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The role of plasma micronutritions in relation to risk of oral cancer in Taiwan
Poster I I / T u m o r Surgery/Tumor Biology observed in almost all neoplastic cells. Almost tumor cells showed DPD expression in tubular type and cribriform type of ACC, whereas restricted number of tumor cells showed DPD expression in solid type of ACC. Our results suggest that except for patients with solid type of ACC, malignant salivary neoplasms may be resistant to 5-Fu.
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EOSINOPHILIC ULCER OF THE MANDIBULAR GINGIVA OF A CHILD - REPORT OF A CASE
S. Nagaoka 1 , M. Yoshida 1 , K. Ohtsuki 1 , M. Ohnishi 1 , Y. Hirata 3, H. Maeda 2 , Y. Kameyama 3. 1Department of Oral&Maxillofacial Surgery,
Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan; 2Department of Pathology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan; 3Maxillofac, Japan The purpose of the present study was to report a case of eosinophilic ulcer of the mandiblar gingiva in a child. The patient was a 5-yearold female who had suffered an indurated ulcer on the right mandibular gingiva of two month's duration. The tissue of excisional biopsy was examined histologically, histochemically and immunohistochemically. Immunohistochemical staining for S-100, CD15, CD68, PCNA and Ki67(MIB-1)antigens were performed on formalin-fixed, paraffinembedded sections using the avidin-biotin peroxidase complex (ABC) method. The lesion in the right mandibular gingiva between cuspid and premolar healed without any additional treatment after excisional biopsy in spite of the clinical finding similar to carcinomatous ulcer. X-ray and CT photographs showed no alveolar bone resorption under the lesion. Plural mandiblar limph nodes were recognized. The density of eosinophil in the blood-constituents was at the safty level (2.8%). Histologically, the lesion consisted of granulomatous tissue with a mixed infiltrate containing large mononuclear histiocytes with slight atypia, eosinophilis and lymphocytes. Histochemically, the lesion showed many mast cells. Immunohistochemically, many S-100, CD15, CD68, PCNA and Ki67 (MIB-1) positive cells were recognized. Based on the above findings, the lesion was diagnosed as eosinophilic ulcer of the gingiva. Only two cases of eosinophilic ulcer have been reported previously in Japan. The importance of eosinophilic ulcer is that it may simulates malignant lesion and may lead to overtreatment because of florid and ulcerative process.
•2•]
RELIEVING SYMPTOMS OF XEROSTOMIA WITH ORAL PILOCARPINE (SALAGEN) DURING IRRADIATION IN HEAD-AND-NECK CANCER
Z. Ny~r~dy 1 , ,&. N6meth 2, ,&. B~n 1 , I. Ember 2, L. Olasz 1 . 1Department
of Oral and Maxillofacial Surgery, University P~cs, P&cs, Hungary; 2Department of Public Health, University P~cs, P~cs, Hungary A common complication of irradiation of the head-and-neck is xerostomy. Pilocarpine, a muscarine agonist, is long used for treating patients with postirradiative xerostomia. In our randomized study the aim was to compare the antixerostomic effectiveness of orally administered pilocarpine chloratum (Salagen) during and after irradiation. Between October 1999 and October 2003 we treated 60 patients with head-and-neck cancer irradiation as a part of our complex protocoll. Patients were distributed randomly in two groups. They received minimum 50Gy irradiation to the head-and-neck. They had to have at least both parotids and two of their other major salivary glands retained. One group received 15 mg pilocarpine chloratume (Salagen) per os from the first day of radiotherapy, while the other group from the first postirradiative day. Saliva secretion and seven symptoms of xerostomia were assessed on a visual analogue scale questionnaire from the beginning of therapy every second week for 12 weeks. Our results show a minor development of xerostomia symptoms and increased salivary production when pilocarpine was already administered during irradiation. The symptoms disappeared also earlier in this group. Side effects were mild and tolerable. We recommend the start of pilocarpine hydrochloride therapy at the time of beginning irradiation to minimize the developing xerostomia and discomfort realated to it.
