Deepa R. Mane

Anthropometric and anthroposcopic analysis of different shapes of faces in group of Indian population: A pilot study

Focus of facial identification research is to isolate features that can be considered a factor of individualization. Anthropometry and Anthroposcopy have been the most important research tools in the field of forensic anthropology. These two methods of observation and data collection are made both on the living and on skeletonized human remains. Anthropometry is a systematic study of human measurements. Morphological analysis of unmeasurable features usually is the area of anthroposcopy. Hence, this study aims to assess different human faces using anthropometry and anthroposcopy. A total of 100 subjects were included in the study, prosopic index given by Martin and Saller was used to classify facial types. An anthropometric measurement was used to assess the facial proportions and anthroposcopy for facial morphology. A significant number of subjects were of hyperleptoprosopic facial type, and with a significant sexual dimorphism observed among the Indian population. Anthroposopic analysis showed common morphological features in each prosopic indices. The findings in our study may throw light on anthropometric and anthroposcopic features of Indians and help significantly in the field of forensic anthropology.

Expression of transforming growth factor β and its correlation with lipodystrophy in oral submucous fibrosis: an immunohistochemical study.

Objective: In our routine review of Oral Submucous Fibrosis (OSMF) biopsies, we observed decreased adipose tissue even though most are from buccal mucosa. Pathogenesis of OSMF has demonstrated the role of Transforming Growth Factor β (TGF β), in causing fibrosis. This study aims to correlate the role of TGF β with loss of adipose tissue in OSMF. Study Design: From our archives, 84 OSMF cases (24 early and 60 advanced OSMF) were screened for adipose tissue. Immunoexpression of TGF β in these cases were investigated. Results: Adipose tissue was seen in 67% of early OSMF and in 13% of advanced cases. Early cases showed more intense TGF β staining of epithelium, fibroblast, macrophages and inflammatory cells than the advanced cases. Conclusion: These findings suggest that TGF β plays a key role in causing lipodystrophy in OSMF and is secreted more during early course of the disease than in advanced stage. Key words:Adipose tissue, oral submucous fibrosis (OSMF), transforming growth factor β (TGF β), lipodystrophy.

Establishment of field change by expression of cytokeratins 8/18, 19, and MMP-9 in an apparently normal oral mucosa adjacent to squamous cell carcinoma: A immunohistochemical study.

Background: Squamous cell carcinoma is the most frequent malignancy of the oral cavity. The survival rate of this malignancy has not improved from past two decades. The major factors responsible for this could be due to loco regional and distant metastatic spread. However, the other important prognostic factor is concomitant occurrence and recurrence of multiple primary carcinomas in the head and neck region, which is explained as the concept of field cancerization. The evidence to support the field change in normal mucosa of Oral squamous cell carcinoma (OSCC) through biological markers using immunohistochemistry has always been challenging. Aim: Hence, the aim of the present research is to identify changes in the expression of CK 8/18, 19, and MMP-9 to visualize field changes in the clinically normal mucosa adjacent to OSCC and compare with non neoplastic normal oral mucosa. Materials and Methods: 20 cases of OSCC with radical resection specimens were included in the study. Lesional tissue and adjacent normal looking mucosa were taken during grossing. Ten cases of non-neoplastic normal oral mucosa are also included in the study. Markers such as CK 8/18, CK 19, and MMP-9 are used by the immunohistochemical method in this present study. Result and Conclusion: The enhance expression of CK 8/18 (80%), CK 19 (70%), and MMP 9 (90%) in ANM was noted and furthermore in six ANM showing severe dysplasia with enhance expression of CK 8/18, CK 19, and MMP 9 in the apparently normal oral mucosa can suggest a field cancerization.

Expression of cytokeratin subtypes: MMP-9, p53, and αSMA to differentiate basaloid squamous cell carcinoma from other basaloid tumors of the oral cavity.

