44 research outputs found

    Prevalence of oral cancer, oral potentially malignant disorders and other oral mucosal lesions in Cambodia

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    Objectives: To obtain data on the prevalence of oral mucosal lesions (OMLs) among Cambodians, and to assess the relationship between known risk habits of oral diseases with prevalence of oral potentially malignant disorders (OPMDs). Design: This was a population-based, cross-sectional study whereby subjects were adults aged 18 years old and above. A workshop on the identification of OML was held to train and calibrate dental officers prior to data collection in the field. Sociodemographic and risk habits data were collected via face-to-face interview, whilst presence of OML and clinical details of lesions such as type and site were collected following clinical oral examination by the examiners. Data analysis was carried out using the Statistical Package for Social Science (SPSS) version 12.0. The association between risk habits and risk of OPMD was explored using logistic regression analysis. Results: A total of 1634 subjects were recruited. Prevalence of OML for this population was 54.1%. Linea alba was the most common lesion seen (28.7%). This study showed an overall OPMD prevalence of 5.6%. The most common type of OPMD was leukoplakia (64.8%), followed by lichen planus (30.8%). Subjects who only smoked were found to have an increased risk for OPMD of almost four-fold (RR 3.74, 95%CI 1.89–7.41). The highest risk was found for betel quid chewers, where the increased risk observed was more than six times (RR 6.75, 95%CI 3.32–13.72). Alcohol consumption on its own did not seem to confer an increased risk for OPMD, however when practiced concurrently with smoking, a significant risk of more than five times was noted (RR 5.69 95%CI 3.14–10.29). Conclusion: The prevalence of OML was 54.1%, with linea alba being the most commonly occurring lesion. Smoking, alcohol consumption and betel quid chewing were found to be associated with the prevalence of OPMD, which was 5.6%

    Oral mucosal lesion detection accuracy post lectures and tests in clinical dental students

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    The oral medicine field of dentistry comprises learning to diagnose oral soft tissue disease and is taught from the third year of dental school. Despite long-term learning on oral medicine, there are no data on the clinical accuracy of oral mucosal lesion (OML) diagnosis by clinical dental students (CDS). Purpose: to evaluate the effectiveness of oral medicine lectures prior to community service in Tanjung Pandan, Indonesia. Methods: An observational study was done by 60 CDS, divided into 3 groups, who were tested and/or given prior lectures. OML detection was performed by CDS and re-confirmed by an oral medicine specialist. The analyses were done by t-test, ANOVA, and Cohen's Kappa. The results: Out of 615 patients, only 243 patients had OML. There was a significant difference in test scores found between groups with or without prior lectures(P=.026; P=.015). The accuracy and inter-agreement of OML detection was good with substantial agreement (AUC=.825; K=.629); however, there was fair agreement on normal variant oral lesions (AUC=.68; k=.322), and all groups failed to detect and diagnose OPMD lesions (AUC=.501; k=.003). There was a positive correlation between test #2 and AUC OML (R=.845), and with every increase in test score, the accuracy is expected to be .033 higher. Dental student OML knowledge should be upgraded by frequent oral lesion case practice. Further educational strategy is needed to develop dental student's knowledge and skill, so that they can integrate their learning into their practice

    Association of DSM-5 Betel-Quid Use Disorder With Oral Potentially Malignant Disorder in 6 Betel-Quid Endemic Asian Populations

