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Carcinogen biomarkers for lung or oral cancer chemoprevention trials.

The potential applicability of specific carcinogen-derived biomarkers in chemoprevention trials against lung and oral cancer is discussed. At present, there are no examples of the use of these biomarkers in chemoprevention trials, but the principle has been established in chemoprevention trials directed at aflatoxin B1-induced liver cancer. Polycyclic aromatic hydrocarbons (PAHs) and tobacco-specific nitrosamines are among the most important carcinogens invoked as causes of lung and oral cancer. Biomarkers that are potentially practical for current application in chemoprevention trials are 7,8-dihydroxy-9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene-DNA adducts, as determined by HPLC with fluorescence detection, nitrosamino acids in urine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides in urine, nicotine metabolites in urine, and metabolites of cytochrome P450 substrates in urine. Biomarkers that need further development or exploration before application in trials include 7-methylguanine in DNA, tobacco-specific nitrosamine-DNA adducts, acrolein/crotonaldehyde-DNA adducts, PAH-protein adducts, acetaldehyde-protein adducts, pyrene metabolites in urine and benzo[a]pyrene metabolites in urine. Such carcinogen derived-biomarkers could be applied in chemoprevention trials to test the hypothesis that chemopreventive agents alter carcinogen metabolic activation and detoxification and, ultimately, risk for cancer.

Anticarcinogenic Agents↗

Metabolic polymorphisms as susceptibility markers for lung and oral cavity cancer.

Lung and oral cavity cancers are causally associated with tobacco use. Alcohol is an independent risk factor for oral cavity cancer. Major classes of carcinogens present in tobacco and tobacco smoke are converted into DNA-reactive metabolites by cytochrome P450 (CYP)-related enzymes, several of which display genetic polymorphism. Individual susceptibility to cancer is likely to be modified by the genotype for enzymes involved in the activation or detoxification of carcinogens in tobacco and repair of DNA damage. Molecular epidemiological studies to assess the risk associated with metabolic polymorphisms for cancers of the lung and head and neck have shown that the overall effect of common polymorphisms is moderate in terms of penetrance and relative risk. However, some gene combinations like mutated CYP1A1/GSTM1-null genotype seem to predispose the lung and oral cavity of smokers to an even higher risk for cancer or DNA damage, although these results require confirmation in larger well defined studies that take into account the existence of ethnic variations even within the commonly defined groups. Retinoids, isothiocyanates and tea polyphenols have been identified as possible chemopreventive agents for cancers of the lung and oral cavity. While a number of trials have been conducted with retinoids or beta-carotene, the results were ambiguous and the causes are still being debated. The possible interaction of chemopreventive agents with metabolic polymorphisms as biomarkers in chemoprevention trials is discussed.

Anticarcinogenic Agents↗

Paediatric oral surgical pathology service in an African population group: a 10 year review.

The records of the Oral Pathology Services of the University College Hospital Ibadan Dental Centre contains data on 2264 biopsies between 1986-1996. There were 561 biopsies on patients aged 1-16 years representing 16.2% of total. Case notes and radiographs (where available) were retrieved and analysed for diagnosis, sex, age and site. For convenience, tissue pathology was compartmentalised into, Neoplasm (benign and malignant), cysts, and inflammatory/reactive. Neoplasm constitutes the highest with 47.6%, followed by inflammatory/reactive 27.6% and cystic lesions at 24.8%. A significant preference for male over female was noted and the mandible was also the site of preference for most of the lesions.

Adolescent↗

Retinoids: application in premalignant lesions and oral cancer.

Squamous cell carcinoma (SCC) of the oral cavity is a multistep process, progressing through a series of discrete, irreversible and complementary alterations in genes that control cell growth, death, and differentiation. In the premalignant state, the oral mucosa progresses through various grades of epithelial dysplasia, with the potential to convert to SCC. Natural and synthetic vitamin A metabolites and analogs (retinoids) were found to suppress head and neck and lung carcinogenesis in animal models, and inhibit carcinogenesis in individuals with premalignant lesions and a high risk to develop cancer of the aerodigestive tract. Likewise, retinoids prevent the development of second primary cancers in head and neck and lung cancer patients who had been treated for the first primary. These effects are thought to result from changes in the expression of genes that regulate cell growth and differentiation. Chemopreventive strategies are designed to suppress, reverse, or prevent the formation of premalignant lesions and their subsequent progression to SCC. This is a review of the application of retinoids in the chemoprevention of head and neck cancer.

