Salivary Alpha-Amylase Reactivity under Psycho-Physiological Stress. A Nonverbal Communication Measurement Tool?

Previous studies have shown that changes in salivary alpha-amylase (sAA) levels are dependent on psychosocial stress stimulation and reflect the activity of the sympathetic nervous system. sAA measurement can be performed easily and quickly;therefore, it may be useful for evaluating psychosocial or physical stress. The aim of this preliminary study was to examine the use of sAA measurements as objective indicators of psychological and physiological stress levels by examining sAA changes in volunteers subjected to conditions similar to those suffered by children with severe motor and intellectual disabilities and cerebral paralysis. Twelve healthy volunteers were required to not move or speak, as is found in patients suffering from total paralysis, for 30 min. Saliva samples were taken at three points, and sAA activity was measured using a hand-held monitor before the test, immediately after the test, and 10 min after the test. In the present study, a marked increase in sAA activity due to physiological stress and a rapid return to the baseline level were observed. Many subjects felt bodily pain and psychotic discomfort. This measurement method is useful for evaluating stress in children with severe motor and intellectual disabilities, who can not fully express their emotions or communicate with their caregivers.

Increase in Salivary Alpha-Amylase Levels among Non-Attending Junior High School Students Diagnosed with Social Anxiety Disorder

Purpose: Several studies have demonstrated that the measurement of salivary alpha-amylase (sAA) levels is a useful tool for evaluating the autonomic nervous system. Psychosocial stress increases the release of sAA as a useful marker for autonomic nervous system (ANS). To our knowledge, although some studies have evaluated sAA levels under psychosocial stress, no studies have investigated the changes in sAA activity that occur in junior high school students who are not attending school due to social anxiety disorder (SAD). We aimed to investigate the relationship between the sAA levels and psychiatric states of such patients. Methods: The study subjects consisted of SAD patients (n = 39) and healthy controls (n = 57). We used a portable hand-held monitor to measure the level of sAA and State-Trait Anxiety Index (STAI) to evaluate the psychiatric state. Results: The patients’ sAA activity was significantly higher than that of the controls (n = 57) (p < 0.001). Significant differences in heart rate (HR) (76.10 ± 11.96 vs. 68.69 ± 10.61, respectively, p < 0.01) and STAI scores (both the STAI-State and STAI-Trait scores) (49.35 ± 10.57 vs. 41.24 ± 8.59, respectively, p < 0.01;55.69 ± 10.44 vs. 45.61 ± 9.36, respectively, p < 0.001) were detected between the patients and healthy controls. Conclusions: These results indicated that junior high school students with SAD exhibit a higher state of anxiety and high autonomic activity, probably due to changes in the sympathetic nervous system. As a result, junior high school students with SAD are expected to exhibit high levels of sAA accompanied by anxiety symptoms.

Salivary alpha-amylase activity—An indicator of relaxation response in perioperative patients

The psychological stress of most perioperative patients has been reduced by many interventions. In order to evaluate the effects of these interventions, biomarkers are being considered as objective assessment tools in addition to the subjective assessment tools. It has been thought that salivary α-amylase (sAA) activity is associated with sympathetic nervous system activity, which reflects psychological stress. We examined the relationship between sAA, self-reported data, and autonomic nervous system activity to assess the reliability of sAA as a marker for relaxing response in surgery-related stress. The sAA, the State anxiety, Visual Analogue Scale (VAS) of pain, and heart rate variability were used to assess prior to and after the relaxation on the day before surgery, and on postoperative days (POD) 1, 2, 3, and 7. A total of 75 patients participated and 301 relaxing response readings were obtained. We found that the sAA significantly decreased depending upon the pain and anxiety by relaxation, but they were unrelated to sympathetic nervous system activity. There was weak correlation between the change in sAA, and anxiety and VAS pain. Thus, sAA appears to be an easy-to-use, non-invasive and good marker for relaxing response within a short period in surgery-related stress patients.

