Nur Mollaoglu

Expression of melanoma-associated antigens in oral squamous cell carcinoma

BACKGROUND Melanoma-associated antigens-A (MAGE-A) are expressed in a variety of tumors but not in normal tissues. Thus, their detection is highly specific to cancer cells, which makes them potential targets for the diagnosis, prognosis and also immunotherapy of neoplastic diseases. METHODS To determine the expression pattern and potential role of MAGE-A antigens in oral squamous cell carcinoma (OSCC), expression patterns of MAGE-A1-A6 and A12 were analyzed in 55 OSCC and 20 healthy oral mucosa using high-sensitive reverse transcription-nested polymerase chain reaction (RT-nPCR). RESULTS The 85.45% of tumor specimens expressed at least one of these genes. A significant correlation between the expression of MAGE-A1-A6 and A12 and malignancy was ascertained (P = 0.0001). On the contrary, none of the normal mucosal specimens expressed one of the MAGE-A subtypes. Antigen expression did not correlate with clinicopathological parameters, such as TNM classification, grading and clinical stage of OSCC. CONCLUSIONS Multiple simultaneous detection of MAGE-A1-A6 and A12 expression has been found to be more specific and sensitive than the detection of single MAGE-A antigen for the diagnostic and prognostic evaluation of OSCC. In addition, monitoring the expression of several MAGE-A subtypes may determine suitable immunotherapeutic targets. Subsequently, coexpressed genes may be warranted for developing polyvalent vaccines.

Patterns of third molar impaction in a group of volunteers in Turkey.

Abstract.The aim of this study was to investigate the different variables in mesio-vertically positioned impacted or erupted third molars in a group of volunteers in Turkey to determine the angular changes and levels of eruption radiographically using standardised panoramic radiographs. There were 213 volunteers with impacted and erupted third molars included in this study, most of whom were dental students. Standardised panoramic radiographs were taken from all the volunteers. The radiographic parameters included angulation of tooth, level of eruption, development of root, mesiodistal crown width, retromolar space, and gonial angle. Statistical analysis was done using the t-test for independent groups. It was found that the mesiodistal angulation of third molars was significantly greater while the retromolar space of third molars was significantly smaller in the impacted group (P<0.05). There was also a significant difference in retromolar space/third molar crown width ratio (P<0.05).

Expression of MAGE-A12 in Oral Squamous Cell Carcinoma

Melanoma associated-A antigens (MAGE-A) are silent in normal tissues except testis. However, they are activated in a variety of different tumors. Thus, their expression is highly specific to cancer cells. Reverse transcription-nested polymerase chain reaction (RT-nPCR) is a highly sensitive technique that has been used successfully for the detection ofMAGE genes in tissue samples. The aim of the study is to analyze the expression rate of MAGE-A12 in oral squamous cell carcinoma (OSCC) using a high sensitive RT-nPCR. Total of 57 tissue samples obtained from patients with OSCC and 20 normal oral mucosal (NOM) probes of otherwise healthy volunteers were included to this study. No expression of MAGE-A12 was observed in the non-neoplastic NOM tissues. MAGE-A12 was expressed in 49.1% of the investigated tumor samples. The correlation between malignant lesion and MAGE-A12 detection was significant (p < 0.001). It is concluded that results of this study may indicate MAGE-A12 as a useful additional diagnostic marker especially for the early detection of OSCC distinguishing neoplastic transformation and detection of occult and/or rare disseminated cancer cells. In addition, MAGE-A12 expression in OSCC may also determine a new immunotherapeutic target and might be warranted to develop vaccine for OSCC.

