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O68. Association of the oral microbiome with cigarette smoking and oral cancer
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Abstracts, A. Kale / Oral Oncology 47 (2011) S28–S73
a hamartoma that may sometimes present as mass in the cyst wall. Extremely rare cases of AOT has been reported to arise in a dentigerous cyst and unicystic ameloblastomas. A rare case report has also shown the presence of dentinoid in the wall of an OKC. The adenomatoid odontogenic tumor has been never reported to arise in the wall of an odontogenic keratocyst.It may be suggested that the development of AOT like features in a cyst may be a secondary change and that the secondary change could influence the overall prognosis of the primary lesion and its management accordingly. Hamartomas generally are benign and never fatal except that they may enlarge to cause disfigurement. Can the occurrence of an AOT potentiate the aggressiveness of OKC and change management needs to be studied and elucidated? doi:10.1016/j.oraloncology.2011.06.178
O68. Association of the oral microbiome with cigarette smoking and oral cancer I. Ganly *,a, L. Yang b, L. Morris a, F. Palmer a, H. Deng c, J. Ahn b a Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA b NYU School of Medicine, New York, NY 10016, USA c Rockefeller University, New York, NY 10065, USA
Objectives: To determine if cigarette smoking and oral squamous cell carcinoma (OSCC) are associated with an alteration of the oral microbiome, and to determine if the oral microbiome is capable of activating cigarette carcinogens. Methods: Oral wash samples were collected from 9 patients with OSCC and 10 non-cancer controls (including 5 smokers and 5 non-smokers). Bacterial DNA was isolated from each oral wash and then 16S rRNA gene survey performed by 454 pyrosequencing of the V3–5 region to identify bacterial sequences present in oral wash samples. Bacterial sequences present in OSCC patient samples and in control patient samples were then categorized. Also, a mock community, composed of 5 bacterial species found in the oral microbiome, was tested for its ability to metabolize cigarette carcinogens. Results: Samples of the oral microbiome were classified into type I and type II microbiomes, based on taxonomic similarity between samples. The type I microbiome was dominated by Grampositive bacteria whereas the type II microbiome was dominated by Gram-negative bacteria. Non-cancer control patients had the type I microbiome (9/10). In contrast, OSCC patients had the type II microbiome (6/9). Furthermore, OSCC was associated with an apparent decrease in the relative abundance of Streptococcus (22.3%) compared with non-smoking (39.4%) and smoking controls (40.1%). There was a step-wise increase in the relative abundance of Veilonella along the non-smoking controls (2.3%) ? smoking controls (6.8%) ? OSCC (9.9%) sequence. Metabolomic analysis demonstrated that a mock bacterial community composed of Streptococcus mitis and Veilonella dispar was able to hydroxylate N-nitrosodiethylamine and degrade p-chloroaniline, both being carcinogens found in cigarette smoke. Conclusions: Cigarette smoking and oral squamous cell carcinoma are associated with an alteration of the oral microbiome. The oral microbiome has the potential to modulate oral cancer risk by activating cigarette carcinogens. doi:10.1016/j.oraloncology.2011.06.179
O69. Expression of cytokeratin subtypes, MMP-9, p53 and a SMA to differentiate basaloid squamous cell carcinoma from other basaloid tumors of the oral cavity D. Mane *, A. Kale KLE Institute of Dental Sciences, KLE University, India Introduction: Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of oral squamous cell carcinoma (SCC) with predilection for upperaerodigestive tract. Here with we report 10 new cases of BSCC which were clinically diagnosed as SCC but on histologically satisfied the criteria of Wain et al. to be diagnosed as BSCC. It has distinct histological features but still frequently been confused with other basaloid tumors of oral cavity, like conventional SCC, adenosquamous cell carcinoma (ADSCC), adenoid cystic carcinoma (ACC), mucoepidermoid carcinoma (MEC), salivary ductal carcinoma (SDC), basal cell adenocarcinoma (BCA) and ameloblastic carcinoma (ABC). Hence the aim is to establish differentiating features of BSCC with that of other oral basaloid tumours by means of immunohistochemical (IHC) expression of cytokeratin (CK) subtypes, MMP-9, p53 and a SMA. Material and method: Retrospective study included 34 cases with 10 cases each of BSCC and conventional SCC, four cases of ACC, two cases each of ADSCC, MEC, SDC and BCA and ABC. IHC staining was done by using primary antibodies for CK-14, CK-8/18, CK-19, MMP-9, p53 and a SMA Results: There was enhance expression of all CK subtypes, MMP9, p53. Whereas negative expression of a SMA in all cases of BSCC. Discussion: CK-19 enhance expression in BSCC can be correlated with the concept that CK-19 down regulation plays a key role in terminal differentiation of superficial squamous cells with degree of keratinisation, where in BSCC majority being basaloid cells. Similarly CK-8/18 embryonic mucosal marker and CK-14 basal cell marker of non keratinized mucosa, their enhance expression in majority of BSCC cases can further help in differentiating with other basaloid tumors. Furthermore with negative a SMA can be distinctly differentiated with other myoepithelial differentiated tumors. Its expression was enhanced in peripheral tumour cells of ACC, epidermoid component of MEC, focal in SDC and BCA. Expression of prognostic markers like p53 and MMP-9 was consistently present in all our high grade malignancies. Hence enhance expression of CK-19, CK-14, CK-8/18 and co-existence of p53 and MMP-9 expression but negative for a SMA suggests an accurate diagnosis of BSCC. doi:10.1016/j.oraloncology.2011.06.180
O70. Estimation of folic acid levels in oral submucous fibrosis and its implications in the etiopathogenesis S. Hallikerimath *, A. Kale KLE Institute of Dental Sciences, KLE University, India Introduction: Oral Submucous fibrosis (OSMF) is a chronic disease of insidious onset. At any stage in the disease the overlying epithelium may become the site of non specific ulceration, dysplastic change or malignant transformation and hence a premalignant condition of major concern. To date most of the studies have emphasized the role of local irritants and their chemical constituents acting locally on the oral mucosa for development of OSMF. If only this was true every person in contact with irritants would have developed the disease, which is not so. Alongside the role of local irritants such as areca nut capsaicin, tobacco, pungent, spicy foods and alcohol, an equally important second aspect which needs to be considered is the pre-conditioning of the oral mucosa following pro-
Abstracts, A. Kale / Oral Oncology 47 (2011) S28–S73
a hamartoma that may sometimes present as mass in the cyst wall. Extremely rare cases of AOT has been reported to arise in a dentigerous cyst and unicystic ameloblastomas. A rare case report has also shown the presence of dentinoid in the wall of an OKC. The adenomatoid odontogenic tumor has been never reported to arise in the wall of an odontogenic keratocyst.It may be suggested that the development of AOT like features in a cyst may be a secondary change and that the secondary change could influence the overall prognosis of the primary lesion and its management accordingly. Hamartomas generally are benign and never fatal except that they may enlarge to cause disfigurement. Can the occurrence of an AOT potentiate the aggressiveness of OKC and change management needs to be studied and elucidated? doi:10.1016/j.oraloncology.2011.06.178
O68. Association of the oral microbiome with cigarette smoking and oral cancer I. Ganly *,a, L. Yang b, L. Morris a, F. Palmer a, H. Deng c, J. Ahn b a Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA b NYU School of Medicine, New York, NY 10016, USA c Rockefeller University, New York, NY 10065, USA
Objectives: To determine if cigarette smoking and oral squamous cell carcinoma (OSCC) are associated with an alteration of the oral microbiome, and to determine if the oral microbiome is capable of activating cigarette carcinogens. Methods: Oral wash samples were collected from 9 patients with OSCC and 10 non-cancer controls (including 5 smokers and 5 non-smokers). Bacterial DNA was isolated from each oral wash and then 16S rRNA gene survey performed by 454 pyrosequencing of the V3–5 region to identify bacterial sequences present in oral wash samples. Bacterial sequences present in OSCC patient samples and in control patient samples were then categorized. Also, a mock community, composed of 5 bacterial species found in the oral microbiome, was tested for its ability to metabolize cigarette carcinogens. Results: Samples of the oral microbiome were classified into type I and type II microbiomes, based on taxonomic similarity between samples. The type I microbiome was