The association of salivary alpha-amylase, heart rate variability, and psychological stress on objectively measured sleep behaviors among college students

Objective:This study aimed to evaluate sleep behaviors among college students,to assess salivary alpha-amylase(sAA)and heart rate variability(HRV)in association with stress,and to investigate sleep-related factors including sAA,HRV,and stress among them.Methods:Saliva samples for sAA assessment and HRV measurements in the supine position were taken between 3 PM and 6 PM.The level of prolonged psychological stress for the previous week was evaluated using the Korean version of the Global Assessment of Recent Stress(GARS-K),and sleep behaviors were assessed using an actigraphy device.Results:A total of 86 healthy college students participated in this study.Sleep behaviors of the college students were not good,with 84%sleep efficiency(SE)and 62.7 min wake after sleep onset(WASO).The average sAA level was 65.8 U/mL in the participants.Although neither the sAA level nor HRV indices were significantly correlated with prolonged psychological stress,decreased normalized high frequency(nHF)on HRV was independently associated with a higher level of stress when adjusted for age and sex.Higher stress(r=-0.276,P=0.011)and lower sAA(r=0.266,P=0.030)had significant correlations with shorter time in bed;however,it was sAA that was independently associated with time in bed(β=0.244,p=0.044).Decreased nHF(β=0.245,P=0.027)and higher body mass index(BMI)(β=-0.224,P=0.043)were independently related to and poorer SE.Conclusions:Poor sleep behaviors were associated with decreased parasympathetic activity,a physiological change to psychological stress,rather than with psychological stress itself among college students.Thus,sAA and HRV should be considered as significant factors for impaired sleep behaviors in relation to psychological stress.

Hypothesis that alpha-amylase evokes regulatory mechanisms originating in the pancreas,gut and circulation,which govern glucose/insulin homeostasis

The anti-incretin theory involving the abolishment of diabetes type(DT)II by some of methods used in bariatric surgery,first appeared during the early years of the XXI century and considers the existence of anti-incretin substances.However,to date no exogenous or endogenous anti-incretins have been found.Our concept of the acini-islet-acinar axis assumes that insulin intra-pancreatically stimulates alpha-amylase synthesis(“halo phenomenon”)and in turn,alphaamylase reciprocally inhibits insulin production,thus making alpha-amylase a candidate for being an anti-incretin.Additionally,gut as well as plasma alphaamylase,of pancreatic and other origins,inhibits the appearance of dietary glucose in the blood,lowering the glucose peak after iv or oral glucose loading.This effect of alpha-amylase can be interpreted as an insulin down regulatory mechanism,possibly limiting the depletion of pancreatic beta cells and preventing their failure.Clinical observations agree with the above statements,where patients with high blood alpha-amylase concentrations are seldom obese and seldom develop DT2.Obese-DT2,as well as DT1 patients,usually develop exocrine pancreatic insufficiency(EPI)and vice versa.Ultimately,DT2 patients develop DT1,when the pancreatic beta cells are exhausted and insulin production ceases.Studies on biliopancreatic diversion(BPD)and on BPD with duodenal switch,a type of bariatric surgery,as well as studies on EPI pigs,allow us to observe and investigate the above-mentioned phenomena of intra-pancreatic interactions.

The Effect of Umami Stimulation on Salivary Secretion Rate and Duration

Purpose: Umami reportedly promotes salivation. We aimed to investigate the effects of taste stimuli on slow and fast salivary secretion in humans using umami, sweet, and sour stimuli. Methods: Eight healthy women participated between 14:00 and 15:00, taking the circadian rhythm of salivary secretion into account. The types and concentrations of the taste solutions were glutamic acid (1.7 × 10−3 M), inosinic acid (9.8 × 10−3 M), and guanylic acid (9.8 × 10−3 M) for umami stimulation, citric acid (6.5 × 10−3 M) for acidity stimulation, and sucrose (1.6 × 10−2 M) for sweetness stimulation. First, the unstimulated salivary flow rate was measured. Then, 3 ml of a flavor solution was dropped under the tongue using a syringe. The saliva was expelled into an aluminum cup every minute and weighed. The first minute’s value minus 3 ml flavor solution was the stimulated salivary secretion rate produced by each flavor. The time-to-return to the initial unstimulated salivary flow rate was the duration of the stimulated saliva secretion rate. Results: The mean unstimulated salivary flow rate across participants was 0.64 ± 0.25 ml/min (range: 0.23 - 1.03 ml/min). The highest amount of saliva was induced by citric acid. There were significant differences between citric acid and the other flavor solutions (p < 0.05 for glutamic acid, inosinic acid, and sucrose;p < 0.01 for guanylic acid). There were no significant differences in duration of salivation between the flavor solutions. When the participants were divided into slow (0.45 ± 0.16 ml/min) and fast groups (0.83 ± 0.15 ml/min) based on their median resting salivary secretion rate, there were no significant differences between the two groups in the amount of saliva secreted at 1 minute after stimulation and the duration of the salivary secretion rate. Conclusion: Umami stimulation was effective in slowing salivary secretion and sustaining salivary secretion after stimulation.

