC. Our analysis identified sixteen DEHGs in HNSCC and determined their importance in stage stratification and HPV infection. We found a total of 55 HNSCC driver genes that were identified as targets of DEHGs. The involvement of DEHGs and their targets in cancer-associated signaling mechanisms have confirmed their role in pathophysiology. Further, we found that their oncogenic nature could be targeted by using the novel and approved anti-neoplastic drugs in HNSCC. Construction of the regulatory network depicted the interaction between DEHGs, DEHMs and their targets genes in HNSCC. Hence, aberrantly expressed HOX cluster genes function in a coordinated manner to drive HNSCC. It could provide a broad perspective to carry out the experimental investigation, to understand the underlying oncogenic mechanism and allow the discovery of new clinical biomarkers for HNSCC

A bibliometric analysis of publication output in selected South American countries [version 1; peer review: 2 approved]

Research output provides an insight into the development of the scientific capability of a country. Budget allocation for research and development (R&D) is directly proportional to the research output of a country. Bibliometric analysis of South American countries has not been done in many studies. The purpose of this paper was to analyse research outputs from South American countries on various metrics. An analysis was done for a period of 11 years from 2010 to 2020. The analysis revealed that Brazil with highest percentage of research spend has lowest Field Weighted Citation Impact (FWCI). This contrasts with Uruguay, whose FWCI is high despite comparatively lower spend on R&D and lower publication output. Although Argentina has the highest percentage of researchers per million population (1202), it has the least papers per researchers (0.3 per year) among the countries studied. A huge disparity in terms of percentage of research spent, research output, papers per researcher, and output with national and international co-authorship was observed

Exploring the regulatory interactions between mutated genes and homeobox genes in the head and neck cancer progression.

ObjectiveUnderstanding the regulatory role of homeobox (HOX) and mutated genes in the progression of head and neck cancers is essential, although their interaction remains elusive. This study aims to decipher the critical regulation of mutation driven effects on homeobox genes to enhance our understanding of head and neck cancer progression.MethodsGenomic mutation data from The Cancer Genome Atlas-Head and Neck Squamous Cell Carcinoma were analyzed using VarScan2 for somatic variant detection. Mutational clustering, driver mutation identification, and cancer signaling pathway analysis were performed using the OncodriveCLUST method. Harmonizome datasets were retrieved to identify critical cancer driver genes affecting HOX genes. The effects of HPV infection on HOX and mutated genes were assessed using the oncoviral database. Altered pathway activity due to the effects of cancer drivers on HOX genes was analyzed with Gene Set Cancer Analysis. Functional enrichment analysis of gene ontology biological processes and molecular functions was conducted using the ClusterProfiler R package.ResultsSignificant alterations in HOX genes were observed in head and neck cancer cohorts with mutated TP53, FAT1, and CDKN2A. HOX genes were identified as functionally downstream targets of TP53, signifying transcriptionally mediated regulation. The interaction between HOX genes and mutated TP53, FAT1, and CDKN2A dysregulated the epithelial-to-mesenchymal transition, cell cycle, and apoptosis pathways in head and neck cancer progression.ConclusionThe interplay between cancer driver genes and HOX genes is pivotal in regulating the oncogenic processes underlying the pathogenesis of head and neck squamous cell carcinoma