dominated by Grampositive bacteria whereas the type II microbiome was dominated by Gram-negative bacteria. Non-cancer control patients had the type I microbiome (9/10). In contrast, OSCC patients had the type II microbiome (6/9). Furthermore, OSCC was associated with an apparent decrease in the relative abundance of Streptococcus (22.3%) compared with non-smoking (39.4%) and smoking controls (40.1%). There was a step-wise increase in the relative abundance of Veilonella along the non-smoking controls (2.3%) ? smoking controls (6.8%) ? OSCC (9.9%) sequence. Metabolomic analysis demonstrated that a mock bacterial community composed of Streptococcus mitis and Veilonella dispar was able to hydroxylate N-nitrosodiethylamine and degrade p-chloroaniline, both being carcinogens found in cigarette smoke. Conclusions: Cigarette smoking and oral squamous cell carcinoma are associated with an alteration of the oral microbiome. The oral microbiome has the potential to modulate oral cancer risk by activating cigarette carcinogens. doi:10.1016/j.oraloncology.2011.06.179
O69. Expression of cytokeratin subtypes, MMP-9, p53 and a SMA to differentiate basaloid squamous cell carcinoma from other basaloid tumors of the oral cavity D. Mane *, A. Kale KLE Institute of Dental Sciences, KLE University, India Introduction: Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of oral squamous cell carcinoma (SCC) with predilection for upperaerodigestive tract. Here with we report 10 new cases of BSCC which were clinically diagnosed as SCC but on histologically satisfied the criteria of Wain et al. to be diagnosed as BSCC. It has distinct histological features but still frequently been confused with other basaloid tumors of oral cavity, like conventional SCC, adenosquamous cell carcinoma (ADSCC), adenoid cystic carcinoma (ACC), mucoepidermoid carcinoma (MEC), salivary ductal carcinoma (SDC), basal cell adenocarcinoma (BCA) and ameloblastic carcinoma (ABC). Hence the aim is to establish differentiating features of BSCC with that of other oral basaloid tumours by means of immunohistochemical (IHC) expression of cytokeratin (CK) subtypes, MMP-9, p53 and a SMA. Material and method: Retrospective study included 34 cases with 10 cases each of BSCC and conventional SCC, four cases of ACC, two cases each of ADSCC, MEC, SDC and BCA and ABC. IHC staining was done by using primary antibodies for CK-14, CK-8/18, CK-19, MMP-9, p53 and a SMA Results: There was enhance expression of all CK subtypes, MMP9, p53. Whereas negative expression of a SMA in all cases of BSCC. Discussion: CK-19 enhance expression in BSCC can be correlated with the concept that CK-19 down regulation plays a key role in terminal differentiation of superficial squamous cells with degree of keratinisation, where in BSCC majority being basaloid cells. Similarly CK-8/18 embryonic mucosal marker and CK-14 basal cell marker of non keratinized mucosa, their enhance expression in majority of BSCC cases can further help in differentiating with other basaloid tumors. Furthermore with negative a SMA can be distinctly differentiated with other myoepithelial differentiated tumors. Its expression was enhanced in peripheral tumour cells of ACC, epidermoid component of MEC, focal in SDC and BCA. Expression of prognostic markers like p53 and MMP-9 was consistently present in all our high grade malignancies. Hence enhance expression of CK-19, CK-14, CK-8/18 and co-existence of p53 and MMP-9 expression but negative for a SMA suggests an accurate diagnosis of BSCC. doi:10.1016/j.oraloncology.2011.06.180
O70. Estimation of folic acid levels in oral submucous fibrosis and its implications in the etiopathogenesis S. Hallikerimath *, A. Kale KLE Institute of Dental Sciences, KLE University, India Introduction: Oral Submucous fibrosis (OSMF) is a chronic disease of insidious onset. At any stage in the disease the overlying epithelium may become the site of non specific ulceration, dysplastic change or malignant transformation and hence a premalignant condition of major concern. To date most of the studies have emphasized the role of local irritants and their chemical constituents acting locally on the oral mucosa for development of OSMF. If only this was true every person in contact with irritants would have developed the disease, which is not so. Alongside the role of local irritants such as areca nut capsaicin, tobacco, pungent, spicy foods and alcohol, an equally important second aspect which needs to be considered is the pre-conditioning of the oral mucosa following pro-