Basaloid squamous cell carcinoma (BSCC) is rare variant of oral squamous cell carcinoma (OSCC) with predilection for upper aerodigestive tract. Although it is characterized by distinct histologic features it is often confused with conventional OSCC and other basaloid tumors. The study aims to establish differentiating features of BSCC with oral basaloid tumors using immunohistochemical (IHC) markers. This retrospective study included 34 cases, including BSCC, OSCC, and basaloid tumors. IHC staining was performed with primary antibodies against cytokeratin (CK) 19, 14, 8/18, &agr;-smooth muscle actin (&agr;SMA), p53, and MMP-9. A prominent CK 19, 14, and 8/18 expression was observed in BSCC as compared with basaloid tumors suggesting of basal cell origin with undifferentiated type of tumor cells. Expression of &agr;SMA was intense in tumor cells of myoepithelial differentiation but lacked in BSCC. The intense expression of p53 and MMP-9 was noted in all basaloid malignancies. Considering standard histologic criteria in diagnosing BSCC, when in confusion with other basaloid tumors, IHC markers gain importance. Hence, enhanced expression of CK 19, 8/18, and 14 and coexistence of p53 and MMP-9 expression and negativity for &agr;SMA suggest an accurate diagnosis of BSCC.

Immunoexpression of Epithelial Mesenchymal Transition Proteins E-Cadherin, β-Catenin, and N-Cadherin in Oral Squamous Cell Carcinoma

Aims. Epithelial mesenchymal transition (EMT) is a crucial process for acquisition of malignant phenotype, aggressiveness, and metastatic capacity in neoplasms. It is characterized by loss of epithelial markers and gain of mesenchymal markers. Studies on EMT and its potential association with the histological grading are sparse in oral squamous cell carcinoma (OSCC). This study aims to evaluate the expression of EMT-associated proteins—E-cadherin, β-catenin, and N-cadherin—in different grades of OSCC. Methodology. In all, 60 cases of OSCC further subdivided into 20 cases each of well-, moderately, and poorly differentiated OSCCs were stained immunohistochemically with E-cadherin, β-catenin, and N-cadherin antibodies. The differences in the expression were evaluated using χ2 and Fisher exact tests, whereas Spearman’s correlation was used to analyze the correlation between the markers. Results. A reduced E-cadherin expression noted in 40% of the OSCCs was associated with reduced β-catenin expression in 66.6% of the cases and increase in the expression of mesenchymal N-cadherin seen in 80% of cases. This expression pattern demonstrated a significant association with histological grades. A membrane to cytoplasmic shift of E-cadherin (73.3%) and β-catenin (78.3%) increased with histological grade. A negative correlation was observed with the E-cadherin and N-cadherin localization, though it did not reach statistical significance. Conclusion. OSCC tissues had high levels of EMT phenotype as compared with the normal oral mucosa. This phenotype was characterized by reduced E-cadherin and β-catenin expression and overexpression of N-cadherin. Aberrant localization of the studied proteins was a hallmark for depicting EMT.

Validation of immunoexpression of tenascin-C in oral precancerous and cancerous tissues using ImageJ analysis with novel immunohistochemistry profiler plugin: An immunohistochemical quantitative analysis

Background: Immunohistochemistry (IHC) is a molecular technique that has grown tremendously over the years. However, the assessment is only qualitative which is subjective and causes errors. Due to this limitation, several excellent markers have not gained importance and reached clinical trials. Hence, we aimed to quantify IHC by ImageJ analysis with a novel IHC profiler plugin. ImageJ has not been tried in oral precancerous tissues with minimal attempt for matrix markers. Aim: This study aimed to validate the quantification of immunoexpression of tenascin-C (TN-C) in oral precancerous tissues and oral squamous cell carcinoma (OSCC) using ImageJ software with IHC profiler plugin. Materials and Methods: After IHC staining for TN-C and image acquisition, ImageJ analysis was performed as per the standard recommended algorithm. Assessment was done by two observers by blinding the histopathological diagnosis. The immunoscore was assessed for interobserver variability using Kohens kappa statistics. Results: All our cases were in agreement and found to be statistically significant with P < 0.005. Moderate agreement was for mild dysplasia, moderate dysplasia and oral lichen planus. Substantial agreement was for oral submucous fibrosis and OSCC and almost perfect agreement noted for cases of severe dysplasia. Conclusion: IHC can now be quantified using freely downloadable software ImageJ analysis in oral precancerous tissues and OSCC. This software with good threshold control can quantify matrix marker such as TN-C. Hence, herewith, we propose that IHC markers should be quantified using ImageJ by our entire oral pathology fraternity so as to have a standard immunoscore for all markers.