149 [-P-~]
THE ROLE OF PLASMA MICRONUTRITIONS IN RELATION TO RISK OF ORAL CANCER IN TAIWAN
W.E Chiang, C.'~ Yen, S.'~ Liu. Department of Oral & Maxillofacial
Surgery, Chi-Mei Medical Center, Taiwan The study compare the plasma levels of retinol, alpha-tocopherol, betacarotene, and lycopene between oral squamous cell carcinoma (OSCC) group, premalignant lesions (PML) group and normal control groups and to investigate the relationship between the levels of these micronutritions and various clinicopathological parameters of OSCC and PML. A crosssectional sample of 230 patients, including 94 OSCC patients, and 40 PML cases, was from November 2003 to February 2004. Plasma levels of concentration of micronutritions were analyzed with the help of reversephase high-pressure liquid chromatography. The plasma levels of betacarotene and lycopene were all significant lower in patients with PML and OSCC, compared to those of the normal control group. The status of the beta-carotene showed significant correlation with the prognostic factors of OSCC. These findings suggest a potential role of antioxidant system in the carcinogenesis and prognosis of OSCC. [-P-~"~ METAPLASTIC CARTILAGE FORMATION IN LINGUAL APONEUROSIS
H. Hasegawa, F. Shen. Department of Oral Pathology, Matsumoto Dental University School of Dentistry, 1780 Gobara, Hirooka, Shiojiri, Nagano 399-0791, Japan The occurrence of cartilaginous lesions in tongue is uncommon, and most of which are benign tumor, hamartoma, teratoma or choristoma, such as chondroma or chondrolipoma. Metaplastic cartilage formation is also rare. We screened archival cases to assess cartilaginous tissue formation in lingual aponeurosis, and simultaneously investigated the nature of cartilaginous tissues. The 591 samples removed from tongue were screened. All of materials were fixed in 10% of neutral-buffered formalin and embedded in paraffin. Using these archival paraffin blocks, 4um paraffin sections were prepared and stained with Hematoxylin and Eosin, PAS, alcian blue, toluidine blue, elastica-van Gieson and von Kossa stains. For immunostainings, mouse anti-collagen type II and anti-collagen type X antibodies were used for LSAB technique after antigen retrieve. We also performed scanning electric microscopic (SEM) analysis. Microscopical observations revealed cartilagenous formation in six patients of the median age of 55.5 years (raging 34-72). The male to female ratio was equal. Five of them were diagnosed as squamous cell carcinoma (SCC) without any subjective symptoms of chondroid tissues. Two cases had the history of irradiation or chemotherapy before surgical resection. The only exceptional patient without SCC developed a nodular lesion located on the middle-dorsal tongue. Microscopically, neither capsule formation nor atypical change was noted in all cartilagenous lesions. These tissues showed fibrous thickening of aponeuroses in the middle dorsum or the middle to posterior third of dorsal area. Thickened aponeuroses comprised dense and irregular-arranged collagen bundles and amorphous basophilic matrices that demonstrated PAS and alcian-blue positive reactions and metachromasia by toluidine blue stain. Chondrocyte-like cells were scattered in dense matrices. In four cases, positive-reactions for type II collagen was observed in the periphery of chondroid cells. Inflammatory cells infiltrated in the exceptional case without SCC. Calcium deposition was detected in two cases by both von Kossa reaction and SEM analysis. Cartilaginous metaplasia of lingual aponeurosis seems to have some relations to SCC, but it could occur without chemotherapeutic or irradiated effects. Results of our study suggest that chondroid tissue formation may be caused by chemical, physiological, mechanical or inflammatory chronic stimuli. [-P-~]
CLINICO-PATHOLOGICAL ANALYSIS OF RECURRENT A M E L O B L A S T O M A TREATED BY THE "DREDGING METHOD"
I. Kobayashi 1, K. Kasahara 1 , "~ Ohiro 1 , H. Henmi 1 , E. Yamamoto 1 , N. Inoue 1 , Y. Totsuka 1 , T. lizuka 2, M. Shindoh 2, T. Kohgo 2. 1Oral and
