Oral Cancer

口腔癌
  • 文章类型: Journal Article
    前哨淋巴结活检(SLNB)目前被认为是治疗cN0口腔鳞状细胞癌(OCSCC)的选择性颈部淋巴结清扫术(END)的可行替代方法。然而,由于注射部位的所谓“穿透放射性”,在口底(FOM)和腹侧舌肿瘤的前哨淋巴结(SLN)识别中发现了一些困难,这可能会掩盖附近的节点热点。我们评估了将99mTc-Tilmanocept与吲哚菁绿(ICG)荧光淋巴血管造影术结合在T1/T2N0口腔癌SLNB的专用多模式方案中的可行性和潜在优势,以评估这两种示踪剂在提供适当的敏感性和易用性方面的协同作用。即使在如此关键的解剖亚位点。详细的,提供了我们多式联运协议的逐步描述,并介绍了其在两例早期腹侧舌肿瘤中的应用。术前使用99mTc-Tilmanocept的放射性指导进行平面淋巴闪烁显像和单光子发射计算机断层扫描/计算机断层扫描,并定义淋巴结热点和手术“路线图”。此外,术中使用它以高特异性但有限的空间分辨率精确定位每个淋巴结热点内的SLN位置.然后加入在瘤床注射ICG和近红外荧光成像的光学引导,在具有高空间分辨率的每个淋巴结热点内提供直观的术中指导。说明了我们对该协议的小经验,并强调了未来的观点。
    Sentinel lymph node biopsy (SLNB) is currently considered as a viable alternative to elective neck dissection (END) for the management of cN0 oral cavity squamous cell carcinoma (OCSCC). However, some difficulties were detected in sentinel lymph node (SLN) identification in floor of mouth (FOM) and ventral tongue tumors because of the so-called \"shine-through radioactivity\" of the injection site, which may mask nodal hotspots in proximity. We assessed the feasibility and the potential strengths of combining 99mTc-Tilmanocept with indocyanine green (ICG) fluorescence lympho-angiography in a dedicated multimodal protocol for SLNB in T1/T2N0 oral cancer to evaluate the synergistic role of each of these two tracers in providing the appropriate sensitivity and ease of learning, even in such a critical anatomical subsite. A detailed, stepwise description of our multimodal protocol is provided, together with the presentation of its application in two cases of early-stage ventral tongue tumors. Radioactive guidance with 99mTc-Tilmanocept was used preoperatively to perform planar lymphoscintigraphy and single-photon emission computed tomography/computed tomography and to define the nodal hotspot(s) and the surgical \"roadmap\". In addition, it was used intraoperatively to pinpoint the SLN location within each nodal hotspot with high specificity but limited spatial resolution. Optical guidance with ICG injection at the tumor bed and near-infrared fluorescence imaging was then added, providing intuitive intraoperative guidance within each nodal hotspot with high spatial resolution. Our small experience with this protocol is illustrated and future perspectives are highlighted.
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  • 文章类型: Case Reports
    在大型动物物种中很少报道下颌骨的肿瘤形成过程及其治疗。具体来说,骨巨细胞瘤是一种在动物中不常见的肿瘤,在人类中具有局部侵袭行为和高复发率。整块切除是首选的治疗方法,但是取决于肿瘤的位置,这可能会导致功能缺陷。此报告详细说明了诊断工作,治疗,以及涉及山羊的延髓下颌骨和下颌骨联合的骨巨细胞瘤的长期结果。进行了涉及整个下颌骨联合的广泛的鼻端下颌骨切除术,而没有对半臂进行手术固定。肿瘤的组织学和电子显微镜检查结果与骨巨细胞瘤一致。尽管H3F3A基因的突变被认为是人类巨细胞瘤中肿瘤发展的驱动因素,使用分子分析,在这种情况下,这种基因突变无法得到证实。随访检查显示,两种半脑自发二次融合,没有肿瘤复发的迹象。手术后将近一年,所有者报告没有肿瘤再生的迹象。
    Neoplastic processes of the mandible and their treatment are rarely reported in large animal species. Specifically, giant cell tumor of bone is an uncommon tumor in animals and has been associated in humans with locally invasive behavior and a high recurrence rate. En-bloc resection is the treatment of choice, but depending on the localization of the tumor, this may result in functional deficits. This report details the diagnostic work-up, treatment, and long-term outcome of a giant cell tumor of bone involving the rostral mandible and mandibular symphysis of a goat. Extensive rostral mandibulectomy involving the entire mandibular symphysis without surgical fixation of the hemimandibles was performed. Histological and electron microscopic findings of the tumor were consistent with a giant cell tumor of bone. Although a mutation of the H3F3A gene is considered the driver of tumor development in human giant cell tumors, using molecular analysis, this gene mutation could not be confirmed in this case. Follow-up examinations revealed spontaneous secondary fusion of both hemimandibles and no signs of tumor recurrence. Nearly 1 year after surgery, the owners reported no signs of tumor regrowth.
