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Dental xeroradiography as an adjunct in the evaluation of oral cancer: a preliminary report.

This pilot study of an experimental dental xeroradiography imaging system involved twelve oral cancer clinic patients. Xeroradiographs were compared with conventional intraoral film radiographs, taken with similar x-ray projections. The new dental xeroradiographic system was judged superior for the imaging of both osseous and soft-tissue structures. Especially significant was the new imaging system's ability to portray early bone erosion not detectable with the conventional intraoral film technique. These results point to the need for controlled clinical evaluations of dental xeroradiography, in order to assess the full potential of this rapid, low-radiation imaging system in the evaluation of oral cancer.

Bone Resorption↗

The clinical and histopathologic features of a series of 464 oral squamous cell papillomas.

A clinical and histopathologic analysis of 464 oral squamous cell papillomas is presented. Data on age, sex, race, location, clinical appearance, duration, recurrence, and clinical diagnosis are reviewed. One hundred seventy-six of the 464 specimens were examined for hyperkeratosis, character and amount of inflammatory infiltrate, and evidence of cellular atypia. The trends seen in this study support claims made by previous authors regarding incidence and inflammatory involvement. The data support a slightly higher occurrence rate in males than in females and in white as opposed to black patients. Papillomas were most abundant on the palatal complex, dorsum and lateral tongue borders, and lower lips, respectively. Confusion of papilloma for fibroma in the clinical diagnosis was less common than expected. Recurrence rate and incidence of multiple papillomas were low. Histologic study revealed a tendency for hyperkeratotic lesions to arise from nonkeratinized oral sites. Cellular atypia was found, but it is still unclear whether these changes are preneoplastic or due to an increased growth rate.

Adolescent↗

Inflammatory pseudotumors in the buccal tissues of children.

Inflammatory pseudotumor is a nonneoplastic lesion of unknown origin. Most cases occur in the respiratory tract or orbit. This study reports three cases, all involving children, of rapidly enlarging masses in the soft tissues of the oral cavity. They were initially suspected to be malignant but proved to be inflammatory pseudotumors. The histologic appearance was that of a fibroproliferative process containing chronic inflammatory cells. The pleomorphism and mitotic activity of the fibroblasts were worrisome features. Regression without sequelae occurred in all three patients.

Child↗

Vitamin E inhibition of hamster buccal pouch carcinogenesis. A gross, histologic, and ultrastructural study.

Sixty-four young adult male and female golden hamsters (Mesocricetus auratus) were divided into four equal experimental groups of sixteen animals. In Group 1 animals the left buccal pouch was painted three times weekly with a 0.25 percent solution of 7, 12-dimethylbenz(a)anthracene (DMBA) in heavy mineral oil. In Group 2 animals the left buccal pouch was similarly painted with DMBA, but the animals also received 7 I.U. of vitamin E (alpha tocopherol) twice weekly on days alternate to the DMBA painting. The vitamin E was administered orally via a fine pipette. Group 3 animals were similarly painted with DMBA and received vitamin E vehicle by pipette. Group 4 animals served as untreated controls. Four animals in each group (two male, two female) were killed at 8, 10, 12, and 14 weeks. Buccal pouches were photographed and excised. Tumors were noted and measured in the left buccal pouches. The buccal pouches as well as major organs were fixed in formalin, sectioned in paraffin, and stained with hematoxylin and eosin. In the Group 2 animals receiving vitamin E, there was a significant delay in tumor formation so that by 12 to 14 weeks there were fewer tumors and their average size was smaller than those in the Group 1 and Group 3 animals painted with DMBA but receiving no vitamin E supplement. Microscopic examination revealed that there was less invasion of underlying tissues and less surface necrosis. The tumors in both control and vitamin E groups were well-differentiated epidermoid carcinomas. No differences in the nature of the cellular patterns of the carcinomas in control and vitamin E groups were revealed by electron microscopic studies.

9,10-Dimethyl-1,2-benzanthracene↗

Two-phase carcinogenesis in hamster buccal pouch.

A two-phase mechanism of chemical carcinogenesis in hamster buccal pouch has been demonstrated. Painting of buccal pouches three times weekly with a 0.1 percent solution of 7,12-dimethylbenz(a)anthracene (DMBA) in mineral oil for 10 weeks resulted in no visible tumors nor any microscopic evidence of dysplasia after the animals had been maintained for a 20 week period (Group 1 animals). Painting with 0.1 percent DMBA for 10 weeks, no treatment for a following 6 week period, and painting with 0.5 percent DMBA for a subsequent 4 weeks resulted in epidermoid carcinomas (Group 2 animals). Painting with 0.5 percent DMBA for 4 weeks in animals without prior treatment resulted in no tumors (Group 3 animals). It is postulated that the early treatment in Group 2 may serve for initiation and the later treatment for promotion.