Maxillofacial Surgery, Oral Pathology and Biology, Japan; 2Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan The "Dredging Method" is a surgical procedure in which, after deflation and enucleation, repeated dredging is applied to accelerate new bone
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EOSINOPHILIC ULCER OF THE MANDIBULAR GINGIVA OF A CHILD - REPORT OF A CASE
S. Nagaoka 1 , M. Yoshida 1 , K. Ohtsuki 1 , M. Ohnishi 1 , Y. Hirata 3, H. Maeda 2 , Y. Kameyama 3. 1Department of Oral&Maxillofacial Surgery,
Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan; 2Department of Pathology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan; 3Maxillofac, Japan The purpose of the present study was to report a case of eosinophilic ulcer of the mandiblar gingiva in a child. The patient was a 5-yearold female who had suffered an indurated ulcer on the right mandibular gingiva of two month's duration. The tissue of excisional biopsy was examined histologically, histochemically and immunohistochemically. Immunohistochemical staining for S-100, CD15, CD68, PCNA and Ki67(MIB-1)antigens were performed on formalin-fixed, paraffinembedded sections using the avidin-biotin peroxidase complex (ABC) method. The lesion in the right mandibular gingiva between cuspid and premolar healed without any additional treatment after excisional biopsy in spite of the clinical finding similar to carcinomatous ulcer. X-ray and CT photographs showed no alveolar bone resorption under the lesion. Plural mandiblar limph nodes were recognized. The density of eosinophil in the blood-constituents was at the safty level (2.8%). Histologically, the lesion consisted of granulomatous tissue with a mixed infiltrate containing large mononuclear histiocytes with slight atypia, eosinophilis and lymphocytes. Histochemically, the lesion showed many mast cells. Immunohistochemically, many S-100, CD15, CD68, PCNA and Ki67 (MIB-1) positive cells were recognized. Based on the above findings, the lesion was diagnosed as eosinophilic ulcer of the gingiva. Only two cases of eosinophilic ulcer have been reported previously in Japan. The importance of eosinophilic ulcer is that it may simulates malignant lesion and may lead to overtreatment because of florid and ulcerative process.
•2•]
RELIEVING SYMPTOMS OF XEROSTOMIA WITH ORAL PILOCARPINE (SALAGEN) DURING IRRADIATION IN HEAD-AND-NECK CANCER
Z. Ny~r~dy 1 , ,&. N6meth 2, ,&. B~n 1 , I. Ember 2, L. Olasz 1 . 1Department
of Oral and Maxillofacial Surgery, University P~cs, P&cs, Hungary; 2Department of Public Health, University P~cs, P~cs, Hungary A common complication of irradiation of the head-and-neck is xerostomy. Pilocarpine, a muscarine agonist, is long used for treating patients with postirradiative xerostomia. In our randomized study the aim was to compare the antixerostomic effectiveness of orally administered pilocarpine chloratum (Salagen) during and after irradiation. Between October 1999 and October 2003 we treated 60 patients with head-and-neck cancer irradiation as a part of our complex protocoll. Patients were distributed randomly in two groups. They received minimum 50Gy irradiation to the head-and-neck. They had to have at least both parotids and two of their other major salivary glands retained. One group received 15 mg pilocarpine chloratume (Salagen) per os from the first day of radiotherapy, while the other group from the first postirradiative day. Saliva secretion and seven symptoms of xerostomia were assessed on a visual analogue scale questionnaire from the beginning of therapy every second week for 12 weeks. Our results show a minor development of xerostomia symptoms and increased salivary production when pilocarpine was already administered during irradiation. The symptoms disappeared also earlier in this group. Side effects were mild and tolerable. We recommend the start of pilocarpine hydrochloride therapy at the time of beginning irradiation to minimize the developing xerostomia and discomfort realated to it.
