Monica Charlotte Solomon

Cytomorphological Analysis of Keratinocytes in Oral Smears from Tobacco Users and Oral Squamous Cell Carcinoma Lesions ——A Histochemical Approach

AimTo analyse the cytomorphological features of keratinocytes in smears obtained from the oral mucosa of tobacco users and from oral squamous cell carcinoma lesions.MethodologyOral smears were obtained from clinically, normal appearing mucosa of oral squamous cell carcinoma patients (n=20) and from the mucosa of smokers (n=20), and apparently healthy individuals (n=20) were used as controls. The smears were histochemically stained and cytomorphological assessment of the keratinocytes was carried out. One‐way ANOVA (Analysis of Variance) was used for comparing the parameters among multiple groups and Tukey‐HSD test was used to compare the mean values between groups.ResultsThe mean nuclear area of keratinocytes from the mucosa of tobacco users was 46 ± 2.57 and that of the oral squamous cell carcinoma lesion was 81.54 ± 4.31. While there was a significant (P=0.001) reduction in the cellular area of keratinocytes from oral squamous cell carcinoma lesion when compared with those from oral smears of tobacco users.ConclusionCytomorphometric analysis of keratinocytes can serve as a useful adjunct in the early diagnosis of oral squamous cell carcinomas.

Clinico-pathological correlation of E-cadherin expression at the invasive tumor front of Indian oral squamous cell carcinomas: An immunohistochemical study

Background: Recent studies have indicated that although malignant cells at the invasive tumor front, bare morphological resemblance to the cells at central portion of the tumor, their molecular character differs significantly. E-cadherin is a cell-cell adhesion molecule that connects epithelial cells. This study attempts to correlate the E-cadherin expression at the invasive tumor front with tumor differentiation along with its clinico-pathological parameters. Materials and Methods: Immunohistochemical staining with E-cadherin was carried out on archival cases of primary oral squamous cell carcinomas (n = 30). The E-cadherin expression at the invasive tumor front was analyzed and was linked to clinico-pathological parameters including patient prognosis. Results: The downregulation of E-cadherin expression at the invasive tumor edge when compared with patients prognosis yielded a significant correlation (P = 0.041) but its correlation with the degree of differentiation determined was not significant (P = 0.27). Also, its association with tumor size and lymph node status was negative. Conclusions: Loss of E-cadherin expression at the invasive tumor front is an important event in the progression of oral squamous cell carcinomas. Tumors with a loss of expression of E-cadherin are those which had a poor prognosis

Osteoid osteoma of the mandible: A case report with review of the literature

Osteoid osteoma is a benign skeletal neoplasm most frequently observed in young individuals. The tumor most commonly occurs in the femur, the tibia, and the phalanges; however, jaw lesions are very rare. Herein, we report a rare case of osteoid osteoma that presented in the mandible of a 20-year-old boy. This report also reviews the cases of osteoid osteomas of the jaws that have been reported in the English literature so far.

A guise of osteosarcoma: chondroblastoma-like.

Osteosarcoma (OS) is a rare tumor arising from immature bone forming cells or through neoplastic differentiation of other immature mesenchymal cells into osteoblasts. Chondroblastoma-like OS is one of the rare forms of OS to be seen in jaw bones. Aggressive clinical behavior, osteolytic areas in the radiograph and histological presentation of chondroblastoma such as cells with grooved nuclei, typical chicken-wire calcification along with areas of tumor osteoid, implied the diagnosis as chondroblastoma-like OS. Use of reticulin stain further confirmed the diagnosis. A case of chondroblastoma-like OS is reported, emphasizing the importance of early diagnosis of aggressive jaw lesions with the help of routine radiography, histopathology, and special stains.

The Histological Spectrum of Myxoma, Myxofibroma /Fibromyxoma and Odontogenic Fibroma- "A Chicken And Egg Situation"

The spectrum of odontogenic fibroma, fibromyxoma/ myxofibroma and myxoma represents a histogenetically related but behaviourally distinct heterogenous group of benign mesenchymal neoplasms. The terminologies myxofibromas/ fibromyxomas have been used histologically in the literature in a contradictory way either synonymously to myxomas or to designate simple odontogenic fibromas/ fibromas undergoing myxomatous degeneration. This article is shedding light on the importance of these disputed terminologies and emphasizes on the required distinctions pertaining to the clinical relevance of the same along with a case-report of a clinically soft to fibrous lesion with a histological diagnosis of peripheral odontogenic myxofibroma in a 33years old male patient.