A systematic review of salivary biomarkers in Parkinson's disease

The search fo r reliable and easily accessible biomarkers in Parkinson's disease is receiving a growing emphasis,to detect neurodegeneration from the prodromal phase and to enforce disease-modifying therapies.Despite the need for non-invasively accessible biomarke rs,the majo rity of the studies have pointed to cerebrospinal fluid or peripheral biopsies biomarkers,which require invasive collection procedures.Saliva represents an easily accessible biofluid and an incredibly wide source of molecular biomarkers.In the present study,after presenting the morphological and biological bases for looking at saliva in the search of biomarkers for Parkinson's disease,we systematically reviewed the results achieved so far in the saliva of different cohorts of Parkinson's disease patients.A comprehensive literature search on PubMed and SCOPUS led to the discovery of 289articles.After screening and exclusion,34 relevant articles were derived fo r systematic review.Alpha-synuclein,the histopathological hallmark of Parkinson's disease,has been the most investigated Parkinson's disease biomarker in saliva,with oligomeric alphasynuclein consistently found increased in Parkinson's disease patients in comparison to healthy controls,while conflicting results have been reported regarding the levels of total alpha-synuclein and phosphorylated alpha-synuclein,and few studies described an increased oligomeric alpha-synuclein/total alpha-synuclein ratio in Parkinson's disease.Beyond alpha-synuclein,other biomarkers to rgeting diffe rent molecular pathways have been explored in the saliva of Parkinson's disease patients:total tau,phosphorylated tau,amyloid-β1-42(pathological protein aggregation biomarkers);DJ-1,heme-oxygenase-l,metabolites(alte red energy homeostasis biomarkers);MAPLC-3beta(aberrant proteostasis biomarker);cortisol,tumor necrosis factor-alpha(inflammation biomarkers);DNA methylation,miRNA(DNA/RNA defects biomarkers);acetylcholinesterase activity(synaptic and neuronal network dysfunction biomarkers);Raman spectra,proteome,and caffeine.Despite a few studies investigating biomarkers to rgeting molecular pathways different from alpha-synuclein in Parkinson's disease,these results should be replicated and observed in studies on larger cohorts,considering the potential role of these biomarkers in determining the molecular variance among Parkinson's disease subtypes.Although the need fo r standardization in sample collection and processing,salivary-based biomarkers studies have reported encouraging results,calling for large-scale longitudinal studies and multicentric assessments,given the great molecular potentials and the non-invasive accessibility of saliva.

A Study on the Correlation between Salivary Cortisol Content and Anxiety and Depression in Pregnant and Postpartum Women

Objective: To analyze the correlation between salivary cortisol content and anxiety and depression in pregnant and postpartum women. Method: 300 pregnant and postpartum women who were admitted from January 2021 to December 2021 were selected as the research subjects. They were all tested with the Hamilton Anxiety Scale (HAMA) and the Edinburgh Postnatal Depression Scale (EPDS). 40 pregnant women with anxiety and depression were selected as the observation group, and 50 normal pregnant women were selected as the control group, adopting logistic regression analysis to investigate the correlation between salivary cortisol and postpartum anxiety and depression during pregnancy. Result: The salivary cortisol levels in the observation group were significantly higher than those in the control group before bedtime, after waking up the next day, 15 minutes after waking up, 30 minutes after waking up, 60 minutes after waking up, and 1 hour before lunch (p < 0.05). Maternal depression and anxiety were not related to age, weight, gestational age, negative events, or history of adverse pregnancy and childbirth (p > 0.05). Maternal depression and anxiety are closely related to salivary cortisol levels and educational background (p Conclusion: There is a close correlation between anxiety and depression and an increase in cortisol levels, suggesting that the salivary cortisol awakening response during pregnancy has a predictive effect on the occurrence of postpartum depression.

