The purpose of this study was to investigate the local immune response to 80 Stage I and II oral squamous cell carcinomas by immunohistochemical examination of the expression of human leukocyte antigen- (HLA) DR and T-lymphocyte infiltration.
The results were as follows :
1. The expression of HLA-DR antigen was detected in 21 of the 80 cases (26%) of oral squamous cell carcinomas (stage I and II) .
2. The expression of HLA-DR antigen was frequently detected in tongue squamous cell carcinoma.
3. The expression of HLA-DR antigen was significantly more common in well-differentiated types than in moderately differentiated types.
4. Tumor invasive tendency significantly correlated with the expression of HLA-DR antigen.
5. The expression of HLA-DR antigen correlated with infiltrating lymphocytes in tumor tissues.
6. The expression of HLA-DR antigen had a correlation with a 5-year survival rate but not with significant recurrence or delayed metastasis in lymph nodes.
7. These results suggested that the expression of HLA-DR antigen in oral squamous cell carcinomas was correlated with the local immune response.

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Effect of combination with 5-fluorouracil (5-FU) and cepharanthin (CE) on a oral squamous cell carcinoma cell line (KM-1) was examined using flow cytometry (FCM) with DNA/BrdU dual staining. 5-Fu and CE, dosage 1μg/ml respectively, were 5 Fu depressed the DNA synthetic rate until 48 hours after the treatment, and rapid restoration was detected at 72 hours. Combination 5 Fu CE depressed the DNA synthetic rate like 5 Fu until 48 hours. However, at 72 hours after treatment the DNA synthetic rate was observed to be clearly depressed, compared with 5 Fu. It was suggested that CE may suppress DNA synthethis, and the present study confirmed that combination therapy of CE and 5 Fu is effective.

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A case of adenomatoid odontogenic tumor (AOT) associated with remarkable root resorption at the maxilla in a 50-year-old female was presented. Cytological, histopathological, and electron microscopical examinations of AOT revealed some valuable findings. The smears had cohesive clusters with ductal structure and sheets of spindle cells characteristic for AOT. Cytological findings were found to be useful for diagnosis. It was also found that neoplastic cells of the present AOT showed remarkable nulear pleomorphism and nuclear pocket.

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Multiple primary malignant tumors were found in 62 (10.3%) of 603 patients with oral cancer who received treatment at our department from 1976 to 1995. Among them, 47 patients were male and 15 were female. Double cancers were found in 54 patients, triple cancers were found in 4, quadruple cancer was found in 1, and multicentric oral cancers with other primary malignancies were found in 3.
In 54 cases with double cancers, 22 had primary malignant tumors in an other part of the body, and the rest had an oral cancer as the primary tumor. In the cases with the primary cancer in the oral cavity, the cancers appeared in the tongue in 34.4% and in the oral floor in 31.3% of the cases, and the secondary tumors developed in the digestive tract in 37.5% and in the respiratory system in 25.0% of the cases.
In 30% of the double cancer cases with primary oral cancer, the secondary tumor appeared within 1 year, and 75% of them died due to the secondary cancer. At the time of initial treatment and during the course of follow-up of the primary oral cancer, examination of the upper G-I tract and the chest should be performed for the early detection of synchronous and/or subsequent tumors.

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To reduce the risk to spread tumor cells by incisional biopsy, excisional biopsy for the early oral squamous cell carcinomas was performed. However, whether or not excisional biopsy should be adopted as a radical modality for oral carcinomas is still controversial.
To evaluate excisional biopsy for stage I and II squamous cell carcinoma (SCC) of the oral cavity, 58 patients with oral SCC treated by excisional biopsy were examined clinico-pathologically. Among the 58 patients, 7 patients had recurrence in the primary site and 7 had secondary lymph node metastasis in the neck. A significant correlation was found between local recurrence and margin status. Additionally, absence or presence of dysplasia adjacent to cancerous tissue is important for predicting local recurrence. For superficial tumors which frequently accompany pericancerous epithelial dysplasia, tumors should be excised with a surgical safety margin of 5mm or more. Exophytic tumors of 25mm or less in size can be treated by excisional biopsy alone. On the other hand, as endophytic tumors have high aggressivity and high propensity to metastasize cervical lymph nodes, endophytic tumors of 15mm or less in size should be an indication of excisional biopsy.

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Multi-center study to evaluate the anti-tumor effect and toxicity of carboplatin (CBDCA) on oral squamous cell carcinoma was conducted. Thirty-four patients, 28 males and 6 females aged 38 to 78 years (mean age 63 years) who agreed to participate in this trial were selected from 7 hospitals. CBDCA (300-400mg/m²) combined with UFT (400mg/m²/day, p.o.) or 5-FU (250-500mg/body/day, i.v. or i.a.) was administered intravenously to these patients.
The clinical response was evaluated 4 weeks after beginning this study. Seven patients were excluded from evaluation of the anti-tumor effect caused by irregular course of admini-stration of medicines and another one was unmeasurable 4 weeks later. Therefore, the response could be evaluated in 26 patients UFT was administrated to 22 of 26 patients for 4 weeks and 5-FU to 4 patients for 4 or 5 days immediately after prescription of CBDCA. Eighteen of the 26 patients were previously untreated and 8 had been recurrent cases. In a distribution of stage in these 18 previously untreated patients, 3 were stage II, 6 stage III and 9 stage IV cases. For evaluation of CBDCA toxicity, all 34 cases were used. A complete response was obtained in two cases and partial response in 9 cases, the overall response rate was 42.3%. Among the 18 previously untreated patients, a complete response was obtained in 2 cases and partial response in 7 cases (response rate 50.0%) . Among the 8 recurrent cases, a partial response was observed in only 2 cases (response rate 25.0%) . In stage IV cases, the highest response rate (66.7%) was obtained. In stages II and III, 33.3% of the patients showed a partial response respectively. Relatively severe myelosuppression was observed. Thrombocytopenia occurred in 55.8% of 43 courses (34 patients), leukocytopenia occurred in 58.1% and a decrease of hemoglobin was observed in 74.4%. Grade IV thromboocytopenia occurred in two courses and grade IV leukocytepenia in one course. Nausea occurred in 10 of the 34 patients and vomiting in 4 patients. Granisetron was useful to prevent to nausea and vomiting caused by CBDCA.

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