Concerning cell kinetics of oral cancer, the following findings were obtained as a result of both measurement of nuclear DNA-RNA contents, and examination using antiBromodeoxyuridine (BrdU) monoclonal antibody. 1. A significant difference was noted between the BrdU labelling index of normal gingival epithelium (2.9±0.5%) and that of oral squamous cell carcinoma (11.4±3.8%) . In the normal epithelium positive identification was restricted to the basal cell layer or the 2nd-3rd supra basal cell layers ; while in squamous cell carcinoma, it was commonly observed to occur around the focus of tumor cells in the well differentiated area, and was seen scattered in the poorly differentiated area. 2. No definite relationship was observed between the BrdU labelling index and clinical stages of tumor. With respect to the relationship with histopathological malignancy, the labelling index did not show any association with the grading of differentiation or atypia, but showed positive correlation with the mitotic index. The value of the labelling index was 11.5 times as large as that of mitotic index. 3. With the introduction of the BrdU labelling index applied to the results of measurement of nuclear DNA-RNA contents was it admittedly possible to clarify its significance in oral squamous cell carcinoma, a factor which had not been revealed by conventional analyses.
Subrenal capsule assay (SRC assay) has been reported to be an effective method for predicting the sensitivity of individual patients with tumor to anticancer agents. However, there still remain some inherent problems including host immune responses. In animals pretreated with minute immunosuppressive doses of cyclophosphamide (CPM) and X-ray irradiation both of which had been administered 24 hours prior to tumor implantation, the growth rate in Irradiation Group 6 days post implantation, was much higher than that in CPM Group. The histopathological observation and the study 9 days post implantation using the percentage inhibition of %DNA/protein content of the implanted tumor also indicated that Irradiation Group showed high rate of inhibition of host immune cell infiltration and the existence of viable tumor cells. Therefore, X-ray irradiation was admitted to be a valuable maneuver for the inhibition of host immune responses in the study of SRC assay.
Reconstructive surgery was performed for five patients suffering malignant tumors in oral cavity using autogenous iliac bone graft immediately following mandibular resection. After a careful three year follow up in any case, grafted bone was found to retain its vitality and no infection or recurrence was any observed. The results were satisfactory not only esthetically but functionally. These cases showed the usefulness of autogenous graft with iliac crest to immediately reconstruct the defects caused by mandibular resection.
A recently developed ultasonic surgical aspirator, or an ultrasonic surgical knife was applied to excise some tumors in oral and maxillo-facial regions, and we will report on several findings. As objected tumor we selected hemangioma, parotoid tumor, etc. We admit that if the indications given and procedures followed are adequate, the results after operation could be expected better both in function and form.
Synovial sarcomas constitute 5-12% of malignant tumors of soft tissue. The majority of synovial sarcomas occur in the extremities, while the occurrence in the region of head and neck is very rare. This paper presents a case of synovial sarcoma in the depth of the cheek. The patient, a 42-year-old woman, visited our clinic on March 8, 1983 complaining of diffuse swelling and pain in the right cheek, and trismus. In the past 6 years she had suffered pain of the same nature several times, and had been treated as an inflammatory disease. The first examination taken revealed diffuse swelling, moderate tenderness on the right cheek and trismus (mouth opening : 18mm) . CT showed a small round mass lesion between masseter muscle and lateral pterygoid muscle on the right side. The operation was done extraorally under general anesthesia on June 22, 1983. The globular tumor about 1.5cm in diameter was located in the pterygomandibular space and was encapsulated by relatively thick pseudocapsule. It was enucleated in some pieces. Microscopically, the majority of the tumor consisted of irregular bands or sheets of relatively uniform spindle cells. It exhibited the monophasic pattern of synovial sarcoma. After operation, a course of radiation totalling 50Gy to the right cheek and an administration of tegaful and UFT totalling 110g were given. The patient is alive at present without recurrence and metastasis of the tumor.