Effects of Exposure to GSM Mobile Phone Base Station Signals on Salivary Cortisol,Alpha-Amylase,and Immunoglobulin A

Objective The present study aimed to test whether exposure to radiofrequency electromagnetic fields （RF-EMF） emitted by mobile phone base stations may have effects on salivary alpha-amylase, immunoglobulin A （IgA）, and cortisol levels. Methods Fifty seven participants were randomly allocated to one of three different experimental scenarios （22 participants to scenario 1, 26 to scenario 2, and 9 to scenario 3）. Each participant went through five 50-minute exposure sessions. The main RF-EMF source was a GSM-900-MHz antenna located at the outer wall of the building. In scenarios 1 and 2, the first, third, and fifth sessions were ＂low＂ （median power flux density 5.2 μW/m^2） exposure. The second session was ＂high＂ （2126.8 μW/m^2）, and the fourth session was ＂medium＂ （153.6 μW/m^2） in scenario 1, and vice versa in scenario 2. Scenario 3 had four ＂low＂ exposure conditions, followed by a ＂high＂ exposure condition. Biomedical parameters were collected by saliva samples three times a session. Exposure levels were created by shielding curtains. Results In scenario 3 from session 4 to session 5 （from ＂low＂ to ＂high＂ exposure）, an increase of cortisol was detected, while in scenarios 1 and 2, a higher concentration of alpha-amylase related to the baseline was identified as compared to that in scenario 3. IgA concentration was not significantly related to the exposure. Conclusions RF-EMF in considerably lower field densities than ICNIRP-gnidelines may influence certain psychobiological stress markers.

Salivary metabolites are promising noninvasive biomarkers of druginduced liver injury

BACKGROUND Drug-induced liver injury(DILI)is one of the most common adverse events of medication use,and its incidence is increasing.However,early detection of DILI is a crucial challenge due to a lack of biomarkers and noninvasive tests.AIM To identify salivary metabolic biomarkers of DILI for the future development of noninvasive diagnostic tools.METHODS Saliva samples from 31 DILI patients and 35 healthy controls(HCs)were subjected to untargeted metabolomics using ultrahigh-pressure liquid chromatography coupled with tandem mass spectrometry.Subsequent analyses,including partial least squares-discriminant analysis modeling,t tests and weighted metabolite coexpression network analysis(WMCNA),were conducted to identify key differentially expressed metabolites(DEMs)and metabolite sets.Furthermore we utilized least absolute shrinkage and selection operato and random fores analyses for biomarker prediction.The use of each metabolite and metabolite set to detect DILI was evaluated with area under the receiver operating characteristic curves.RESULTS We found 247 differentially expressed salivary metabolites between the DILI group and the HC group.Using WMCNA,we identified a set of 8 DEMs closely related to liver injury for further prediction testing.Interestingly,the distinct separation of DILI patients and HCs was achieved with five metabolites,namely,12-hydroxydodecanoic acid,3-hydroxydecanoic acid,tetradecanedioic acid,hypoxanthine,and inosine(area under the curve:0.733-1).CONCLUSION Salivary metabolomics revealed previously unreported metabolic alterations and diagnostic biomarkers in the saliva of DILI patients.Our study may provide a potentially feasible and noninvasive diagnostic method for DILI,but further validation is needed.

Salivary C-reactive protein and mean platelet volume as possible diagnostic markers for late-onset neonatal pneumonia

BACKGROUND Neonatal sepsis,a formidable threat to newborns,is a leading cause of neonatal mortality,with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning.Pneumonia,a prevalent sepsis presentation,poses a significant risk,especially during the neonatal phase when lung defenses are compromised.Accurate diagnosis of pneumonia is imperative for timely and effective interventions.Saliva,a minimally invasive diagnostic medium,holds great promise for evaluating infections,especially in infants.AIM To investigate the potential of serum C-reactive protein(CRP),salivary CRP(sCRP),and mean platelet volume(MPV)as diagnostic markers for late-onset neonatal pneumonia(LONP).METHODS Eighty full-term neonates were systematically examined,considering anthropometric measurements,clinical manifestations,radiology findings,and essential biomarkers,including serum CRP,sCRP,and MPV.RESULTS The study reveals noteworthy distinctions in serum CRP levels,MPV,and the serum CRP/MPV ratio between neonates with LONP and healthy controls.MPV exhibited a robust discriminatory ability[area under the curve(AUC)=0.87]with high sensitivity and specificity at a cutoff value of>8.8.Correlations between serum CRP,sCRP,and MPV were also identified.Notably,sCRP demonstrated excellent predictive value for serum CRP levels(AUC=0.89),underscoring its potential as a diagnostic tool.CONCLUSION This study underscores the diagnostic promise of salivary and serum biomarkers,specifically MPV and CRP,in identifying and predicting LONP among neonates.These findings advocate for further research to validate their clinical utility in larger neonatal cohorts.