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  • 文章类型: Case Reports
    合并肿瘤是由两个良性肿瘤或良性和恶性肿瘤或在同一肿瘤群体中发生的两个恶性肿瘤组成的那些。合并肿瘤的发生率非常罕见。由于这些肿瘤的稀有性,他们的生物学行为仍未受到破坏。一名48岁女性患者的切口活检,口腔弥漫性肿瘤块显示恶性黑色素瘤和鳞状细胞癌的合并肿瘤或碰撞肿瘤。这通过免疫组织化学研究得到证实。口腔恶性黑色素瘤和鳞状细胞癌合并肿瘤的发生率极为罕见。据我们所知,根据以前的文献记录,这是人类口腔中首次出现此类病例。
    Combined tumours are those composed of two benign tumours or a benign and malignant tumour or two malignant tumours occurring within the same tumour population. The incidence of combined tumours is very rare. Due to the rarity of these tumours, their biological behaviour remains unlashed. Incisional biopsy of a 48 years old female patient with single, diffuse tumour mass in the oral cavity showed combined tumour or collision tumour of malignant melanoma and squamous cell carcinoma. This was confirmed with immunohistochemistry study. The incidence of combined tumour of malignant melanoma and squamous cell carcinoma in oral cavity is extremely rare. To the best of our knowledge based on the previous literature records, this is the first case report of its kind where there is incidence in the human oral cavity.
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  • 文章类型: Case Reports
    我们报告一例胆管炎,免疫相关不良事件(IRAE),在口腔癌肺转移患者中使用nivolumab引起的。一名72岁的男子在口腔癌手术后出现肺转移。第二次治疗后观察到肝酶异常,根据血液检查结果和内窥镜检查结果诊断为irAE胆管炎。我们建议使用类固醇治疗,但病人拒绝了.因此,他接受了熊去氧胆酸治疗。胆管炎逐渐恶化,患者一般情况恶化,他在胆管炎发作169天后死亡。
    We report a case of cholangitis, an immune-related adverse event (irAE), caused by the administration of nivolumab in a patient with lung metastasis of oral cancer. A 72-year-old man developed pulmonary metastasis after surgery for oral cancer. Hepatic enzyme abnormalities were observed after the second session of treatment, and irAE cholangitis was diagnosed based on the results of the blood test results and endoscopy findings. We suggested steroid treatment, but the patient refused it. Therefore, he was treated with ursodeoxycholic acid. The cholangitis gradually deteriorated, the patients\' general condition worsened, and he died 169 days after the onset of cholangitis.
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  • 文章类型: Case Reports
    棘齿松解鳞状细胞癌(ASCC)是鳞状细胞癌(SCC)的非典型形式。尽管众所周知,ASCC通常出现在面部和颈部的阳光照射区域,口腔病例非常罕见。在这个案例报告中,我们介绍了一个罕见的病例,一个50岁的男性,他的右下颌肺泡出现了溃疡,活检后诊断为ASCC。关于组织病理学分析,观察到具有假腺外观的棘皮细胞。随后,通过改良的根治性颈淋巴结清扫术切除肿瘤,并进行了厚度分裂的移植物。患者对手术反应良好,术后无并发症。
    Acantholytic squamous cell carcinoma (ASCC) is an atypical form of squamous cell carcinoma (SCC). Although it is well known that ASCC typically appears in sun-exposed regions of the face and neck, oral cavity cases are incredibly rare. In this case report, we present a rare case of a 50-year-old male who developed an ulcer on his right mandibular alveolus, diagnosed with ASCC post-biopsy. On histopathological analysis, acantholytic cells with a pseudo-glandular appearance were observed. Subsequently, the tumor was resected by modified radical neck dissection with a split-thickness graft. The patient responded well to surgery and had no complications post-surgery.