Animals↗

[Therapeutic arterial embolization of oral and maxillofacial plexiform hemangioma with absolute ethanol and gelfoam particles].

OBJECTIVE: To treat arteriovenous malformations of the oral and maxillofacial region by embolization with absolute ethanol and Gelfoam particles. METHODS: Six patients with arteriovenous malformations of the oral and maxillofacial region were treated by selective embolization through the feeding arteries with absolute ethanol and Gelfoam particles. RESULTS: A follow up at 2-13.5 months after embolization showed no recurrence. Response rate is 100 percent. CONCLUSION: Alcohol and Gelfoam as an agent used to ablate high-flow vascular malformations in oral and maxillofacial region is a method of choice.

Adolescent↗

Segmental resection of the anterior mandibular arch with fibular microvascular reconstruction.

Segmental mandibular resection should be undertaken if there is a demonstrable invasion by cancer or if such invasion is suspected. Before the advent of microvascular free flaps, immediate osseous reconstruction of the anterior mandible was technically demanding and unreliable. Mandibular reconstruction with microvascular free flaps is no longer a novelty, nor is it reserved for unusually large resections. It has become the method of choice for the immediate reconstruction of defects resulting from mandibular cancer. This technique is particularly well-suited for defects of the anterior mandibular arch.

Bone Plates↗

The relationship among the polymorphisms of SULT1A1, 1A2 and different types of cancers in Taiwanese.

Sulfotransferase (SULT) enzymes play an important role in the detoxification, metabolism and bioactivation of numerous xenobiotics, many dietary and environmental mutagens, drugs, neurotransmitters and hormones. The genes for SULT1A1 and SULT1A2 contain common genetic polymorphisms that are associated with individual variations in the level of enzyme activities as well as variations of biochemical and physical properties. We developed a PCR-RFLP method to analyze the frequencies of SULT1A1 and SULT1A2 alleles among cancerous patients and normal controls in Taiwan. The results showed that SULT1A1*1 and SULT1A2*1 were in positive linkage disequilibrium. Neither SULT1A1*3 nor SULT1A2*3 were found in this study. The frequencies of SULT1A1*2 and SULT1A2*2 for hepatic, colon, lung, oral, gastric, renal and cervical cancerous patients were 3.95, 5.56, 4.92, 3.84, 2.70, 7.41 and 4.50%, respectively. No statistical significance was found for these cancer patients after comparison with normal controls (4.0%) for the allelic frequencies of SULT1A1*2 and SULT1A2*2.

Arylsulfotransferase↗

[Relation between the expression of P-gp and GST-pi in oral and maxillofacial squamous carcinoma and chemoresistance].

OBJECTIVE: To investigating the relation between the expression of P-glycoprotein and Glutathione transferase-pi and the chemoresistance. METHODS: The expressions of these two proteins in patients with oral and maxillofacial squamous carcinoma and normal oral tissues were detected by immunohistochemistry. RESULTS: The positive expression rate of P-gp and GST-pi in oral and maxillofacial malignant tumor was 57.1% and 53.6% respectively, and no expression in normal oral tissues; the expression of GST-pi was relevant to the resistance to cisplatin, while the expression of P-gp was relevant to the resistance to chemotherapeutic drug in general. CONCLUSIONS: The method of immunohistochemistry combining MTT assay in vitro may become an efficient way to predict the sensitivity to chemotherapeutic drug.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Neurofibromatosis type 1: a clinicopathological study of the orofacial manifestations in 6 pediatric patients.

Neurofibromatosis type 1 (NF1) is a relatively frequent mucocutaneous syndrome, which is transmitted as an autosomal dominant trait or which may represent neomutation. It is characterized by a variety of clinical manifestations, including multiple neurofibromas that are associated with a high risk of sarcomatous transformation. The aim of this report was to elucidate the orofacial manifestations observed in 6 pediatric patients (between 4 and 15 years of age) diagnosed with NF1. Physical, clinical, radiological, histological, and immunohistochemical studies were performed. Orofacial lesions were observed in all studied patients, located either in the soft tissues (4 cases) or centrally in the jaws (2 cases). All cases showed facial asymmetry, one of them exhibiting marked facial hemihypertrophy. All cases with soft tissue involvement were plexiform neurofibromas, while the intraosseous cases were diagnosed as solitary neurofibromas. Knowledge of the variability of presentation of orofacial soft tissue and bone manifestations of NF1 in children is necessary for prompt diagnosis.