Influences of AMY1 gene copy number and protein expression on salivary alpha-amylase activity before and after citric acid stimulation in splenic asthenia children

OBjECTIVE:To compare the correlations between salivary alpha-amylase(sAA) activity and amylase,alpha 1(salivary) gene(AMY1) copy number or its gene expression between splenic asthenia and healthy children,and investigate the reasons of attenuated sAA activity ratio before and after citric acid stimulation in splenic asthenia children.METHODS:Saliva samples from 20 splenic asthenia children and 29 healthy children were collected before and after citric acid stimulation.AMY1 copy number,sAA activity,and total sAA and glycosylated sAA contents were determined,and their correlations were analyzed.RESULTS:Although splenic asthenia and healthy children had no differences in AMY1 copy number,splenic asthenia children had positive correlations between AMY1 copy number and sAA activity before or after citric acid stimulation.Splenic asthenia children had a higher sAA glycosylated proportion ratio and glycosylated sAA content ratio,while their total sAA content ratio and sAA activity ratio were lower compared with healthy children.The glycosylated sAA content ratio was higher than the total sAA content ratio in both groups.Splenic asthenia and healthy children had positive correlations between total sAA or glycosylated sAA content and sAA activity.However,the role played by glycosylated sAA content in sAA activity in healthy children increased after citric acid stimulation,while it decreased in splenic asthenia children.CONCLUSION:Genetic factors like AMY1 copy number variations,and more importantly,sAA glycosylation abnormalities leading to attenuated sAA activity after citric acid stimulation,which were the main reasons of the attenuated sAA activity ratio in splenic asthenia children compared with healthy children.

Autologous mesenchymal stem cells offer a new paradigm for salivary gland regeneration

Salivary gland(SG)dysfunction,due to radiotherapy,disease,or aging,is a clinical manifestation that has the potential to cause severe oral and/or systemic diseases and compromise quality of life.Currently,the standard-of-care for this condition remains palliative.A variety of approaches have been employed to restore saliva production,but they have largely failed due to damage to both secretory cells and the extracellular matrix(niche).

Chronic Urticaria Due to Allergy to Wheat Alpha-Amylase Inhibitor Proteins

Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of wheals, angioedema, or both, for at least 6 weeks, due to known or unknown causes [1]. In some patients who present a CSU with daily or almost daily symptoms a type I allergy could be the underlying cause. We present one adult patient with chronic urticaria who was finally diagnosed as a non-occupational case of IgE-mediated wheat allergy manifested following exposure by 3 different routes: inhalation (rhinitis and bronchial asthma), dermal absorption (contact urticaria) and ingestion (systemic chronic urticaria). We were able to detect the culprit proteins by immunoblotting. Serum IgE binds mainly to alpha-amylase/trypsin inhibitors and, to a lesser extent, to other proteins associated with food allergy to grains (e.g. beta-glucanase, serpin, peroxidase). In our opinion, skin prick tests with a food standard battery could help in the etiological diagnosis of chronic urticaria. The identification of responsible allergens could be difficult because only a few complex in vitro techniques allow detecting the allergy to several proteins.