Elucidating the role of Cyclooxygenase-2 in the pathogenesis of oral lichen planus – an immunohistochemical study with supportive histochemical analysis

OBJECTIVE Oral lichen planus (OLP) is a chronic, inflammatory disorder that affects the oral mucous membrane. During an inflammatory response, several chemokines and cytokines are released by the cells of the immune system. Activation of MMPs, along with mast cell-derived chymase and tryptase, degrades the basement membrane structural proteins, resulting in basement membrane breaks. AIM To investigate the association between the COX-2 expressions, presence of intact or degranulating mast cells within the connective tissue and the extent of basement membrane discontinuity in OLP cases. METHODS This study included a total of 50 formalin-fixed paraffin-embedded specimens (FFPE) of histologically confirmed cases of idiopathic oral lichen planus. A retrospective cross-sectional analysis was carried out by immunohistochemistry to study the epithelial expression of COX-2 and by the use of special stains such as toluidine blue and periodic acid-Schiff (PAS) to study the mast cell count and basement membrane changes in the oral mucosal tissue, respectively. RESULTS There was a significant (P = 0.03) association between the COX-2 expressions and mast cell count. As the intensity of COX-2 expression increased from mild to moderate or severe, the number of mast cell count almost doubled. CONCLUSION Interaction between upregulation of COX-2, mast cell and basement membrane sets a vicious cycle which relates to the chronic nature of the disease. Inhibitors of COX-2 may reduce the inflammatory process preceding the immune dysregulation in OLP.

Expression of Mismatch Repair Protein Mlh1 in Primary Oral Squamous Cell Carcinoma in An Indian Population An Immunohistochemical Study

Background: MutL homolog 1, colon cancer, nonpolyposis type 2 (E. coli), also known as MLH1 is an integral DNA mismatch repair (MMR) gene whose role in tumorigenesis has been implicated in an extensive group of human cancers. Our study attempted to correlate MLH1 immunoexpression with different clinicopathological parameters in oral squamous cell carcinoma (OSCC) by immunohistochemical staining. Materials and method: A retrospective cross-sectional study was carried out to detect MLH1 in formalin fixed paraffin embedded (FFPE) specimens of OSCC (n=60) by immunohistochemistry. Results: Positive nuclear expression of MLH1 in tumor cells was recorded and scored. An over expressed MLH1 in well differentiated OSCC cases with a significant reduction in its expression with deteriorating histologic grade was observed (P<0.001). Also, the MLH1 immunoexpression was directly proportional to the tumor stage (P<0.05). Conclusion: The over expression of MLH1 thus reflects an attempt to amend the DNA lesions through the MMR system and restore genomic stability. Analysis of MLH1 expression may assist in prognostication and aid in designing superior treatment protocols.

Abstract 480: Analysis of the expression of EGFR, p53, cyclin D1, Bcl-2 and p16 in a cohort of 178 primary locally advanced oral squamous cell carcinoma cases: the prognostic implication

