Background: Squamous cell carcinoma (SCC) is the most common cancer in the oral area. Matrix metalloproteinases (MMPs) and especially MMP-2 and MMP-9 are increased in malignancy and lymph node involvement in oral SCCs. We aimed to evaluate the serum levels of MMP-2 and MMP-9 in patients with oral SCC compared to normal subjects and their relation with clinicopathological findings. Materials and Methods: In this case control study, 20 patients with oral SCC and 20 healthy subjects were included and serum levels of MMP-2 and MMP-9 were compared between groups. Also, the correlation between these markers with clinicopathological findings including grade (T) and node (N) were evaluated. Results: Patients with oral SCC had significantly higher serum levels of MMP-2 (p=0.01) and MMP-9 (p<0.001) compared to healthy subjects. With increase in grade T, MMP-2 was significantly increased (p=0.001), but in the MMP-9 case this was not significant (p=0.27). The levels of MMP-2 (p=0.002) and MMP-9 (p=0.01) in cases with lymph node involvement and that of MMP-2 in subjects with smoking history (p=0.001) were significantly high. There was significantly positive correlation between MMP-2 with grade T tumor (r=0.598, p=0.005), lymph node involvement (r=0.737, p<0.001) and smoking (r=0.674, p=0.001) and also between MMP-9 and lymph node involvement (r=0.474, p=0.03). Conclusions: Both markers are significantly increased in oral SCC compared to healthy subjects. However, MMP-2 was better for evaluating lymph node involvement and tumor grade.
Background: Laryngeal cancer is an important malignancy in head and neck area and squamous cell carcinoma (SCC) is the most common type accounting for 95% of cases. Increase in matrix metalloproteinases (MMPs) in different tumors and their correlation with tumor invasiveness has been documented. However, most studies have evaluated MMP-2 and MMP-9 expression and few have evaluated serum levels. The aim of current study was to evaluate serum levels in patients with laryngeal SCC compared to normal subjects and assess any relation with tumor clinicopathological findings. Materials and Methods: In this case control study, 20 patients with oral SCC and 20 healthy subjects were included. Serum levels of MMP-2 and MMP-9 were compared between groups and correlations with findings including grade (T) and node involvement (N) were evaluated. Results: Patients with laryngeal SCC had significantly higher serum levels of MMP-2 (p=0.01) and MMP-9 (p=0.03) compared to healthy subjects. Patients with higher T stage (T3,4) had significantly higher MMP-2 (p=0.04) and MMP-9 (p=0.01). There was significant positive correlation between serum levels of MMP-2 with T stage (r=0.45, p=0.04) and lymph node involvement (r=0.563, p=0.01) and between levels of MMP-9 with T stage (r=0.527, p=0.01). Conclusions: Our results showed that compared to healthy subjects, both MMP-2 and MMP-9 are significantly increased in serum of laryngeal SCC cases. MMP-2 was correlated with lymph node involvement while MMP-9 has stronger correlation with T stage compared to MMP-2.
hile information regarding many aspects of in-W traductal carcinoma (IDCA) continues to be accumulated, there are several issues that particularly require combined attention and effort by clinicians and pathologists for their optimal resolution. The following outline presents the issues of concern, current approaches, and future considerations. 1.The optimal configuration (shape), method of orientation, and processing of the biopsy specimen.Currently, the excised specimen is generally an irregularly shaped mass that is removed in a manner to contain the mammographic lesion (calcification, density, etc.). When sutures are placed by surgeons for orientation, they are placed to identify the superior, inferior, lateral, and medial margins, with rare if any reference to the nipple margin. In processing the specimen, serial sections are made in a majority of cases, but these sections are cut perpendicular to the longitudinal axis of the specimen; therefore, the specimen may be serially sectioned from superior to inferior, lateral to medial, or anterior to the posterior margin.It has been shown that IDCA predominantly originates in the terminal duct-lobular units (1) and migrates or extends toward the nipple generally within a single segment, but it may cross over to other segments through anastomosing ducts (2, 3 ) . Therefore, any attempts at determination of the extent of IDCA and preThe opinions and assertions contained herein are the viewpoints of the author and do not reflect the official views of the Department of the Army or Defense.diction of possible residual disease requires assessment of the route of extension toward the nipple. Optimal resection should consider the segmental nature of the duct system and its branching pattern as it moves away from the nipple; this would result in a conical specimen with the tip of the cone toward the nipple. Attempts should be made to remove any suspicious lesions along their possible route of extension toward the nipple. The resected specimen should have sutures identifying the direction of the nipple, overlying skin, deep and lateral margins. Regardless of their ultimate shape, these samples should be serially sectioned toward the direction of the nipple margin. Since currently a vast majority of specimens are neither optimally excised, nor so oriented or cut, it is difficult to determine the extent of lateral or central (toward the nipple) spread of the lesion. 2.Specification of the morphologic subtype and grade of IDCA.At present, a diagnosis of intraductal carcinoma is generally, but not invariably, followed by a designation of its subtype (comedo, papillary, cribriform, and micropapillary) and far less frequently by a grade assignment (4-12). Though various methods have been proposed (8, lo), there is no standardized approach to grading IDCA. Since a proportion of IDCA do not fit any of the classic subtypes, the grade of the IDCA may be more important as a possible predictor of the aggressive potential of the lesion. The significance of identifying the subtype and gr...
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