Diagnostic efficacy of diffusion-weighted imaging and semiquantitative and quantitative dynamic contrast-enhanced magnetic resonance imaging in salivary gland tumors

BACKGROUND Increased use of functional magnetic resonance imaging(MRI)methods such as diffusion-weighted imaging(DWI)and dynamic contrast-enhanced(DCE)MRI consisting of sequential contrast series,allows us to obtain more information on the microstructure,cellularity,interstitial distance,and vascularity of tumors,which has increased the discrimination power for benign and malignant salivary gland tumors(SGTs).In the last few years,quantitative DCE MRI data containing T1 perfusion parameters(K_(trans),K_(ep)and V_(e)),were reported to contribute to the differentiation of benign or malignant subtypes in SGTs.AIM To evaluate the diagnostic efficacy of DWI and semiquantitative and quantitative perfusion MRI parameters in SGTs.METHODS Diffusion MRI[apparent diffusion coefficient(ADC)value]with a 1.5 T MR machine,semiquantitative perfusion MRI[time intensity curve(TIC)pattern],and quantitative perfusion MRI examinations(K_(trans),K_(ep)and V_(e))of 73 tumors in 67 patients with histopathological diagnosis performed from 2017 to 2021 were retrospectively evaluated.In the ADC value and semiquantitative perfusion MRI measurements,cystic components of the tumors were not considered,and the region of interest(ROI)was manually placed through the widest axial section of the tumor.TIC patterns were divided into four groups:Type A=T_(peak)>120 s;type B=T_(peak)≤120 s,washout ratio(WR)≥30%;type C=T_(peak)≤120 s,WR<30%;and type D=flat TIC.For the quantitative perfusion MRI analysis,a 3D ROI was placed in the largest solid component of the tumor,and the K_(trans),K_(ep)and V_(e)values were automatically generated.RESULTS The majority of SGTs were located in the parotid glands(86.3%).Of all the SGTs,68.5%were benign and 31.5%were malignant.Significant differences were found for ADC values among pleomorphic adenomas(PMAs),Warthin's tumors(WTs),and malignant tumors(MTs)(P<0.001).PMAs had type A and WTs had type B TIC pattern while the vast majority of MTs and other benign tumors(OBTs)(54.5%and 45.5%,respectively)displayed type C TIC pattern.PMAs showed no washout,while the highest mean WR was observed in WTs(59%±11%).K_(trans)values of PMAs,WTs,OBTs,and MTs were not significantly different.K_(ep)values of PMAs and WTs were significantly different from those of OBTs and MTs.Mean V_(e)value of WTs was significantly different from those of PMAs,OBTs,and MTs(P<0.001).CONCLUSION The use of quantitative DCE parameters along with diffusion MRI and semiquantitative contrastenhanced MRI in SGTs could improve the diagnostic accuracy.

Relation of tea ingestion to salivary redox and flow rate in healthy subjects

The biochemistry of human saliva can be altered by food intake.The benefits of tea drinking were extensively studied but the influence of tea ingestion on human saliva has not been revealed.The work aimed to investigate the immediate and delayed effect of vine tea,oolong tea and black tea intake on certain salivary biochemistry and flow rate.The saliva samples of healthy subjects were collected before,after and 30 min after tea ingestion.The chemical compositions and antioxidant capacity of tea samples were analyzed to correlate with salivary parameters.Principal component analysis indicated that the effects of vine tea consumption were dominated by increasing salivary flow rate(SFR),production rate of total protein(TPC),thiol(SH),malondialdehyde,catalase activity and antioxidant capacity(FRAP)in saliva.The antioxidant profile of studied tea samples(FRAP,polyphenols,flavonoids)was positively correlated with salivary SFR,TPC,SH and FRAP but negatively correlated with salivary uric acid concentration in saliva.

Pattern and Trends in the Presentation of Salivary Gland Tumours in a Tertiary Centre in Gombe, Northeast Nigeria

