Immunohistochemical localization of monoclonal keratin antibodies in monomorphic adenoma (n=5) and pleomorphic adenomas (n=21), including myoepithelioma, were evaluated. Keratin proteins consist of two types; type I keratin consists of K1, 2, 3, 4, 5, 6, 7, and 8 and type II 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, and 20. The presnt study was conducted to evaluate immunoreactivity with MoAb to K4, 7, 8, 10, 13, 17, 18, 19, and 20, KL1, and K 8.12. The intercalated duct cells of normal salivary gland, and the luminal cells of monomorphic adenomas and pleomorphic adenomas showed expression of keratin pairs K8 and K18. Intercalated duct cells in the normal glands are possible pressible precurosr cells of luminal tumor cells of monomorphic and plemorphic adenoma.

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Dysplastic grade of the leukoplakia on the border of the tongue, particularly of the basal cells and the lamina propria, was assessed by immunohistochemistry.
The subjects were 50 patients with clinical leukoplakia, including 12 patients without dysplasia, 17 with mild dysplasia, 14 with moderate dysplasia, four with severe dysplasia and three with initial invasive squamous cell carcinoma (IISCC), and 10 patients each with so-called fibroma and deep invasive squamous cell carcinoma (DISCC) on the border of the tongue. The scoring system of dysplasia, grade of infiltrating lymphocytes, and loss of basement membrane as histological factors, as well as expression of ki-67, p53, glutathione S-transferase π (GST-π) UCHL-1, L-26, HLA-DR, and type IV collagen as immunohistochemical ones were examined.
The score of dysplasia corresponded well to the conventional dysplastic grade except for that of IISCC. Factors related with dysplastic grade were disarray of ki-67-expressing cells as the epithelial parameter, high degree of lymphocytic infiltration, predominantly T cells, and loss of type IV collagen in the lamina propria as the host-reactivity one. The number of HLA-DR-expressing cells was significantly decreased in leukoplakia and DISCC, although no correlation was found with some displastic grade.
These results suggest that dysplastic changes and subsequent malignant transformation may be caused by abnormal characteristics of both basal cells and the local immunodefense system.

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Control rates of primary lesion and cervical lymph node metastasis and 5-year-cumulative survival rate were evaluated for 43 primary cases of carcinoma of upper gingiva and alveolus. There were 4 cases of stage I, 13 of stage II, 9 of stage III, and 17 of stage IV, and the primary lesions of 3 cases were seen in the anterior subdivisional region, 29 in the lateral subdivisonal region, and 11 in the posterior subdivisional region. Eleven, 5, and 27 cases received surgery, radiation, and combination therapy with surgery, radiation, and/or chemotherapy, respectively, as the initial therapy. The control rates of the primary lesions in cases that received surgery and radiation were 65.8% and 20.0%, respectively. The control rates of the primary lesions were low in the T4 cases of the lateral subdivisional region and posterior subdivisional region. It is suggested that extraoral surgical approach and the combination of the radiation therapy are needed to improve the control rate of the primary lesions. The cervical lesions were controlled at 6 out of 8 sites (4 of 6 cases), which could be evaluated in this study. Of these cases, 2 of 4 cases died of metastasis at the opposite site, and the other 2 cases died of distant metastasis. Bilateral lymph node metastasis was seen in 5 of 6 cases. These results suggest that contralateral or bilateral elective neck dissection may be recommended for patients with positive neck node or T4 cases of lateral subdivisional region. The cumulative 5-year-survival rates in cases that received surgery and the total cases were 50.2 % and 42.9 %, respectively.