Evaluation of cannibalistic cells: a novel entity in prediction of aggressive nature of oral squamous cell carcinoma

Abstract Objective. Cellular cannibalism is a distinctive morphologic feature exclusively seen in aggressive malignancies and is defined as a large cell enclosing a slightly smaller one within its cytoplasm. This phenomenon has been illustrated in several malignancies and is correlated well with the degree of anaplasia, invasive and metastatic potential of tumor cells. However, this marker has not been extensively studied and is often unnoticed during the routine histopathological assessment of Oral squamous cell carcinoma (OSCC). Thus, the aim of this research was to evaluate the presence of cannibalistic cells (CC) and to find if there exists any association with the aggressive nature of OSCC. Materials and methods: In total, 20 neck dissection cases of OSCC with follow-up data were included in the study. The cannibalistic cells were evaluated in the lesion tissues. Cellularity of cannibalism is graded asGrade I: < 5 cells, Grade II: 6–15 cells and Grade III:> 16 cells. The data was analyzed using Fischer Exact test. Results. Out of 20 cases, all the cases showed presence of CC, Grade I in five cases, Grade II in eight cases and Grade III in seven cases. A statistically significant relation between advanced grade of cellular cannibalism and lymph node positive status (p≤ 0.001) was obtained. Conclusion. Interestingly the cases with positive lymph node metastasis demonstrated Grade 3 CC.Hence, during routine histopathological examination, the search of CC can be considered as one of the important parameters to note the aggressive nature of OSCC.

Oral pulse granuloma associated with keratocystic odontogenic tumor: Report of a case and review on etiopathogenesis.

Pulse granuloma is a distinct oral entity characterized as a foreign body reaction occurring either centrally or peripherally. It is usually seen in the periapical or in the sulcus area. Occasionally the lesions occur in the wall of the cyst, commonest being the inflammatory odontogenic cyst. Histologically, they present as eosinophilic hyaline mass with giant cell inclusions and inflammatory cells. They may show different histological characteristics, possibly related to the length of time in the tissue. Adequate recognition is important to avoid misdiagnosis. Many authors suggest that pulse granuloma results due to implantation of food particles of plant or vegetable origin into the tissue following tooth extraction. This paper aims to report a case of pulse granuloma associated with keratocystic odontogenic tumor with its histochemical and polarizing microscopic features and discuss on etiopathogenesis of pulse granuloma.

Immunohistochemical expression of Tenascin in embryogenesis, tumorigenesis and inflammatory oral mucosa.

OBJECTIVE Tenascin is a large extracellular matrix glycoprotein that plays specific role in cell matrix interaction. This protein is mainly attracted because of its oncofetal predominance expression at epithelial-mesenchymal interaction and also been associated with inflammatory response. Thus the aim was to study the expression of Tenascin within the oral cavity in a developing tooth, normal oral mucosa, squamous cell carcinoma and inflammatory mucosa and further to compare its expression in inflammatory mucosa with that of squamous cell carcinoma. DESIGN A total numbers of 92 cases were included, with 22 being all morphological stages of developing tooth, 10 cases of normal oral mucosa, 30 cases each of inflammatory gingival hyperplasia and oral squamous cell carcinoma. The intensity and pattern of expression was assessed immunohistochemically using anti-human mouse monoclonal Tenascin antibody. RESULTS AND CONCLUSION Tenascin expression in developing tooth was seen mainly at epithelial-mesenchymal junctions, but temporally reduced at cap stage. In normal mucosa TN expression was restricted only at basement membrane zone. Inflammatory gingival hyperplasia intensity of expression was enhanced at the juxtraepithelial stroma and showed reticular pattern of expression. In oral squamous cell carcinoma, intensity of expression was seen in superficial front of the stroma and also around tumour islands with intraepithelial expression and predominantly showed fibrillar pattern of expression. Furthermore, Tenascin expression was noticed around neovascularization. Hence, there is a regulatory system in Tenascin expression and plays a vital role in embryogenesis, tumerogenesis and inflammation in remodelling the stroma for cell migration and also for healing.

Efficacy of stereomicroscope as an aid to histopathological diagnosis.

Grossing and microscopic examination of the received specimens in a histopathological laboratory is a routine procedure for achieving a fi nal diagnosis. Errors in either of the steps may lead to an inaccurate diagnosis since wrong orientation of the specimen may either cause diagnostic delays or pose a diagnostic dilemma. Stereomicroscope is an important accessory instrument which can be used to study a variety of specimens. It not only enables us to study the surface details but also aids in minute work including dissection and microsurgery to name a few. Aim: To assess the effectiveness of stereomicroscope in routine grossing and its role in arriving at a final diagnosis. Materials and Methods: Cases from the archives of the department for which stereomicroscopic evaluation was done were retrieved and reviewed. Results and Conclusion: Stereomicroscopic images aided not only in the proper orientation of the specimen but also in the diagnosis.