A novel Multiple-Marker Method for the Early Diagnosis of Oral Squamous Cell Carcinoma

Objective: Melanoma associated antigens-A (MAGE-A) expression is highly specific to cancer cells. Thus, they can be the most suitable targets for the diagnosis of malignancy. The aim of this study was to evaluate the sensitivity of multiple MAGE-A expression analysis for the diagnosis of oral squamous cell carcinoma (OSCC). Methods: Total of 70 OSSC and 20 normal oral mucosal (NOM) samples of otherwise healthy volunteers were examined for the expression of 10 different single antigens out of 12 different MAGE-A subtypes by highly sensitive reverse transcriptase polymerase chain reaction (RT-PCR) methods. The results were correlated to clinicopathological parameters of tumor samples. Results: Expression of MAGE-A was restricted to OSCC. The expression frequency of single antigen was between 10% and 55%. However, expression rate was increased up to 93% by the elevated number of genes examined. A significant correlation was found between the expression of MAGE-A and malignancy (p = 0.0001). In addition, multiple MAGE-A detection has also correlated to the incidence of lymph node metastasis, grading and advanced clinical stages. Conclusions: Analysis of multiple MAGE-A expression is more sensitive than the analysis of a single MAGE-A for the diagnostic evaluation of OSCC. Multiple MAGE-A expression analysis may be a very sensitive method to be used for the diagnosis even in the early stage of OSCC.

The effect of dental profile on daily functions of the elderly

The aim of the study was to evaluate statistically dentition and its effect on daily functions for a group of elderly volunteers. The study was conducted on 144 elderly people (86 males, 58 females) living in different nursing homes in Ankara, Turkey. Their ages varied between 60 and 100 years. Data assessed as dentition variables were number of teeth remaining and prosthesis use. Nearly 55% of the residents were edentulous and removable prosthesis users. The mean number of remaining teeth in subjects aged 60–69 was highest for all age groups in both sexes. The level of education and dental insurance of these subjects were also correlated with the dentition of elderly subjects. We found a statistically significant increase in the number of removable prosthesis users among educated and insured subjects. Functional capacity was better when the subjects had more remaining teeth or a removable prostheses. It is revealed by this study that healthy and good dentition prevents the decline of daily function and improves the social interaction and general well being of the elderly.

Does Laterally Rotated Flap Design Influence the Short-Term Periodontal Status of Second Molars and Postoperative Discomfort After Partially Impacted Third Molar Surgery?

PURPOSE To assess the influence of the surgical removal of partially impacted third molars (3Ms) and compare the effects of a 3-cornered laterally rotated flap (LRF) with primary closure (flap 1) and an envelope flap with secondary closure (flap 2) on the short-term periodontal status of the adjacent second molars (2Ms). We also assessed the postoperative complications after removal of the partially impacted 3M. MATERIALS AND METHODS A split mouth, randomized clinical study was designed. The study sample included patients with bilateral partially impacted 3Ms. The primary predictor variable was the type of flap design (flaps 1 and 2). The primary outcome variable was periodontal status (gingival recession [GR], probing depth [PD], plaque index [PI], and gingival index) of the 2Ms measured preoperatively and 90 days postoperatively. The secondary outcome variables were postoperative complications, including pain, facial swelling, alveolitis, and local wound infection. The other variables included gender, position of the 3Ms, and surgical difficulty. We performed descriptive, comparative, correlation, and multivariate analyses. RESULTS The sample included 28 patients aged 18 to 28 years. The GR, PD, and PI values with the flap 2 design were greater than those with the flap 1 design (P < .05). Facial swelling with the flap 1 design was significantly greater than with the flap 2 design on the second postoperative day (P < .05). The pain levels with the flap 1 design were significantly greater than those with the flap 2 design on the first and second postoperative days (P < .05). According to the multivariate regression analyses, flap design was closely related to the periodontal status of the 2Ms and postoperative discomfort. CONCLUSION The results of the present clinical study have shown that the flap design in partially impacted 3M surgery considerably influences the early periodontal health of the 2Ms and postoperative discomfort. However, although the 3-cornered LRF design might cause more pain and swelling, it could be the method of choice for partially impacted 3M surgery because of the early periodontal healing.