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In this study, 53 cases with N0 carcinoma of the tongue who received Ra needle interstitial brachytherapy between 1978 and 1994 at Metropolitan Komagome Hospital were used. To study the effect of combined external radiation and combined chemotherapy with Ra needle, 53 cases were divided into 3 groups, the group of Ra needle alone, the group of Ra needle combined with external radiation, the group of Ra needle combined with chemotherapy. Total dose of all interstitial irradiation was 70 Gy, total dose of combined external radiation was 26.1 Gy on average, and CDDP, MTX, and BLM were used for the combined chemotherapy. Incident of secondary neck metastasis, local recurrence and after side effect of radiation were investigated in each group. There were 34 cases in the group of Ra needle alone (T1: 8, T2: 24, T3: 2), 8 cases (T1: 1, T2: 6, T3: 1) in the group of combined with external radiation and 11 cases (T1: 4, T2: 6, T3: 1) in the group of combined with chemotherapy.
As for the result of incident of secondary neck metastasis, 9 cases were found in the Ra needle alone, 1 case in the combined with external radiation, 3 cases in the combined with chemotherapy. It was found that the combined with extranal radiaiton tended to be more effective than other two groups. But as for local reccurence, effect of combined therapies could not be determined. As for side effect of radiation, there were 2 cases in the Ra needle alone group, 2 cases in the combined with external radiation group, and no cases in the combined with chemotherapy. It was considered that the combined with external radiation could be more dangerous than the other two therapies.

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The treatment and clinical course of 157 intraoral minor salivary gland tumors at the Department of Oral and Maxillofacial Surgery, Hokkaido University School of Dentistry from August 1967 to July 1992 were reviewed and clinically analyzed.
The results were as follows:
1. Of the 94 benign tumors, 70 cases were treated with excision, 23 cases with extirpation, and 1 case with cryosurgery.
2. Of the benign tumors, 3 cases of 50 pleomorphic adenoma recurred.
3. Of the 63 malignant tumors, 41 cases were treated with surgery (S) alone, 11 cases with surgery and irradiation (R), 1 case with surgery, irradiation (R), and chemotherapy (C), 7 case with irradiation alone, and 3 cases with (R+C) .
4. Overall 5, 10, 15, and 20-year cumulative survival rates of malignant tumors were 76.9 %, 63.6%, 44.0%, 32.1%, respectively.
5. Of 59 primary malignant tumors, the 10-year cumulative survival rate in each clinical stage was 90.0% (stage I), 69.2%, (stage II), 50.0% (stage III), 42.6% (stage IV), 62.3% (all stage) ; at each primary site was 83.9% (floor of the mouth), 71.4% (mucosa of the cheeks), 60.1% (palate), 50.0% (retromolar areas), 25.0% (alveolus) ; in each histopathological classification was 70.3% (adenoid cystic carcinoma), 68.2% (mucoepidermoid carcinoma), 66.7% (carcinoma in pleomorpic adenoma), 20.0% (adno-carcinoma) ; and for each treatment was 76.1% (surgery alone), 72.7% (S+R, S+R+C), 10.0 % (R, R+C) .
6. Of 59 primary malignant tumors, during the clinical course, cervical lymphonodus metastasis and distant metastasis were found in 15 cases and 18 cases (15 lung), respectively. After primary treatment, recurrence and residual of tumor were found in 11 cases and 3 cases, respectively. The incidence of distant metastasis, recurrence, and residual of tumor were high in adenoid cystic carcinoma.

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Twenty-four patients with salivary gland carcinomas underwent surgery with and without irradiation, following adjuvant immuno-chemotherapy and followed-up for at least 10 years. There are many patients with major salivary gland tumors and adenocystic carcinomas in stage II and IV. The adjuvant immuno-chemotherapy consisted of 5-FU analogue and OK-432 and was performed for 2 years after loco-regional treatment. The survival rates and the incidences of primary recurrence, cervical node metastases, and distant metastases and the mean times of relapses since initial treatments were examined.
The incidences of primary recurrence, cervical lymph node metastases, and distant metastases are 20.8%, 16.7% and 33.3%, respectively, and the mean times of these relapses are 4y9m, 1y7m and 4y7m, respectively. As to development of distant metastases among the loco-regionally controlled cases, the occurrence rate is 23.8% and the mean time of relapse is 5y8m.
Five- and ten-year survival rates by Kaplan-Meier methods are 83.3% and 70.8%, respectively. Among the loco-regionally controlled cases, five- and ten-year survival rates are 90.5% and 81.0%, respectively.

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