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    IMPORTANCE Betel-quid (BQ) is the fourth most popular psychoactive agent worldwide. An emerging trend across Asia is the addictive consumption of BQ, which is associated with oral cancer and other health consequences. OBJECTIVE To investigate the validity and pattern of DSM-5-defined BQ use disorder (BUD) and its association with oral potentially malignant disorder (OPMD) among Asian populations. DESIGN, SETTING, AND PARTICIPANTS In-person interviewswere conducted from January 1, 2009, to February 28, 2010, among a random sample of 8922 noninstitutionalized adults from the Asian Betel-quid Consortium study, an Asian representative survey of 6 BQ-endemic populations. Statistical analysis was performed from January 1, 2015, to December 31, 2016. MAIN OUTCOMES AND MEASURES Participantswere evaluated for BUD using DSM-5 criteria for substance use disorder and for OPMD using a clinical oral examination. Current users of BQ with 0 to 1 symptoms were classified as having no BUD, those with 2 to 3 symptoms as having mild BUD, those with 4 to 5 symptoms as having moderate BUD, and those with 6 or more symptoms as having severe BUD. RESULTS Among the 8922 participants (4564 women and 4358 men; mean [SD] age, 44.2 [0.2] years), DSM-5 symptoms showed sufficient unidimensionality to act as a valid measure for BUD. The 12-month prevalence of DSM-5-defined BUD in the 6 study populations was 18.0%(mild BUD, 3.2%; moderate BUD, 4.3%; and severe BUD, 10.5%). The 12-month proportion of DSM-5-defined BUD among current users of BQ was 86.0% (mild BUD, 15.5%; moderate BUD, 20.6%; and severe BUD, 50.0%). Sex, age, low educational level, smoking, and drinking were significantly associated with BUD. Among individuals who used BQ, family use, high frequency of use, and amount of BQ used were significantly linked to moderate to severe BUD. Compared with individuals who did not use BQ, those who used BQ and had no BUD showed a 22.0-fold (95%CI, 4.3-112.4) risk of OPMD (P < .001), whereas those with mild BUD showed a 9.6-fold (95%CI, 1.8-56.8) risk (P = .01), those with moderate BUD showed a 35.5-fold (95%CI, 4.3-292.3) risk (P = .001), and those with severe BUD showed a 27.5-fold (95%CI, 1.6-461.4) risk of OPMD (P = .02). Individuals with moderate to severe BUD who used BQ and had the symptom of tolerance had a 153.4-fold (95%CI, 33.4-703.6) higher risk of OPMD than those who did not use BQ, and those with moderate to severe BUD who used BQ and had a larger amount or longer history of BQ use had an 88.9-fold (95%CI, 16.6-476.5) higher risk of OPMD than those who did not use BQ. CONCLUSIONS AND RELEVANCE This international study gathered data about BQ users across 6 Asian populations, and it demonstrates that DSM-5 symptoms could fulfill a BUD construct. Most current Asian users of BQ already have BUD, which is correlated with risk of OPMD. Among individuals with moderate to severe BUD who used BQ, tolerance and a larger amount or longer history of BQ use are the key symptoms that correlated with enhanced risk of OPMD. These findings play an important role in providing a new indication of an additional psychiatric management plan for users of BQ who have BUD

    Vitamin E (-Tocopherol) Exhibits Antitumour Activity on Oral Squamous Carcinoma Cells ORL-48

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    Cancers involving the oral cavity, head, and neck regions are often treated with cisplatin. In cancer therapy, the main target is to eliminate unwanted cancerous cells. However, reports on the nonselective nature of this drug have raised few concerns. Incorrect nutritional habits and lifestyle practices have been directly linked to cancer incidence. Nutrients with antioxidant activity inhibit cancer cells development, destroying them through oxidative stress and apoptosis. -tocopherol, the potent antioxidant form of vitamin E is a known scavenger of free radicals. In vitro study exhibited effective antitumor activity of -tocopherol on ORL-48 at 2.5 +/- 0.42 mu g/mL. Cisplatin exhibited stronger activity at 1.0 +/- 0.15 mu g/mL, but unlike -tocopherol it exhibited cytotoxicity on normal human epidermal keratinocytes at very low concentration (<0.1 mu g/mL). Despite the lower potency of -tocopherol, signs of apoptosis such as the shrinkage of cells and appearance of apoptotic bodies were observed much earlier than cisplatin in time lapse microscopy. No apoptotic vesicles were formed with cisplatin, instead an increased population of cells in the holoclone form which may suggest different induction mechanisms between both agents. High accumulation of cells in the G0/G1 phase were observed through TUNEL and annexin V-biotin assays, while the exhibition of ultrastructural changes of the cellular structures verified the apoptotic mode of cell death by both agents. Both cisplatin and -tocopherol displayed cell cycle arrest at the Sub G0 phase. -tocopherol thus, showed potential as an antitumour agent for the treatment of oral cancer and merits further research

    A hybrid prognostic model for oral cancer based on clinicopathologic and genomic markers