Adolescent↗

Bulky DNA adducts and risk of cancer: a meta-analysis.

We present a meta-analysis to test the hypothesis that the presence of a high level of bulky DNA adducts in tissues is associated with an increased risk of cancer in humans. Seven articles were selected that matched the selection criteria, for a total of 691 cancer patients and 632 control subjects. In five studies the cases had lung cancer, in one oral cancer, and in one bladder cancer. Six studies measured adducts in WBCs and one in normal lung tissue around tumor tissue. Six were case-control investigations, and one was a case-control study on lung cancer nested within a cohort. Current smokers showed a statistically significant difference between cases and controls, with cases having 83% higher levels of adducts than controls (95% confidence interval, 0.44-1.22). Results were negative or contradictory in ex-smokers and nonsmokers. This observation was confirmed by sensitivity analyses. Publication bias does not seem to be a problem. Despite some methodological limitations, our meta-analysis shows that current smokers with high levels of adducts have an increased risk of lung and bladder cancers. This conclusion also suggests that similar (aromatic) compounds may be involved in the etiology of both types of cancer.

Biomarkers, Tumor↗

[Flowcytometry DNA analysis of oral and maxillofacial non-Hodgkin's lymphoma].

OBJECTIVE: The purpose of this study was to investigate the relationship between the results of flowcytometry analyses of different clinical stage, location, pathologic grade and cell origin of oral and maxillofacial non-Hodgkin's lymphoma (NHL), and the diagnostic value of flowcytometry analysis in lymphoma. METHOD: This study analyzed 50 oral and maxillofacial NHL cases and 10 reactive lymph nodes (formalin fixed and paraffin embedded) by flowcytometry (FCM). RESULTS: Reactive lymph nodes were all diploid. The diploid rate of NHL was 54%, and aneuploidy rate was 46%. There was statistically significant difference between reactive lymph nodes and NHL in the DNA ploidy status and cell cycle data (SPF, CV, S + G2/M, DI). The S phase fraction (SPF) and S + G2/M had close relationship with the grade of NHL. SPF value and DNA ploidy status had no obvious relationship with the prognosis. CONCLUSION: The results suggested that the FCM had diagnostic value in NHL, especially when the morphological diagnosis was difficult. Although the cell cycle data had no prognostic value, SPF and SPF + G2/M can show the proliferative status of NHL, which can help clinical doctor select therapeutic method.

Cell Cycle↗

[Chemosensitivity testing of oral and maxillofacial cancer with biopsy specimens].

OBJECTIVE: To determine the chemosensitivity in fresh biopsy specimen of human oral and maxillofacial cancer, and the differential chemosensitivity among those drugs used popularly in clinic. METHODS: Human biopsy cancer cells were obtained from 150 oral and maxillofacial malignant tumors. The antitumor drugs tested using modified MTT assay were cisplatin (CDDP), 5-fluorouracil (5-Fu), Pinyangmycin (PYM), Paclitaxel (Taxol), Teniposide (Vm-26), Epi-adriamycin (E-ADM), Vindesin (VDS) and Methortrexatum (MTX). RESULTS: The success rate of the MTT assay was 93.33% (140 of the 150 cases). At a drug concentration of Cmax x 5, the inhibition rates of oral tumor cells were 63.76% for Vm-26, 25.93% for CDDP, 25.86% for E-ADM, 23.52% for Taxol, 22.97% for PYM, 22.08% for 5-Fu, 18.42% for VDS and 18.93% for MTX. The inhibition rate of VM26 was significantly higher than any of other seven chemotherapeutic drugs (P < 0.05). Over forty percent patients with squamous cell carcinoma showed moderate chemosensitivity to VM-26, CDDP and E-ADM, and over forty percent cases with adenoid carcinoma showed moderate chemosensitivity to Vm-26, Taxol and E-ADM. CONCLUSIONS: Most oral and maxillofacial cancers showed chemosensitivity to Vm-26, CDDP, E-ADM and Taxol. Vm-26, E-ADM and Taxol were more potent drugs than VDS, 5-Fu and MTX against oral and maxillofacial cancer cells. Chemosensitivity testing using modified MTT assay was useful in selecting antitumor drugs for patients with oral and maxillofacial cancers.

Antineoplastic Agents↗