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  • 文章类型: Journal Article
    背景:C-X-C基序趋化因子配体(CXCL8),白细胞介素8是一种典型的CXC家族趋化因子,带有谷氨酸-亮氨酸-精氨酸(ELR)基序,在人类一系列癌症的发生和发展中起关键作用。许多先前的研究集中在探索CXCL8基因多态性与癌症风险之间的关系。然而,其中许多报告的统计能力有限,在许多情况下产生模棱两可或冲突的结果。
    方法:因此,PubMed,万方,使用关键字\'IL-8\'或\'白介素-8\'或\'CXCL8\'搜索Scopus和WebofScience数据库,查找直到2023年7月20日发表的文章,“多态性”和“癌症”或“肿瘤”。利用赔率比(ORs)和95%置信区间(CIs)检查相关性。用TaqMan测定评估CXCL8+781多态性基因型。
    结果:为了更好地理解这些多态性与疾病风险之间的关联,进行了约29篇相关出版物。CXCL8-353A/T多态性与总体癌症风险增加相关[A与T,优势比(OR)=1.255,95%置信区间(CI)(1.079-1.459),P异质性=0.449,P=0.003]。CXCL8+781T/C等位基因与高加索人的癌症风险相似[TT与TC+CC,OR=1.320,95CI(1.046-1.666),异质性=0.375,P=0.019]。此外,与CC基因型相比,携带CXCL8+781TT+TC基因型的口腔癌患者血清CXCL8水平显着增加(P<0.01),与基因型匹配的正常对照相比,也显示出相似的趋势(P<0.01)。最后,几个限制,如纳入研究中可能存在发表偏倚或异质性,应引起重视.
    结论:目前的研究表明,CXCL8-353和+781多态性可能与更高的癌症风险有关,这可能会影响癌症的预防,诊断,或通过CXCL8的不同表达进行治疗。同时,+781多态性可能进一步提供作为生物标志物的价值,有助于口腔癌的早期识别和预后评估.
    BACKGROUND: C-X-C motif chemokine ligand (CXCL8), also known as interleukin-8, is a prototypical CXC family chemokine bearing a glutamic acid-leucine-arginine (ELR) motif that plays key roles in the onset and progression of a range of cancers in humans. Many prior studies have focused on exploring the relationship between CXCL8 gene polymorphisms and the risk of cancer. However, the statistical power of many of these reports was limited, yielding ambiguous or conflicting results in many cases.
    METHODS: Accordingly, the PubMed, Wanfang, Scopus and Web of Science databases were searched for articles published until July 20, 2023 using the keywords \'IL-8\' or \'interleukin-8\' or \'CXCL8\', \'polymorphism\' and \'cancer\' or \'tumor\'. Odds ratios (ORs) and 95% confidence intervals (CIs) were utilized to examine the association. The CXCL8 +781 polymorphism genotypes were assessed with a TaqMan assay.
    RESULTS: About 29 related publications was conducted in an effort to better understand the association between these polymorphisms and disease risk. The CXCL8 -353A/T polymorphism was associated with an increased overall cancer risk [A vs. T, odds ratio (OR) = 1.255, 95% confidence interval (CI) (1.079-1.459), Pheterogeneity = 0.449, P = 0.003]. The CXCL8 +781 T/C allele was similarly associated with a higher risk of cancer among Caucasians [TT vs. TC + CC, OR = 1.320, 95%CI (1.046-1.666), Pheterogeneity = 0.375, P = 0.019]. Furthermore, oral cancer patients carrying the CXCL8 +781 TT + TC genotypes exhibited pronounced increases in serum levels of CXCL8 as compared to the CC genotype (P < 0.01), and also shown similar trend as compared to genotype-matched normal controls (P < 0.01). Finally, several limitations, such as the potential for publication bias or heterogeneity among the included studies should be paid attention.
    CONCLUSIONS: Current study suggested that the CXCL8 -353 and +781 polymorphisms may be associated with a greater risk of cancer, which might impact cancer prevention, diagnosis, or treatment through the different expression of CXCL8. At the same time, the +781 polymorphism may further offer value as a biomarker that can aid in the early identification and prognostic evaluation of oral cancer.
