J.G. Cowpe

Detection of field change in oral cancer using oral exfoliative cytologic study

Four smears were taken from the normal buccal mucosa of 55 oral cancer patients and 76 cancer‐free patients. In each case, two were stained by the Papanicolaou method and two underwent Feulgen hydrolysis. Quantitative assessment of nuclear area (NA) and cytoplasmic area (CA) of the Papanicolaou smears was undertaken using a semiautomatic image analysis system. DNA profiles were assessed from the Feulgen smears using a Vickers M85 microdensitometer (Vickers Instruments, York, England) and were found to be diploid for all patients. Results were then analyzed with respect to those patients who took alcohol, tobacco, combination of alcohol and tobacco, and those who took neither. A significant reduction in CA for the oral cancer group (P equals 0.001) but no change in NA (P equals 0.74) was observed. A detailed analysis of alcohol and tobacco habits could identify no significant role for these two factors, in the reduction in cytoplasmic area. Such field change may prove to be of value in predicting the development of second malignant tumors.

Quantitative cytophotometric analysis as an aid to the detection of recurrent oral cancer.

Quantitative cytophotometric analysis may be a useful adjunct to the detection of recurrence of malignancy, prior to it becoming visible, clinically. A case is reported by which DNA cytophotometry indicated recurrence on two occasions prior to its clinical diagnosis.

Evidence of field change in oral cancer

Evidence of field change in oral cancer was assessed using quantitative cytomorphometric analysis of smears taken from normal buccal mucosa in oral cancer and cancer-free patients. The nuclear areas (NA) and cytoplasmic areas (CA) were calculated using a semi-automatic image analysis system. A statistically significant reduction in CA (p = 0.002) but no change in NA was observed for the oral cancer group. This change occurred irrespective of tobacco and alcohol usage. We believe this to be the first evidence for true field change since Slaughters original hypothesis in 1946.

P53 Immunostaining As A Marker For Oral Cancer In Diagnostic Cytopathology-Preliminary Report

The expression of p53 in oral mucosal disorders is strongly associated with malignant disease. Smears from normal and malignant oral mucosa were investigated for the presence of p53 using CM1 polyclonal antibody against p53 protein. the expression of p53 in smears was compared with the expression of the marker in biopsies from these oral carcinomas. p53 was identified in eight smears from 12 biopsy positive oral cancers. It was not seen in smears from eight p53‐negative oral cancers and 40 smears from normal oral mucosa. It is suggested that expression of p53 in smears from a clinically suspicious lesion may be of value in the diagnosis of oral carcinoma.

Are post-operative radiographs necessary in the management of simple fractures of the zygomatic complex?

Post-operative radiographs are usually requested, as an adjunct to clinical judgement, in the management of fractures of the facial skeleton. Unfortunately exposure to X-irradiation is not without risk. The request for radiographs should, therefore, be justified in every case. In this retrospective survey involving 183 simple fractures of the zygomatic complex, all treated via a Gillies temporal approach, only one required a further operation, under the criteria described. The findings in this study might be taken as evidence that clinical judgement alone is sufficient for post-operative evaluation and as such offers a challenge to the accepted protocol of requesting post-operative radiographs in such cases.

Quantitative assessment of various fixatives on nuclear and cytoplasmic areas in oral cytology

SummaryBoth nuclear and cytoplasmic areas are parameters known to be of significance in the diagnosis of malignancy. However, few studies have assessed the effect of fixation on exfoliative cytology and none has looked at such influences upon oral smears. Hence the method of fixation may influence directly diagnostic cytology. The effect of three methods of fixation upon the nuclear and cytoplasmic areas of cells removed from the buccal mucosa was quantitatively assessed. The three methods employed, prior to Papanicolaou staining, were: direct immersion in diethylether and ethanol (1∶1 v/v), spray fixation (Vale Smear Fix) and air drying. Three smears from each of 21 patients were used, each slide being allocated randomly a, method of fixation. After 24h all smears were processed for Papanicolaous stain.The nuclear and cytoplasmic areas were calculated using semi-automated image analysis. No significant differences were found in the two areas whichever method of fixation was used.

Versatile mucoperiosteal retractors for cleft palate surgery

Abstract Two retractors are described for use in secondary bone grafting of alveolar clefts.