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    There are very few prognostic studies that combine both clinicopathologic and genomic data. Most of the studies use only clinicopathologic factors without taking into consideration the tumour biology and molecular information, while some studies use genomic markers or microarray information only without the clinicopathologic parameters. Thus, these studies may not be able to prognoses a patient effectively. Previous studies have shown that prognosis results are more accurate when using both clinicopathologic and genomic data. The objectives of this research were to apply hybrid artificial intelligent techniques in the prognosis of oral cancer based on the correlation of clinicopathologic and genomic markers and to prove that the prognosis is better with both markers. The proposed hybrid model consisting of two stages, where stage one with ReliefF-GA feature selection method to find an optimal feature of subset and stage two with ANFIS classification to classify either the patients alive or dead after certain years of diagnosis. The proposed prognostic model was experimented on two groups of oral cancer dataset collected locally here in Malaysia, Group 1 with clinicopathologic markers only and Group 2 with both clinicopathologic and genomic markers. The results proved that the proposed model with optimum features selected is more accurate with the use of both clinicopathologic and genomic markers and outperformed the other methods of artificial neural network, support vector machine and logistic regression. This prognostic model is feasible to aid the clinicians in the decision support stage and to identify the high risk markers to better predict the survival rate for each oral cancer patient

    Oral extranodal non hodgkin's lymphoma: Series of forty two cases in Malaysia

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    Background: Lymphoma is a malignant neoplasm of lymphoid tissue classified into Hodgkin's and non-Hodgkin's types. It mostly affects lymph nodes although a considerable proportion of Non-Hodgkin's cases occur in extranodal sites. Materials and Methods: Selected cases diagnosed as non-Hodgkin's lymphoma (NHL) during the period of 1980 to 2012 were retrieved from the archives of the Oral Pathology Diagnostic Laboratory, Faculty of Dentistry, University of Malaya. The sections from the formalin-fixed paraffin embedded tissue blocks were stained with H&E as well as with LCA, CD20, and CD3. Results: The mean age was 41.6 years with a male: female ratio of 1.3:1. Out of the forty two cases, nineteen were Malays, eighteen were Chinese, followed by Indians (3) and Indonesians (2). The most common site of involvement was the mandible (22.2%), followed by the maxilla and palate (19.4% each). Most of the lesions presented as a painless progressive swelling. Only thirty six cases were further subdivided into B or T cell types. The majority were B-cell type (26 cases), of these 6 cases were Burkitt's lymphomas. Only ten cases were T-cell lymphoma, with three cases of NK/T-cell lymphoma. Conclusions: In this series of 42 patients diagnosed as extranodal non-Hodgkin's lymphoma, the lesions appeared as painless swellings, mostly in men with the mandible as the most frequent site of involvement. Majority were B-cell lymphomas with Malays and Chinese being equally affected whereas lymphomas were rare in the Indian ethnicity. T-cell lymphomas were found to be common in the Chinese ethnic group

    Four-protein signature accurately predicts lymph node metastasis and survival in oral squamous cell carcinoma

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    The presence of lymph node (LN) metastasis significantly affects the survival of patients with oral squamous cell carcinoma (OSCC). Successful detection and removal of positive LNs are crucial in the treatment of this disease. Current evaluation methods still have their limitations in detecting the presence of tumor cells in the LNs, where up to a third of clinically diagnosed metastasis-negative (NO) patients actually have metastasis-positive LNs in the neck. We developed a molecular signature in the primary tumor that could predict LN metastasis in OSCC. A total of 211 cores from 55 individuals were included in the study. Eleven proteins were evaluated using immunohistochemical analysis in a tissue microarray. Of the 11 biomarkers evaluated using receiver operating curve analysis, epidermal growth factor receptor (EGFR), v-erb-b2 erythroblastic leukemia viral oncogene homolog 2 (BER-2/neu), laminin, gamma 2 (LAMC2), and ras homolog family member C (RHOC) were found to be significantly associated with the presence of LN metastasis. Unsupervised hierarchical clustering demonstrated expression patterns of these 4 proteins could be used to differentiate specimens that have positive LN metastasis from those that are negative for LN metastasis. Collectively, EGFR, HER-2/neu, LAMC2, and RHOC have a specificity of 87.5 and a sensitivity of 70, with a prognostic accuracy of 83.4 for LN metastasis. We also demonstrated that the LN signature could independently predict disease-specific survival (P = .036). The 4-protein LN signature validated in an independent set of samples strongly suggests that it could reliably distinguish patients with LN metastasis from those who were metastasis-free and therefore could be a prognostic tool for the management of patients with OSCC. (C) 2013 Elsevier Inc. All rights reserved
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