BackgroundAmong the diseases of oral mucosa, malignant tumors are the most dangerous, but not the most common lesions that might appear in the oral cavity. Since most of the studies are focused on the detection of cancer in the oral cavity, we were interested in detecting the frequency of benign changes of the oral mucosa in Slovene population. Oral mucosal lesions are important pointer of oral health and quality of life, especially in elderly. The prevalence of oral mucosal lesions, together with information on the risk habits associated with oral health, such as tobacco and alcohol use, can help in planning future oral health studies and screening programs.Patients and methodsSurvey upon oral mucosal lesions was conducted during the national project for oral cancer screening in spring 2017 in the Slovenia in which more than 50% of dentists participated and 2395 patients (904 men and 1491 women) were included.ResultsClinical examination, which was conducted according to the WHO standards revealed that 645 patients (27%) had oral mucosal lesions. The ten most common oral lesions detected were fibroma, gingivitis, Fordyce spots, white coated tongue, cheek biting, linea alba, denture stomatitis, geographic tongue, recurrent aphthous ulcerations and lichen planus.ConclusionsOverall, these epidemiological data suggest need for specific health policies for prevention, diagnosis and treatment of oral mucosal lesions.

Epithelial-mesenchymal transition (EMT) has emerged as a possible mechanism of cancer metastasizing, but strong evidence for EMT involvement in human cancer is lacking. Our aim was to compare oral spindle cell carcinoma (SpCC) as an example of EMT with oral conventional squamous cell carcinoma (SCC) with and without nodal metastases to test the hypothesis that EMT contributes to metastasizing in oral SCC. Thirty cases of oral SCC with and without nodal metastasis and 15 cases of SpCC were included. Epithelial (cytokeratin, E-cadherin), mesenchymal (vimentin, N-cadherin), and stem cell markers (ALDH-1, CD44, Nanog, Sox-2) and transcription repressors (Snail, Slug, Twist) were analyzed immunohistochemically. We also analyzed the expression of microRNAs miR-141, miR-200 family, miR-205, and miR-429. SpCC exhibited loss of epithelial markers and expression of mesenchymal markers or coexpression of both up-regulation of transcription repressors and down-regulation of the investigated microRNAs. SCC showed only occasional focal expression of mesenchymal markers at the invasive front. No other differences were observed between SCC with and without nodal metastases except for a higher expression of ALDH-1 in SCC with metastases. Our results suggest that SpCC is an example of true EMT but do not support the hypothesis that EMT is involved in metastasizing of conventional SCC. Regarding oral SCC progression and metastasizing, we have been facing a shift from the initial enthusiasm for the EMT concept towards a more critical approach with "EMT-like" and "partial EMT" concepts. The real question, though, is, is there no EMT at all?

Our purpose was to determine the repeatability of squamous cell cancer in head and neck (SCCHN) and muscle tissue vascularity measurements as well as the inter- and intra-observer agreement using dynamic contrast-enhanced (DCE) multi-detector CT (MDCT). Twelve patients with histologically proven SCCHN were twice examined within 46 h. Measurement error and repeatability were assessed for each of the four functional parameters using the Bland-Altman plots. Two independent observers recorded the vascularity values of the tumor tissue; inter- and intra-observer agreement was assessed using the Bland-Altman plot analysis and intraclass correlation coefficients. For the tumor, the mean difference (95% limits of agreement) was 0.40 ml/min/100 g tissue (-6.80, 9.60); 0.01 (-0.96, 0.97) ml/100 g tissue; 0.20 (-1.80, 2.30) s; and 0.40 (-2.00, 2.80) ml/min/100 g tissue for BF, BV, MTT, and PS, respectively. For the muscle, the mean difference (95% limits of agreement) was -0.18 (-1.70, 1.35), 0.04 (-1.17, 1.35), -0.10 (-5.80, 5.60), and -0.10 (-2.20, 2.00), respectively. Measurement changes of at least +/-8%, 30%, 36%, and 13% were found to be significant for BF, BV, MTT, and PS, respectively. There was better intra- than inter-observer agreement.

BackgroundThe immune system has a known role in the aetiology, progression and final treatment outcome of oral squamous cell cancers. The aim of this study was to evaluate the influence of radical surgery and radiotherapy on advanced oral squamous cell carcinoma blood counts, lymphocyte subsets and levels of acute inflammatory response markers.MethodsBlood samples were obtained from 56 patients 5 days before and 10 days after surgery, 30 days and 1 year after radiotherapy. The whole blood count, lymphocyte subsets and inflammatory response markers (C-reactive protein, erythrocyte sedimentation rate, leukocyte count, expression of index CD64 and index CD163 on neutrophils and monocytes) were measured, statistically analysed and correlated with clinical treatment outcomes.ResultsThe post-operative period was characterised by the onset of anaemia, thrombocytosis, lymphopenia with reduced B lymphocyte, T helper cell and NK cell counts, and a rise in acute phase reactants. Immediately after radiotherapy, the anaemia improved, the lymphopenia worsened, and thrombocyte levels returned to pre-treatment values. There was a drop in counts across the T and B cell lines, including a reduction in B lymphocytes, naïve and memory T cells with reduced CD4+ and CD8+ counts and a decreased CD4/CD8 ratio. One year after radiotherapy all the lymphocyte subsets remained depressed, the only exception being NK cells, whose levels returned to pre-treatment values.ConclusionsWe concluded that surgery resulted in a stronger acute phase response than radiotherapy, while radiotherapy caused a long-lasting reduction in lymphocyte counts. There was no correlation between any of the pre-treatment parameters and the clinical outcome.