The main surgical goal while treating cancer is to remove all local malignant disease with no residual malignant cells left. Overall benefits of achieving negative resection margins in terms of disease free local recurrence and overall survival has been discussed in many studies. The quantity of normal tissue to be removed during surgical procedure has not been standardised. Local recurrence can also occur among tumours with extensive histological demonstration of adequate resection margins. Oral cavity, submandibular region, tonsil and pharynx are the sites which have high chances of recurrence, even after showing negative margins. Therefore, the current approaches for histological risk assessment and various methods of evaluation of the surgical margins with their limitations are briefed in the present article.
Introduction: Cervical cancer is caused by persistent infection by high risk Human papilloma virus (HPV).Increasing expression of HPV viral oncogenes might be reflected by increased expression of p16. Hence immunohistochemical detection of p16INK4a is an easy and cost effective method than molecular detection of HPV. Aims: The purpose of this study were to evaluate the results of expression of p16INK4a in neoplastic squamous cell lesions of cervix in order to assess the association of HPV infection in those lesions and to study the pattern of expression of p16 and also to compare p16 expression in various histological types of cervical neoplastic squamous cell lesions by immunohistochemistry. Methods: Immunohistochemical analysis of p16 expression was performed on 26 paraffin embedded tissue samples, obtained from cervical biopsy including 2 early invasive squamous cell carcinoma (SCC), 6 large cell keratinizing SCC, 16 large cell non- keratinizing SCC and 2 cases small cell non-keratinizing SCC by using commercially available mouse monoclonal antibody to p16 (clone G175 – 405). Two parameters were evaluated in p16 expression: Percentage of p16 positive cells and reaction intensity of p16 immunostaining. The p16 expression was graded as negative; Grade 1, 2, 3 and its reaction intensity was graded as negative, weak, moderate and strong. Results: In the present study out of 26 cases, the incidence of large cell non- keratinizing SCC constituted majority of the neoplastic lesions of cervix (61.5%). Most of the SCC (96.15%) showed grade 3 scoring for p16 positivity except one case which showed grade 2 scoring. Majority of SCC cases (96%) showed strong reaction intensity for p16 immunostaining. Conclusion: In this study of 26 neoplastic sqaumous cell lesions, all patterns of cervical neoplasia showed p16 positivity. P16 may be useful as an adjunct in histological sections to detect HPV in those lesions.
This entity requires aggressive treatment since biological behavior of this unique lesion is difficult to predict unless more of such lesions are reported and followed up in future.
Aim: The present study aims to estimate as well as compare the amount of immunohistochemical expression of heat shock protein 27 (HSP27) in oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC). Materials and methods:The study group comprised 24 cases of OPMDs, 12 OSCC cases, and 9 normal (controls) oral mucosa specimens. All sections were stained immunohistochemically with HSP27 antibody kit followed by analysis.Results: Increased intensity of staining with statistically significant difference (p = 0.001) was observed in OSCC cases when compared with normal oral mucosa sections. Statistically insignificant results were obtained between OPMDs and normal tissues. Conclusion:Due to significant increase in the staining intensity of OSCC cases when compared with normal sections, HSP27 can be possibly used as a prognostic marker in OSCC cases.Clinical significance: Early diagnosis of malignant transformation through diagnostic markers will markedly improve the overall quality of life. Therefore, early monitoring of the expression of HSP27 in OPMDs will give an insight into their malignant transformation.
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