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Biomedical subjects

P Freedman

Publications and source records attributed to P Freedman.

At least 19 recordsLinked to original sources
PubMed2000

Food group intake and the risk of oral epithelial dysplasia in a United States population.

OBJECTIVES: Oral epithelial dysplasia (OED) is a histopathologic diagnosis associated with an increased risk of oral cancer. The paper explores the relationship between OED risk and food group intake. METHODS: In this case-control study, incident cases of OED were identified through two oral pathology laboratories. Controls, pair-matched 1:1 to cases on age (+/- 5 years), gender, appointment date (+/- 1 year), and surgeon, were identified through the office in which the respective case was biopsied. Exposure data were obtained via a telephone interview and mailed food-frequency questionnaire. Conditional logistic regression was used to obtain odds ratio point estimates. RESULTS: Based upon 87 matched pairs and after controlling for smoking, drinking, and other potential covariates there was an apparent inverse relationship between OED risk and the consumption of fruits and vegetables, with the intake of these foods being associated with a strong attenuating effect among smokers. OED risk decreased with increased poultry consumption, but increased modestly with bread/cereal and dairy food intake. CONCLUSIONS: This investigation provides evidence that some aspects of diet may be associated with the risk of OED. It also suggests that in oral carcinogenesis the role of diet is not simply one of a late effect.

Adult↗
PubMed2000

High frequency of allelic loss in dysplastic lichenoid lesions.

Oral lichen planus (OLP) is a common mucosal condition that is considered premalignant by some, whereas others argue that only lichenoid lesions with epithelial dysplasia are at risk of progressing into oral carcinoma. A recent study from this laboratory used microsatellite analysis to evaluate OLP for loss of heterozygosity (LOH) at loci on three chromosomal arms (3p, 9p, and 17p) (Am J Path 1997;Vol151:Page323-Page327). Loss on these arms is a common event in oral epithelial dysplasia and has been associated with risk of progression of oral leukoplakia to cancer. The data showed that, although dysplastic epithelium demonstrated a high frequency of LOH (40% for mild dysplasia), a significantly lower frequency of LOH was noted in OLP (6%), which is even lower than that in hyperplasia (14%). Such results do not support OLP as a lesion at risk for malignant transformation. As a second step of the research, we determined LOH frequencies in 61 dysplastic lichenoid lesions (mild 35; moderate 19; severe 7) using the same microsatellite markers and compared these results with data obtained from the first study and from 13 normal mucosal specimens. Dysplastic lichenoid lesions showed a high frequency of loss (54% for lichenoid lesions with mild dysplasia), but values did not differ significantly from those observed in dysplasia of similar degree without lichenoid appearance. None of the normal mucosa demonstrated LOH. Epithelial dysplasia is a sign of malignant risk, independent of lichenoid changes. Such results suggest that pathologists should search for dysplasia carefully in lesions that otherwise qualify as OLP and that caution should be used when discounting dysplasia as being merely a reactive condition in lichenoid lesions.

Adult↗
PubMed1997

Mouthwash use and dentures in relation to oral epithelial dysplasia.

This case-control study investigated the potential association between oral epithelial dysplasia (OED) and both mouthwash and denture use. Incident OED cases aged 20-79 years were identified through two oral pathology laboratories. Controls were pair-matched (1:1) to cases on age (+/- 5 years), gender, appointment date and surgeon. A telephone interview was used to obtain exposure information. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were generated using conditional logistic regression. Based upon 127 case-control pairs and after adjusting for smoking, drinking, education and either denture or mouthwash use, the OR for OED and regular mouthwash use (1+ uses/week for 6+ months) was 0.8 (95% CI, 0.4-1.5) while the OR for OED and wearing a denture was 0.7 (95% CI, 0.4-1.3). There were no clear trends of increased OED risk with increased mouthwash use or years of denture wearing. Our findings suggest that neither mouthwash nor denture use are associated positively with OED risk.

Adult↗
PubMed1996

Human papillomavirus-associated oral epithelial dysplasia (koilocytic dysplasia): an entity of unknown biologic potential.

Intraepithelial neoplasia of the female genital tract has long been associated with human papillomavirus infection. To date, there have been no previously published studies of oral dysplasia that have identified light microscopic features predictive of the presence of human papillomavirus. We identified a variant of oral epithelial dysplasia, koilocytic dysplasia, that exhibited light microscopic features suggestive of HPV infection. To determine if these microscopic features were specifically correlated with human papillomavirus infection, DNA in situ hybridization for human papillomavirus 6/11, 16/18, and 31/33/51 was performed on 31 lesions diagnosed histologically as koilocytic dysplasia. Seventeen matched control cases of conventional oral epithelial dysplasia were also analyzed for human papillomavirus. Human papillomavirus DNA was detected significantly more often (p < 0.001) in koilocytic dysplasia (80.6%) than conventional oral epithelial dysplasia (0.0%). Positive cases of koilocytic dysplasia contained either intermediate-risk (31/33/51) or high-risk (16/18) human papillomavirus types whether or not they contained low-risk human papillomavirus types (6/11). The histologic and clinical presentation of koilocytic dysplasia was unique. Lesions demonstrated koilocytes and other microscopic characteristics of human papillomavirus infection, as well as features of conventional epithelial dysplasia. A striking male predominance was noted, as was a relatively young average age of presentation (39.0 years). On the basis of our preliminary analysis, we conclude that oral koilocytic dysplasia represents a unique pathologic entity and that the presence of human papillomavirus can be predicted on light microscopy with at least 80% accuracy. The clinical significance and potential for malignant transformation of koilocytic dysplasia remain to be investigated.

Adult↗
PubMed1995

Oral epithelial dysplasia and the development of invasive squamous cell carcinoma.

Oral epithelial dysplasia, the histopathologic marker of a premalignant disorder of the mouth mucosa, may present clinically as leukoplakia, erythroplakia, or leukoerythroplakia. Its presence in lesions of the oral mucosa is predictive by a variable rate (6.6% to 36%) of transformation to invasive squamous cell carcinoma. We studied the clinical features and microscopic slides of 308 case of oral epithelial dysplasia in our biopsy service and retrospectively evaluated 44 of these with follow-up data for transformation to invasive squamous cell carcinoma. Forty-four patients had follow-up of more than 6 months with a mean follow-up time of 18.4 months. Twenty (45%) were clinically free of disease and 15 (34%) had recurrence of the dysplasia. An additional two cases of lower grades of the disease recurred as carcinoma in situ. Invasive squamous cell carcinoma developed in seven (16%) in a mean transformation time of 33.6 months.

Adult↗
PubMed1980

Trichilemmoma of the lip: report of case.

A case of trichilemmoma of the upper lip has been presented and the entity is discussed. This particular case, similar to so many others reviewed in the literature, was mistaken for a basal cell carcinoma or verruca.

Aged↗
PubMed1975

Synchronous malignant mucoepidermoid tumor of the parotid gland and Warthin's tumor in adjacent lymph node.

A case of a malignant mucoepidermoid tumor (poorly differentiated) occurring simultaneously with a homolateral Warthin's tumor is presented. The simultaneous occurrence of two salivary gland tumors of different types is extremely rare. Only five cases have been reported in the literature. The occurrence of a malignant mucoepidermoid tumor and a Warthin's tumor in the same patient has not been previously reported.

Adenolymphoma↗