149 [-P-~]
THE ROLE OF PLASMA MICRONUTRITIONS IN RELATION TO RISK OF ORAL CANCER IN TAIWAN
W.E Chiang, C.'~ Yen, S.'~ Liu. Department of Oral & Maxillofacial
Surgery, Chi-Mei Medical Center, Taiwan The study compare the plasma levels of retinol, alpha-tocopherol, betacarotene, and lycopene between oral squamous cell carcinoma (OSCC) group, premalignant lesions (PML) group and normal control groups and to investigate the relationship between the levels of these micronutritions and various clinicopathological parameters of OSCC and PML. A crosssectional sample of 230 patients, including 94 OSCC patients, and 40 PML cases, was from November 2003 to February 2004. Plasma levels of concentration of micronutritions were analyzed with the help of reversephase high-pressure liquid chromatography. The plasma levels of betacarotene and lycopene were all significant lower in patients with PML and OSCC, compared to those of the normal control group. The status of the beta-carotene showed significant correlation with the prognostic factors of OSCC. These findings suggest a potential role of antioxidant system in the carcinogenesis and prognosis of OSCC. [-P-~"~ METAPLASTIC CARTILAGE FORMATION IN LINGUAL APONEUROSIS
H. Hasegawa, F. Shen. Department of Oral Pathology, Matsumoto Dental University School of Dentistry, 1780 Gobara, Hirooka, Shiojiri, Nagano 399-0791, Japan The occurrence of cartilaginous lesions in tongue is uncommon, and most of which are benign tumor, hamartoma, teratoma or choristoma, such as chondroma or chondrolipoma. Metaplastic cartilage formation is also rare. We screened archival cases to assess cartilaginous tissue formation in lingual aponeurosis, and simultaneously investigated the nature of cartilaginous tissues. The 591 samples removed from tongue were screened. All of materials were fixed in 10% of neutral-buffered formalin and embedded in paraffin. Using these archival paraffin blocks, 4um paraffin sections were prepared and stained with Hematoxylin and Eosin, PAS, alcian blue, toluidine blue, elastica-van Gieson and von Kossa stains. For immunostainings, mouse anti-collagen type II and anti-collagen type X antibodies were used for LSAB technique after antigen retrieve. We also performed scanning electric microscopic (SEM) analysis. Microscopical observations revealed cartilagenous formation in six patients of the median age of 55.5 years (raging 34-72). The male to female ratio was equal. Five of them were diagnosed as squamous cell carcinoma (SCC) without any subjective symptoms of chondroid tissues. Two cases had the history of irradiation or chemotherapy before surgical resection. The only exceptional patient without SCC developed a nodular lesion located on the middle-dorsal tongue. Microscopically, neither capsule formation nor atypical change was noted in all cartilagenous lesions. These tissues showed fibrous thickening of aponeuroses in the middle dorsum or the middle to posterior third of dorsal area. Thickened aponeuroses comprised dense and irregular-arranged collagen bundles and amorphous basophilic matrices that demonstrated PAS and alcian-blue positive reactions and metachromasia by toluidine blue stain. Chondrocyte-like cells were scattered in dense matrices. In four cases, positive-reactions for type II collagen was observed in the periphery of chondroid cells. Inflammatory cells infiltrated in the exceptional case without SCC. Calcium deposition was detected in two cases by both von Kossa reaction and SEM analysis. Cartilaginous metaplasia of lingual aponeurosis seems to have some relations to SCC, but it could occur without chemotherapeutic or irradiated effects. Results of our study suggest that chondroid tissue formation may be caused by chemical, physiological, mechanical or inflammatory chronic stimuli. [-P-~]
CLINICO-PATHOLOGICAL ANALYSIS OF RECURRENT A M E L O B L A S T O M A TREATED BY THE "DREDGING METHOD"
I. Kobayashi 1, K. Kasahara 1 , "~ Ohiro 1 , H. Henmi 1 , E. Yamamoto 1 , N. Inoue 1 , Y. Totsuka 1 , T. lizuka 2, M. Shindoh 2, T. Kohgo 2. 1Oral and
Maxillofacial Surgery, Oral Pathology and Biology, Japan; 2Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan The "Dredging Method" is a surgical procedure in which, after deflation and enucleation, repeated dredging is applied to accelerate new bone