Background: Salivary gland tumours (SGTs) are rare, but recent reports suggest an increasing incidence. Although there are previous Nigerian studies on the patterns of SGTs, patterns and trends of disease may change over time. The aim of this study was to describe the pattern of presentation of SGTs, and to determine the trends in occurrence of SGTs at Federal Teaching Hospital (FTH), Gombe over a period of 15 years. Method: This descriptive study included cases of histologically diagnosed SGTs from January 2008 to December 2022. Relevant information (age, gender, site, year of diagnosis, and histopathologic diagnosis) was extracted from the cancer registers and histopathologic records. The lesions were then categorized into benign and malignant SGTs and grouped into three groups spanning 5 years each based on the year of diagnosis. Data analysis was done using IBM SPSS version 23, and p ≤ 0.05 was considered statistically significant. Results: There were 93 (61.2%) benign and 59 (38.8%) malignant SGTs. Benign SGTs had a mean age of 36.4 ± 13.6 years, and were more common in females (57.0%), and in the parotid (41.9%). Pleomorphic adenoma (94.6%) was the most common benign SGT. Malignant SGTs had a mean age of 44.5 ± 18.4 years, with male predilection (54.2%) and occurrence mostly in the palate (27.6%) and parotid (22.4%). Mucoepidermoid carcinoma (39.0%) and adenoid cystic carcinoma (32.2%) were the most frequent malignant SGTs. The mean age of occurrence of malignant SGTs was significantly higher than that of benign SGTs (p = 0.005). The trend analysis showed that there has been a steady rise in the proportion of males presenting with malignant SGTs. Similarly, there has been a steady increase in the frequency of benign SGTs in the parotid. The palate was the predominant site for the malignant SGTs between 2008 and 2012, but in the last five years (2018 to 2022), the parotid has become the predominant site. Over the duration of the study, the ratio of benign to malignant SGTs has remained relatively constant. Conclusion: While the overall pattern of presentation of SGTs in Gombe is similar to reports in the literature, this study has identified some changes in trends over the years.

应用WGCNA分析挖掘唾液腺多形性腺瘤恶变关键节点基因及通路

目的:基于高通量转录组测序及WGCNA,挖掘唾液腺多形性腺瘤(PA)恶变为癌在多形性腺瘤中(Ca-ex-PA)过程中的核心驱动基因及相关通路。方法:收集PA、Ca-ex-PA患者肿瘤及癌旁唾液腺的新鲜标本各5例,进行高通量转录组测序(RNA-Seq)分析,筛选PA与瘤旁唾液腺组、Ca-ex-PA与癌旁唾液腺组中的差异表达基因。取PA、Caex-PA共有的差异表达基因进行WGCNA分析,获得与PA恶变相关的基因群体。结果:测得良、恶性肿瘤共有差异表达基因426个,通过WGCNA得到的4个模块中,包含78个基因与恶性肿瘤表型相关。其中评分最高的EFNA3基因表达程度与高组织学分级的腺癌亚型显著相关(P<0.05)。结论:WGCNA能有效筛选出与PA恶变相关的核心驱动基因,EFNA3过表达可能与PA恶变有关,其作为预后评估和治疗靶点的价值有待进一步研究。

唾液腺腺泡细胞癌中NR4A3基因重排及NOR-1蛋白表达分析

目的:探讨NR4A3基因重排和NOR-1蛋白表达在唾液腺腺泡细胞癌中的表达及在鉴别诊断中的价值。方法:收集2020年5月—2024年1月于上海交通大学医学院附属第九人民医院口腔病理科诊断的唾液腺癌119例,包括腺泡细胞癌(acinic cell carcinoma,AciCC)63例,黏液表皮样癌(mucoepidermoid carcinoma,MEC)31例,分泌性癌(secretory carcinoma,SC)25例。分别使用荧光原位杂交和免疫组织化学染色检测NR4A3基因重排和NOR-1蛋白表达情况,采用SPSS 18.0软件包对数据进行统计学分析。结果:AciCC主要发生于大唾液腺。与MEC和SC相比,AciCC好发于女性(P=0.006)。NR4A3基因重排在AciCC、MEC和SC中的阳性率分别为76.2%(48/63)、0%(0/10)和0%(0/7),NOR-1蛋白表达在AciCC、MEC和SC中的阳性率分别为92.1%(58/63)、9.7%(3/31)和0%(0/25),差异具有统计学意义(P<0.001)。单独使用NR4A3基因重排诊断AciCC时,灵敏度和特异度分别为76.2%和100%。单独使用NOR-1蛋白表达诊断AciCC时,灵敏度和特异度分别为92.1%和94.6%。联合使用NR4A3基因重排和NOR-1蛋白表达诊断AciCC时,灵敏度和特异度分别为96.8%和94.6%,曲线下面积为0.896,诊断价值最优。结论:AciCC好发于女性,主要发病部位为大唾液腺。NR4A3基因重排仅见于AciCC中,在诊断工作中具有100%的特异性,但敏感性较低。NOR-1蛋白表达检测具有很好的灵敏度和特异度,可作为鉴别AciCC、MEC和SC的初筛和替代方法。联合使用NR4A3基因重排和NOR-1蛋白表达检测具有最优的诊断价值。