9,10-Dimethyl-1,2-benzanthracene↗

A transplantable anaplastic oral cancer model.

A stable model has been developed for oral mucosal anaplastic epidermoid carcinoma. This model more closely resembles the biologic characteristics of human oral carcinoma than previous models, such as primary epidermoid carcinomas induced in hamster buccal pouches or tongue by chemical carcinogens. This anaplastic oral cancer model was developed by serial abdominal transplantation in neonatal hamsters of original DMBA-induced primary epidermoid carcinomas of hamster buccal pouch. After the second generation, the tumors became stable, maintained an anaplastic appearance histologically, and were biologically aggressive, with rapid growth and metastatic potential. The original DMBA-induced buccal pouch tumors from 42 adult hamsters were transplanted abdominally through five generations in 151 neonatal hamsters. Immunosuppression was crucial in the initial transplantation but became unnecessary in the later serial transplantations. This model can serve as the basis for a variety of future immunologic and biologic studies dealing with oral cancer.

9,10-Dimethyl-1,2-benzanthracene↗

Initiation and promotion in experimental oral carcinogenesis.

A subthreshold dose of 0.1% DMBA in oil applied to hamster buccal pouch three times a week for 10 weeks did not result in the development of carcinoma in up to 25 weeks from the start of the experiment. However, if the subthreshold dose of DMBA was followed by 6 weeks of no treatment and six weeks of 40% benzoyl peroxide treatment, carcinomas developed rapidly. Both benzoyl peroxide and its acetone solvent are noncarcinogenic. An experiment carried out on sixty-six young adult male and female Syrian hamsters demonstrated these results, using appropriate controls.

9,10-Dimethyl-1,2-benzanthracene↗

Monoclonal antibodies against squamous cell carcinoma.

We report on a monoclonal antibody reactive with squamous carcinoma cell lines and with frozen sections from squamous cell carcinomas of the oral cavity but not with frozen sections of normal squamous epithelium of the oral cavity, esophagus, and skin. In addition, we identified other monoclonal antibodies with restricted specificity as reflected by their binding to a panel of established tumor cell lines. Subsequent testing of these monoclonal antibodies against a panel of normal and tumor tissue sections revealed two types of reactivity patterns: binding to normal tissue and binding to normal and tumor tissue.

Animals↗

Loss of intercellular substance antigens in oral hyperkeratosis, epithelial dysplasia, and squamous cell carcinoma.

Tissues from 20 oral squamous cell carcinomas and 32 leukoplakic lesions were investigated for the presence of intercellular substance antigens by the indirect immunofluorescent technique using sera from patients with proven pemphigus vulgaris. The leukoplakic lesions included 19 hyperkeratoses without histologic evidence of dysplasia and 13 hyperkeratoses with varying degrees of epithelial dysplasia. Oral tissues from 20 healthy subjects were included as a control group. The great majority of squamous cell carcinomas (95%) showed partial or complete loss of the intercellular substance antigen reactivity. Similarly, hyperkeratoses with dysplasia demonstrated, in 92% of the cases, decreased or complete absence of intercellular substance antigen reactivity. Furthermore, the degree of antigenic loss seemed to be directly related to the degree of cellular anaplasia. On the other hand, in the hyperkeratosis group without histologic signs of epithelial dysplasia, retention of normal intercellular substance antigenic pattern was observed in 73.7% of the cases as compared to the control specimens. The authors suggest that further studies are necessary to assess what value lies in determining the loss of epithelial antigens in predicting the malignant potential of dysplastic oral epithelium.

Antigens↗

Benzydamine hydrochloride in prevention and management of pain in oral mucositis associated with radiation therapy.

Benzydamine hydrochloride rinse reduced pain associated with radiation mucositis when it was used during the course of radiation therapy. Fewer patients using benzydamine rinse required systemic analgesics. All patients using benzydamine tolerated the rinse well and continued with regular rinsing throughout the course of radiation therapy. Benzydamine hydrochloride is currently undergoing clinical trials in the United States for application for approval from the Food and Drug Administration.

Adult↗

Oral cancer induced in hamsters with herpes simplex infection and simulated snuff dipping.

