Although a few studies have shown that vascularity is increased from normal mucosa to dysplasia to carcinoma suggesting that disease progression in the oral mucosa is accompanied by angiogenesis. The role in lymph node metastasis in oral squamous cell carcinoma (OSCC) is equivocal. Role of angiogenesis in OSCC development and metastasis is evaluated in this study. This retrospective study of 50 samples consisted of 9 normal buccal mucosa, 22 leukoplakias, and 19 OSCC. Polyclonal antibodies to von-Willebrand factor were used to highlight the microvessels. Images were captured and morphometric image analysis was done for microvessel density (MVD), area, and perimeter. Highest, as well as mean values of these three parameters were compared. MVD and perimeter, but not area, are significantly different between normal mucosa and OSCC, and leukoplakia and OSCC. There were no differences between normal mucosa and leukoplakia. MVD, area, and perimeter were not significantly different between the OSCC with and without lymph node metastasis. The highest and mean values of MVD are significantly correlated. In the development of OSCC, angiogenic phenotypic change occurs in carcinomas rather than in the pre-cancerous stage, and quantification of angiogenesis in OSCC does not predict the risk of lymph node metastasis.
Angiogenesis increases during the transition from OL through dysplasia to OL-OSCC. In particular, OL-OSCCs of the tongue, VEGF-A expression may be used for estimation of malignant progression of OL.
The paper discussed during spring 2007 was a case study report entitled "Haemolysis: A Hidden Danger" published in The Nephrology Nursing Journal. The authors, Elisabeth Harman and Paula Dutka, agreed to follow the discussion and respond to points raised. Sixteen contributors from ten different countries provided insights into the potential causes, symptoms and effects of both acute and hidden haemolysis during dialysis, as well as discussing some of the safety systems that can be used to try and minimise occurrences. The use of blood volume monitoring as a potential method of 'seeing' hidden haemolysis was explored as well as some reporting mechanisms and organisational safeguards that are used to manage the risks.
Reading a slide and rendering a diagnosis is not only a science but also requires us to appreciate the constant artifact that is introduced in a controlled manner by tissue processing and obtaining a stained tissue section. There are a number of steps involved in getting the final stained tissue section and all these procedures if not performed properly have the potential to give rise to erroneous picture on the slide. Simple errors in judgments can lead to wrong diagnosis and unwarranted treatment. Such mistakes can put us at risk for Medico-Legal problems. The subject of Medico-Legal issues and practice of pathology has been neglected and amount of information available to the practicing professional in India is scarce. This paper focuses on standardized procedures for the various histopathology laboratory exercises. The paper highlights the importance of proper record maintenance with reporting protocols. A list of do's and don’ts for an Oral Pathologist is provided to help him/her in reducing the probable Medico-Legal issues. It does not in any way address the issue of individual competence and diagnostic abilities: That is an aspect for each individual to introspect upon and take remedial action.
Background: Cathepsin-D, a protease, which is an invasion promoter and plays a central role in solid tumors including oral cancer. Our aim of the study was to look for their expression pattern in epithelium and stroma of odontogenic cysts and tumors and correlate their aggressiveness to the staining intensity.
Materials and Methods:To elucidate the expression patterns of this marker, we examined immunohistochemically on formalin-fixed, paraffin-embedded sections of 24 odontogenic cysts and 10 odonogenic tumors, which are received for histopathologic examination in the Department of Oral Pathology, The Oxford Dental College and Hospital, Bengaluru.
Results:The epithelium of granular cell ameloblastoma (GCA) and odontogenic keratocyst (OKC) showed maximum staining with spillage of stained material in the connective tissue wall and at the separation of epithelium to capsule in OKC compared to other cysts and tumors. Conclusions: Cathepsin-D could be one of the enzymes important in separation of epithelium and connective tissue in OKC which helps in recurrence and intense expression in GCA with spillage into stroma, compared to other odontogenic tumors may explain its aggressive behavior, recurrence, and metastatic potential. To further validate our findings, it is suggested to use more sample size and monoclonal antibody for cathepsin-D.
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