Prediction of recurrence using exfoliative cytology and melanoma-associated antigen-A mRNA analysis following wide excision of oral squamous cell carcinoma: short report

N. Mollaoglu, P. Metzler, J. Zenk, E. Nkenke, F. W. Neukam and J. Ries 
Prediction of recurrence using exfoliative cytology and melanoma‐associated antigen‐A mRNA analysis following wide excision of oral squamous cell carcinoma: short report

MAGE-A as a novel approach in the diagnostic accuracy of oral squamous cell cancer: a case report

BackgroundThe aim of this case report is to introduce the combined use of brush biopsy and measurement of MAGE-A expression in the diagnosis of oral squamous cell carcinoma (OSCC).Case reportWe report of a 49-year old male patient who was referred to our department with a persistent-suspicious looking leukoplakia. Brush biopsy and an incisional biopsy were performed following clinical diagnosis. Histopathological examination revealed no malignancy. Expression analysis of melanoma-associated antigens A (MAGE-A) using real time RT-PCR was applied to brush biopsy materials because of the high prevalence of MAGE-A determined previously in OSCCs. Results indicated significant MAGE-A3 and A4 expression pattern. Therefore, the lesion was excised completely and an early invasive carcinoma was identified.ConclusionThese results emphasize the role of brush biopsy using a tumor marker with a high expression frequency combined with a high sensitive and high specific detection system in the early diagnosis of OSCC, particularly in widespread leukoplakias.

Early findings of a novel established molecular diagnostic technique for the prediction of malignant transformation in leukoplakia.

To date, there are no objective parameters regarding the early prediction of malignant transformation in leukoplakia. Expression analysis of melanoma-associated antigens (MAGE-A) can differentiate between healthy and already malignant transformed tissues. Thus, expression analysis may also be used as an additional diagnostic tool for oral pre-malignant lesions to monitor potential malignant changes. In this study, four specimens collected from the same patient within a year were examined. Specimens were taken from the part of the lesion that displayed a rapid progression from fibroma to oral squamous cell carcinoma (OSCC). Clinically and histopathologically, the oral lesion was first diagnosed as fibroma with inflammatory infiltration, then as leukoplakia with hyperplasia, then as leukoplakia with severe dysplasia, and lastly as OSCC. Expression of MAGE-A1, -A3, -A4, -A6, -A10 and -A12 was investigated in the frozen tissue specimens using RT-PCR and quantitative real-time RT-PCR. There was no expression of MAGE-A in the specimen of fibroma with inflammatory infiltration. However, four genes were expressed by the second specimen of leukoplakia with hyperplasia. With the exception of MAGE-A1, all antigens were expressed in the specimens, which were histopathologically diagnosed as leukoplakia with severe dysplasia and OSCC. Expression analysis of six different MAGE-A genes indicated a high potential for malignant change in the specimens diagnosed as leukoplakia that eventually developed into OSCC. Thus, analysis of MAGE-A expression can predict malignant transformation in leukoplakia.

Single Disseminated Tumor Cell Detection in Peripheral Blood Sample of Patients with Oral Squamous Cell Carcinoma Using MAGE-A4

Background: Present study aimed to investigate the single disseminated tumor cells (DTC) in whole peripheral blood samples collected from patients with oral squamous cell carcinoma (OSCC) for the early detection of metastatic cells and prognosis by expression analysis of Melanoma Associated Antigen-A4 (MAGE-A4). Methods: Eighteen patients with OSCC and 14 otherwise healthy volunteers were included in this study. The QuantiGene 2.0 RNA Quantification System was used as a reagent for RNA detection and quantification, and the results were evaluated by the luminescence reader. Results: There was no DTC detected by the expression analysis of MAGE-A4 in blood samples collected from patients with OSCC. Conclusions: Detection of single DTC in peripheral whole blood samples from OSCC patients may be an effective early detection method when the suggested steps were included in the method according to the authors’ present experience.