不同剂量放射性碘-131治疗甲状腺功能亢进症疗效比较

目的探讨不同剂量放射性碘-131治疗甲状腺功能亢进症的疗效。方法选择2020年4月至2023年4月就诊于新乡医学院第一附属医院的574例甲状腺功能亢进症患者为研究对象,采用随机数字表法将患者分为观察组和对照组,每组287例。对照组患者给予大剂量放射性碘-131治疗(>10~15 mCi),观察组患者给予小剂量放射性碘-131治疗(5~10 mCi)。治疗后6个月评估2组患者的治疗效果;分别于治疗前及治疗后3、6个月采集2组患者晨起空腹静脉血3 mL,离心后取血清,采用荧光免疫层析法测定2组患者游离甲状腺激素(FT_(4))、游离三碘甲状腺原氨酸(FT_(3))、促甲状腺激素(TSH)水平,酶联免疫吸附法测定2组患者血清肿瘤坏死因素-α(TNF-α)、转化生长因子-β_(1)(TGF-β_(1))、白细胞介素(IL)-6、IL-1水平;分别于治疗前及治疗后3、6个月在核素显像下测定唾液腺摄取指数、唾液腺分泌指数;记录2组患者治疗期间不良反应发生情况;治疗后6个月评估2组患者甲状腺功能减退症发生情况。结果对照组和观察组患者治疗总有效率分别为83.27%(234/281)、92.88%(261/281),观察组患者治疗总有效率显著高于对照组(χ^(2)=12.353,P<0.05)。治疗前2组患者FT_(4)、FT_(3)、TSH水平比较差异无统计学意义(P>0.05)。治疗后3、6个月时,2组患者的FT_(4)、FT_(3)水平显著低于治疗前,TSH水平显著高于治疗前(P<0.05);2组患者治疗后6个月时的FT_(4)、FT_(3)水平显著低于治疗后3个月时,TSH水平显著高于治疗后3个月时(P<0.05)。治疗后3、6个月时,观察组患者FT_(4)、FT_(3)水平显著低于对照组,TSH水平显著高于对照组(P<0.05)。治疗前2组患者的唾液腺摄取指数和分泌指数比较差异无统计学意义(P>0.05)。2组患者治疗后3、6个月时的唾液腺摄取指数和分泌指数均显著低于治疗前(P<0.05);2组患者治疗后6个月时的唾液腺摄取指数和分泌指数显著高于3个月时(P<0.05)。治疗后3个月,观察组患者的唾液腺摄取指数和分泌指数显著高于对照组(P<0.05);治疗后6个月,2组患者的唾液腺摄取指数和分泌指数比较差异无统计学意义(P>0.05)。治疗前2组患者血清TNF-α、TGF-β_(1)、IL-6、IL-1水平比较差异无统计学意义(P>0.05)。2组患者治疗后3、6个月时的血清TNF-α、TGF-β_(1)、IL-6、IL-1水平显著低于治疗前(P<0.05);2组患者治疗后6个月时的血清TNF-α、TGF-β_(1)、IL-6、IL-1水平显著低于治疗后3个月时(P<0.05)。治疗后3个月时,观察组患者血清TNF-α、TGF-β_(1)、IL-6、IL-1水平显著低于对照组(P<0.05);治疗后6个月时,2组患者血清TNF-α、TGF-β_(1)、IL-6、IL-1水平比较差异无统计学意义(P>0.05)。治疗期间,对照组和观察组患者不良反应发生率分别为16.38%(47/287)、8.01%(23/287),观察组患者不良反应发生率显著低于对照组(χ^(2)=8.457,P<0.05)。治疗后6个月时,对照组和观察组患者甲状腺功能减退症发生率分别为12.46%(35/281)、3.56%(10/281),观察组患者甲状腺功能减退症发生率显著低于对照组(χ^(2)=15.098,P<0.05)。结论与大剂量放射性碘-131治疗相比,小剂量放射性碘-131治疗甲状腺功能亢进症疗效更好,可有效减轻炎症及唾液腺功能损伤,且甲状腺功能减退症及不良反应发生率低。