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  • 文章类型: Case Reports
    低级别导管内癌(LG-IC),是一种罕见的唾液腺恶性肿瘤,预后很好,必须与其他类型的唾液腺恶性肿瘤区分开来。有完全不同的行为和更差的预后。
    一例病例介绍了一名52岁女性,该女性于2019年在另一家诊所首次诊断并治疗左下颌下腺空间的LG-IC。两年后,她带着新的病变进入我们部门,这次是在左侧的上颚唇,结果也是LG-IC。
    进行磁共振成像和正电子发射断层扫描-计算机断层扫描,以便在治疗干预之前诊断和充分分期疾病。
    6个月的随访显示没有复发的迹象。
    关于这种罕见的组织病理学实体的文献,以及与唾液腺其他恶性病变的鉴别诊断和转移频率,被审查了。
    UNASSIGNED: Low-grade intraductal carcinoma (LG-IC), is a rare malignant tumour of the salivary glands which has a very good prognosis and must be differentiated from the other types of salivary gland malignant tumours, which have a totally different behaviour and a worse prognosis.
    UNASSIGNED: A case is presented of a 52-year-old woman who was first diagnosed and treated in another clinic in 2019 for an LG-IC in the left submandibular gland space. Two years later, she was admitted to our department with a new lesion, this time in the upper jaw lip on the left side, which also turned out to be LG-IC.
    UNASSIGNED: Magnetic resonance imaging and positron emission tomography-computed tomography were performed in order to diagnose and adequately stage the disease prior to the therapeutic intervention.
    UNASSIGNED: A 6-month follow-up reveals no sign of recurrence.
    UNASSIGNED: Literature on this rare histopathological entity, as well as the differential diagnosis with the other malignant lesions of the salivary glands and the frequency of metastasis, were reviewed.
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  • 文章类型: Journal Article
    此回顾性病例系列描述了一种腹侧口外和口内联合方法在猫中进行颌骨切除术,并强调了通过拔牙迅速治疗术后医源性错牙合的重要性。牙冠高度降低与活髓治疗或根管治疗对侧下颌犬牙。九只猫被审查为标志,病史和体格检查,诊断检查,肿瘤类型,下颌骨切除术延长,淋巴结切除以及术中和术后并发症。进行的外科手术是将口外方法与下颌骨腹侧和口内方法相结合,以去除整个或部分下颌骨。使用相同的手术入路进行淋巴结清扫。所有猫都没有术中并发症。术后并发症仅限于持续一周的局部肿胀和流口水。七只猫能够在手术后立即进食。在其他两只猫中,1在一个月内恢复了进食的能力,1只从主人的手中进食。所描述的下颌骨切除术的手术方法可以更好地进入和观察下颌骨的尾部,并直接进入区域淋巴结。此外,如果预期的术后错牙合在同一手术过程中得到处理,与文献报道的相比,术后进食能力的发生率更高。
    This retrospective case series describes a combined ventral extraoral and intraoral approach for mandibulectomy in cats and highlights the importance of prompt management of the postoperative iatrogenic malocclusion through dental extraction, crown height reduction with vital pulp therapy or root canal therapy of the contralateral mandibular canine tooth. Nine cats were reviewed for signalment, history and physical examination, diagnostic workup, tumor type, mandibulectomy extension, lymph node removal as well as both intraoperative and postoperative complications. The performed surgical procedure was a combination of an extraoral approach ventrally to the mandible and an intraoral approach to remove the whole or a part of the mandible. Lymphadenectomy was achieved using the same surgical access. None of the cats had intraoperative complications. Postoperative complications were limited to regional swelling and drooling lasting a week. Seven cats were able to eat immediately after the surgery. Of the other 2 cats, 1 regained the ability to eat within a month and 1 only ate from the owner\'s hands. The surgical approach for mandibulectomy described allowed better access and visualization of the caudal part of the mandible and direct access to regional lymph nodes. Moreover, if the expected postoperative malocclusion is managed during the same surgical procedure, there is a higher rate of postoperative eating ability compared to what is reported in the literature.
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  • 文章类型: Case Reports
    颈清扫术中的脊髓副神经操纵或处死会导致斜方肌神经支配和萎缩,导致肩膀残疾。患者在移动肩膀时开始感到疼痛和虚弱,包括高程,旋转,绑架,以及减少的运动范围(ROM)和下降的肩膀。有几种治疗方法,包括使用止痛药或接受物理治疗。物理治疗在改善肩关节功能方面起着重要作用。干针(DN)是一种新兴的治疗方式,涉及在肌筋膜触发点区域引起局部抽搐反应,这可以减少疼痛和增加ROM。该病例报告记录了DN如何改善一名51岁女性的肩部功能,该女性在接受改良的根治性颈清扫术后移动肩部时疼痛且ROM有限。
    The spinal accessory nerve manipulation or sacrifice during neck dissection results in trapezius muscle denervation and atrophy, leading to shoulder disability. Patients start experiencing pain and weakness while moving their shoulders, including elevation, rotation, and abduction, as well as reduced range of motion (ROM) and dropping of the shoulders. There are several ways to treat the condition, including using painkillers or undergoing physical therapy. Physical therapy plays a major role in improving shoulder function. Dry needling (DN) is an emerging treatment modality that involves eliciting a local twitch response in the region of myofascial trigger points, which can reduce pain and increase the ROM. This case report documents how DN improved shoulder function in a 51-year-old female who had pain when moving the shoulders and limited ROM after undergoing a modified radical neck dissection.