Background: Oral Squamous Cell Carcinomas comprise of a heterogeneous tumor cell population with of varied molecular characteristics; which makes prognostication of these tumors a complex and challenging issue. Thus, molecular profiling of these tumors is advantageous for an accurate prognostication and treatment planning. Study design: A retrospective study on a cohort of primary locally advanced oral squamous cell carcinomas (n = 178) of an Indian rural population Aim: • To evaluate the expression of EGFR, p53, cyclin D1, Bcl-2 and p16 in a cohort of primary locally advanced oral squamous cell carcinomas. • To assess the reliability of this panel of biomarkers for prognostication and treatment planning of locally advanced oral squamous cell carcinomas • To identify a potential biomarker that can predict the tumor response to treatment. Patient Selection: All patients who were diagnosed with locally advanced oral squamous cell carcinomas cases between the year 2009 and 2013 were reviewed. These patients were treated with radiotherapy and adjuvant chemotherapy. The maximum duration of follow-up was 5 years and the minimum follow-up time is 1 ½ years. Material and Methods: Formalin fixed paraffin embedded tumor blocks of (n = 178) of histopathologically diagnosed cases locally advanced oral squamous cell carcinomas were selected. The areas where the tumor cells appeared most aggressive were identified in the Hematoxylin and Eosin stained tissue sections of these cases. The corresponding areas were identified in the tumor blocks and two cores of 2 mm diameter for each case were obtained and tissue microarray blocks were constructed. Four microns thick sections were cut from these tissue microarray blocks. These tissue microarray sections were immunohistochemically stained for EGFR, p53 and Bcl-2 and cyclin D1 and p16. The expression of these markers by the tumor cells was evaluated in a semi quantitatively. The dat Results: In this cohort, EGFR was the most expressed in 150/178 (84%) of the cases. The expression of EGFR was significantly associated with p53 (p = .012), and with cyclin D1 (p = .011). Kaplan Meier analysis showed a significant association (p = .038) between expression of p53 and a poor prognosis. A Poisson regression analysis showed that tumors that expressed p53 had a two times greater chance of recurrence (Unadjusted IRR -95% CI 2.08 (1.03, 4.5), Adjusted IRR- 2.29 (1.08, 4.8) compared with the tumors that did not express this biomarker. Conclusion: Molecular profiling of oral squamous cell carcinomas will enable us to categorize our patients into more realistic risk groups. With biologically guided tumor characterization, personalized treatment protocols can be designed for individual patients, which will improve the quality of life of these patients. Citation Format: Monica C. Solomon, Mammadipuli Vidyasagar, Donald Fernandes, Vasudeva Guddattu. Analysis of the expression of EGFR, p53, cyclin D1, Bcl-2 and p16 in a cohort of 178 primary locally advanced oral squamous cell carcinoma cases: the prognostic implication. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 480.

Emerging strategies against head & neck cancer – A review

Cancer is attributed to be the second most common cause of morbidity and mortality in the world today after cardiovascular problems. Oral cancer comprises of a significant component of the global burden of cancer with an annual incidence of over 300,000 cases. Though efforts have been directed to tackle and curb the spread of cancer; little progress has been made in the regard and it continues to pose a threat. Numerous study methods have come to foray assisting and paving way to arrest cancer. Several new stream of drugs targeting molecular signalling pathways like those of growth signal transduction machinery in cancer cells, processes involved in cellular invasion and metastatic spread, apoptosis and the cell cycle, and tumour-related angiogenesis. Other approaches like tumour-specific antigens, targeted poisons, immunotherapy, gene therapy, telomerase therapy, DNA damage repair and nanotechnology have also come to horizon. With the advancements, in the fields molecular and biochemical analyses it has been proposed that drugs can alter and simultaneously activate several pathways that either positively or negatively regulate cell death induction. This review explains the different processes and pathways that can be targeted to strategize a treatment against head and neck squamous cell carcinoma.

Clinico–Pathological Correlation Of The Expression Of Cyclin D1 And Bcl–2 In Oral Squamous Cell Carcinomas –A Tissue Microarray Study

Oral squamous cell carcinomas (OSCC)containa heterogenous tumor cell population that are at different stages of differentiation and with different levels of proliferative potential. Hence, the behavioural pattern of individual cases is poorly predictable. Several molecules play a vital role in the step-wise process of oral carcinogenesis. A better understanding of the interaction of these molecules will help in identifying the subgroup of patients with poor outcomes. Aim and Objective:To analyse the immunohistochemical expression of the cyclin D1 and bcl-2 in oral squamous cell carcinomas. To evaluate the possible association between cyclin D1 and Bcl-2 during the progression of oral squamous cell carcinomas. Settings and Design: A systematic approach of tissue microarray technology and immunohistochemistry analysis for a cohort of oral squamous cell carcinoma patients. Materials and methods: Formalin Fixed Paraffin Embedded (FFPE) tissue blocks of histological proven cases of OSCC (n=119) were selected. Tissue microarray (TMA)paraffin blocks were constructed using a “handy tissue microarrayer”. 4 μm thick sections were cut from the TMA blocks and the sections were immunostained with cyclin D1 and Bcl2. A semiquantitative analysis of the immunohistochemical expression of these markers in the tumor cells was carried out.