Nuclear DNA content was flow cytometrically determined in 161 samples of oral lesions including malignant tumors. DNA aneuploidy was detected in 38.6% of malignant tumors, 5% of benign tumors, and 18.8% of non-tumor lesions, the incidence of it was significantly high in malignant tumors. There was significant difference in mean DNA index between malignant tumors and benign lesions, 1.56 and 1.22, respectively. These results indicate that DNA aneuploidy is not specific for malignant tumors, and that only the cases showing DNA aneuploidy with more than 1.5 of DNA index strongly may be diagnosed as malignant tumors on the basis of DNA ploidy.
Previous reports indicated that the histological intensity of the tumor infiltrating lymphocytes (TIL), which is one of the manifestations of immunological host's response against malignant tumor cells, correlates with the clinical prognosis of the cancer patients. In the present study, we investigated the antitumor cytotoxicity of TIL (or LN-TIL: lymphocytes of metastatic lymph node) induced by anti-CD3 antibody and interleukin 2 (IL-2), and the availability for the source of the adoptive immunotherapy on patients with oral malignant tumors. TIL were isolated from 28 tumors and LN-TIL were isolated from 6 metastatic lymph nodes obtained from 28 patients with oral malignant tumors. Natural killer (NK) and lymphokine-activated killer (LAK) activity of freshly isolated TIL were usually undetectable. However the antitumor cytotoxicity of TIL was generated with IL-2 in vitro culture. These activated TIL showed high levels of NK and LAK activities, and these were prolonged more than those of PBL. On the other hand, freshly isolated TIL from patients who received IL-2 injection directly into the tumor lesions before surgery, showed NK and LAK activities. The growth of TIL were obviously enhanced by using the plates coated with anti-CD3 antibody at the beginning of the culture. These activated TIL (or LN-TIL) with anti-CD3 antibody and/or IL-2 also showed the cytotoxicity against the autologous tumor cells. These results indicate that anti-CD3 antibody and IL-2 augment the specific and/or nonspecific cytotoxicity of the TIL (or LN-TIL) against the tumor cells, and this augmentation of cytotoxic activity shows the anti-tumoral efficacy for oral malignant tumors. Furthermore, TIL (or LN-TIL) from oral malignant tumors could be on appropriate effector cells for adoptive immunotherapy on the patients with oral malignant tumors.
The expression on tumor suppressor gene product p53 was studied in 137 cases of malignant tumor of oral region. Using monoclonal antibody to p53 protein that was detectable on paraffin sections (BP 53-12), immunohistochemical analysis was performed. Positive staining of p53 protein of nucleus was detected in 43 of 107 cases (40.2%) of squamous cell carcinoma, 2 of 18 cases (11.1%) of adenoid cystic carcinoma, 1 of 9 cases (11.1%) of mucoepidermoid carcinoma, 1 of 2 cases (50%) of osteosarcoma, and 1 case of undifferentiated carcinoma. These evidences suggested that abnormality of p53 protein was involved in malignant tumors of the oral region. The positive cells were always confined to the malignant portion, whereas no expression was detectable in normal areas. In the region just adjacent to some tumors, the expression of p53 protein was distinguished from that in a peripheral normal portion with a clear border. The result suggested that the p53 detection by the immunohistochemical method was valuable for the assessment of the tumor occupied region.
This study was designed to examine the influence of posture on dental stress. The subjects were seventeen healthy male volunteers who were divided into two groups: ten subjects aged 22-29 years (‘young’ group) and seven aged 45-69 years (‘old’ group). Four measurements were performed, in the supine (0°C), semi-supine (45°C) and sitting (85°C) positions. Dental stress was induced by injecting 2 ml of saline into the upper incisal gingiva over two minutes ; blood pressure, heart rate and systolic time intervals were measured before injection as control values, during injection, and 1, 3, 5, 10 and 20 minutes after injection. The concentration of plasma catecholamines was also measured by the HPLC-ECD method. The results are as follows. 1. Before injection higher value of plasma norepinephrine (55.6% in higher ‘young’ group, 77.6% in higher ‘old’ group) was recognized in the sitting position as compared with the supine position, and higher value of pre-ejection phase (PEP)/left ventricular ejection time (LVET)(45.2% in higher ‘young’ group, 38.6% in higher ‘old’ group) was recognized. The more upright posture, the less left ventricular ejection time index (LVETI) was recognized. 2. After injection the concentration of plasma norepinephrine increased in the sitting position (65.2% in ‘young’ group, 103.4% in ‘old’ group). Increase of PEP and PEP/LVET was recognized in each position. 3. In ‘old’ group individual variation of the concentration of plasma catecholamines was remarkable. Increase of PEP and PEP/LVET after injection was greater and the recovery time was longer. In the sitting position the acceleration of sympatico adrenomedullar system and the inhibition of myocardial contractility due to low preload was recognized before injection. In the sitting position the more myocardial contractility inhibition due to increase of afterload was recognized after injection. In ‘old’ group the capacity of myocardial contractility was considered to be low. Therefore posture during dental treatment is important for prevention of shock, and, the supine position is the most effective especially for older patients.
To investigate the factors associated with lymph node metastasis of the stage I and II carcinomas, 94 patients with squamous cell carcinoma of the oral cavity were clinicopathologically analyzed. Postoperative metastases and/or lymph node involvements in elective neck dissection were found in 20 (21.2%), 4 (4.2%) respectively out of the 94 patients. The tumor size, tumor site, histologic differentiation of the primary tumor have no significant relationship with nodal metastasis, however, a significant correlation exists between the vertical invasion of primary cancer and the cervical nodal metastasis. High-malignant potential groups were characterized as follows that the tumor thickness was more than 3.0 mm in grade 2 and 3 of mode of invasion, or more than 1.6 mm in grade 4, which showed endophytic growth pattern. Furthermore, patients with high-malignant potential should perform elective neck dissection. On the other hand, low-malignant potential groups were thought to obtain an excellent clinical course with tumor excision alone.
Histiocytosis X (HX) arising in the oral and maxillofacial region is relatively rare. Here, two cases of HX, i.e., Hand-Schaller-Christian disease (HSC) and Eosinophilic granuloma of bone which occurred in the oral and maxillofacial region are presented with immunohistochemical, light and electronmicroscopic studies. Case 1: a 37-year-old male was referred to our hospital, with the chief complaint of difficulty in chewing and radiolucent lesions in the bilateral mandible. Pathological examination revealed Eosinophilic granuloma of bone. Case 2: a 23-year-old male was admitted to our hospital because of the mobility of the front teeth in the mandible. He had received treatment for HSC since he was 1 year and 6 months old. Electronmicroscopic observations showed a number of proliferated histiocytic cells in both cases and these cells seemed to be Langerhans cells. In the HSC of which the clinical activity seemed to be higher than that of Eosinophilic granuloma, a number of small Birbeck granules were found as compared with in the Eosinophilic granuloma.