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  • 文章类型: Journal Article
    颌骨放射坏死是口腔癌和口咽癌患者放疗的一种病态并发症,可能是通过拔牙引起的。己酮可可碱和生育酚(PENTO)已用于治疗骨坏死,并可预防需要侵入性牙科手术的放射后头颈部肿瘤患者。这项观察性研究旨在报告预防性使用PENTO预防放疗后口腔和口咽部癌症患者拔牙后颌骨放射性坏死的结果,并回顾有关该主题的最新文献。四名放射后的口腔和口咽肿瘤患者被转介到大学牙科诊所的牙科肿瘤诊所,田纳西大学健康科学中心拔牙。所有4名患者在提取前2周和提取后6周被处方为己酮可可碱400mgBID(每天两次)和生育酚400IUBID(口服片剂)。如果可行,所有患者在拔除后第二周后每周随访,直到拔除部位愈合(被粘膜覆盖)。评估终点定义为拔牙后6周,使用由暴露骨面积确定的四个类别评估结果:完全愈合(拔牙部位的完全粘膜覆盖);部分愈合(拔牙部位的尺寸减小);无变化;和进展(拔牙部位的尺寸增加)。在评估终点,所有患者的所有拔牙部位均完全愈合.患者水平(0/4)和个体牙齿水平(0/8)的ORN率为0%。所有患者均耐受PENTO药物,并且没有报告使用这些药物的不良反应。除了其他审查的研究外,这项有限的研究估计,在牙科拔牙/侵入性口腔手术后,放射后头颈部肿瘤患者的ORN发生率为3.2%(14/436)。总之,这种PENTO方案可以降低/预防头颈部肿瘤放疗后患者ORN的发生率.这种安全且具有成本效益的方案(PENTO方案)应进一步评估为需要侵入性牙科手术的放射后头颈部肿瘤患者的预防。我们建议进行大型前瞻性研究以进一步验证这些发现。
    Osteoradionecrosis of the jaw is a morbid complication of radiotherapy in patients with oral and oropharyngeal cancers that may be precipitated by dental extractions. Pentoxifylline and tocopherol (PENTO) has been utilized in the management of osteoradionecrosis and as prophylaxis for post-radiated head and neck oncology patients requiring an invasive dental procedure. This observational study aims to report the outcome of the prophylactic use of PENTO in the prevention of osteoradionecrosis of the jaw after dental extractions in post-radiated oral and oropharyngeal cancer patients and to review the current literature on this topic. Four post-radiated oral and oropharyngeal oncology patients were referred to the dental oncology clinic of the University Dental Practice, University of Tennessee Health Sciences Center for dental extractions. All four patients were prescribed pentoxifylline 400 mg BID (twice a day) and tocopherol 400 IU BID (oral tablets) for 2 weeks before extraction(s) and for 6 weeks after extraction(s). All patients were followed up every week after the second week post-extraction if feasible until the extraction site(s) healed (covered by mucosa). The assessment endpoint was defined as 6 weeks post-extraction with the outcomes assessed as using four categories determined by the area of exposed bone: complete healing (complete mucosal coverage of extraction site); partial healing (reduction in size of extraction site); no change; and progression (increase in size of the extraction site). At the assessment endpoint, all patients had complete healing of all extraction sites. The ORN rate at the patient level (0/4) and individual tooth level (0/8) was 0%. All patients tolerated the PENTO medications and no adverse effects from the use of these medications were reported. This limited study in addition to the other reviewed studies estimates the rate of ORN at the patient level as 3.2% (14/436) for post-radiated head and neck oncology patients after dental extractions/invasive oral procedures. In conclusion, this PENTO regimen can reduce/prevent the incidence of ORN in post-radiated head and neck oncology patients. This safe and cost-effective protocol (PENTO regimen) should be further evaluated as prophylaxis for post-radiated head and neck oncology patients requiring an invasive dental procedure. We recommend large prospective studies to be carried out to further validate these findings.
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