A number of epidemiologic studies indicate that snuff dipping is associated with an increased incidence of oral cancer in human beings. Since inactivated herpes simplex virus (HSV) has been shown to induce malignant changes in vitro and in vivo and is partially inactivated by snuff water extract, we examined the histopathologic changes of hamster buccal pouches after exposure to repeated HSV inoculation combined with long-term simulated snuff dipping. One hundred twenty-five Syrian hamsters were divided into seven groups, and the buccal pouches were inoculated with HSV-1, HSV-2, or culture medium. The mock and HSV inoculations were done once a month for 6 consecutive months. In an effort to determine the effect of snuff on the mock- or HSV-inoculated buccal pouches, a consistent amount of a commercially available snuff was placed into both the right and left pouches twice a day in half of the animals. At the end of the 6 months of simulated snuff dipping (4 weeks after the final mock or viral inoculation), the hamsters were killed and the buccal pouches were removed for the histopathologic evaluation. Neither simulated snuff dipping nor HSV infection alone induced neoplastic changes in hamster buccal pouches. However, HSV infection in combination with simulated snuff dipping resulted in epithelial dysplasia and invasive squamous cell carcinoma in more than 50% of the animals.

Animals↗

Detection of human papillomavirus DNA in oral mucosal lesions using in situ DNA-hybridization applied on paraffin sections.

The in situ DNA hybridization technique, carried out under stringent conditions, was used to detect human papillomavirus (HPV) DNA of types 6, 11, and 16 in paraffin sections of 32 surgically treated oral mucosal lesions. Expression of HPV structural proteins was analyzed by means of the immunoperoxidase (IP-PAP) method. A total of 10 (31.3%) of the 32 lesions proved to express HPV antigens, which were found in 4 of 7 squamous cell papillomas, in 2 of 2 classic condylomas, in 2 of 10 papillary hyperplasias, and in 2 of 3 leukoplakia lesions. Two of the squamous cell papillomas contained HPV 6 DNA, and 4 additional lesions were positive for HPV 11 DNA. In one of the condylomas, a double infection by HPV 6 and 11 was found, while the second was positive for HPV 11 alone. Both the HPV antigen-positive papillary hyperplasias contained HPV 6 DNA, as did the HPV antigen-positive leukoplakia lesions. Of the latter, one was infected by HPV 6 and 11. DNA of the "high-risk" HPV 16 was contained in two lesions: one lichen planus lesion and one of the two squamous cell carcinomas. The results confirm the previously reported evidence of HPV involvement in oral mucosal lesions. The implications of these findings are discussed in terms of the well-established premalignant character of oral leukoplakia and oral lichen planus, although far less commonly versus leukoplakia, with special emphasis on the discovery of the "high-risk" HPV 16 in the latter as well as in oral cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Oral condyloma planus (hairy leukoplakia) among homosexual men: a clinicopathologic study of thirty-six cases.

Thirty-six cases of oral condyloma planus (hairy leukoplakia) occurring in homosexual men are reported. The average age is 36.6 years, with a range from 24 to 51 years, and the disorder exhibits a predilection for the fourth decade. More than 86% of the cases are localized to the tongue (72% lateral border, 14% ventral surface). Microscopically, surface candidiasis could be detected with periodic acid-Schiff staining in 88% of the instances. Parakeratosis with koilocytotic atypia was the characteristic histologic finding; however, comparison with twenty-five cases of leukoplakias exhibiting parakeratosis and twenty-five cases of candidiasis among heterosexual individuals disclosed that koilocytotic changes are not specific for condyloma planus. Follow-up data were obtained in thirty-two cases with a mean of 11 months. During this period six patients died or were hospitalized with a diagnosis of acquired immunodeficiency syndrome.

Adult↗

Cylindrical cell papilloma. Report of a case with light and ultrastructural analysis.

The clinicopathologic features of an additional case of cylindrical cell papilloma are reported. This tumor is relatively rare, with approximately twenty cases recorded under that name in the literature. Surgical correction of papillomas in the nose and paranasal sinuses is discussed. Ultrastructural analyses suggest that cylindrical cell papilloma may possibly be an oncocytic lesion and thus different from the inverted and fungiform types.

Humans↗

The therapeutic effect of an aromatic retinoid (RO-109359) on hamster buccal pouch carcinomas.

Forty male hamsters were divided into three groups. Group 1 (16 animals) received topical applications with a 0.5% solution of DMBA in liquid paraffin on the right buccal pouch for 16 weeks. Group 2 (16 animals) received DMBA for 16 weeks, plus the retinoid RO-109359 three times during the 17th week in doses of 200 mg/kg. Group 3 (8 animals) remained untreated for 16 weeks and, during the 17th week, received the retinoid as in group 2. After administration of the retinoid, a marked regression in the size of the carcinomas of the right pouch in group 2 animals was observed clinically. Histologically, these tumors consisted mostly of large necrotic areas and showed an excessive keratin loss. Although the hypervitaminosis A symptoms could not be avoided, the findings suggest that high doses have a therapeutic effect on hamster buccal pouch carcinomas.

9,10-Dimethyl-1,2-benzanthracene↗