Development and validation of a risk model for noninvasive detection of cancer in oral potentially malignant disorders using DNA image cytometry

Objective:To elucidate whether DNA aneuploidy was an independent discriminator for carcinoma within oral potentially malignant disorders(OPMDs),and further establish and validate a risk model based on DNA aneuploidy for the detection of oral cancer.Methods:A total of 810 consecutive patients with OPMD were prospectively enrolled from March 2013 to December 2018,and divided into a training set(n=608)and a test set(n=202).Brushing and biopsy samples from each patient were processed by DNADNA image cytometry and histopathological examination,respectively.Results:DNA aneuploidy of an outside DNA index≥3.5 in OPMD was an independent marker strongly associated with malignant risk[adjusted odds ratio:13.04;95%confidence interval(CI):5.46-31.14].In the training and test sets,the area under the curve(AUC)was 0.87(95%CI:0.82-0.91)and 0.77(95%CI:0.57-0.97),respectively,for detecting carcinoma in OPMD patients.The independent risk factors of lateral/ventral tongue and non-homogenous type combined with a risk model built with a multivariate logistic regression revealed a more favorable diagnostic efficacy associated with the training set(AUC:0.93;95%CI:0.91-0.96)and test set(AUC:0.94;95%CI:0.90-0.98).The sensitivity and specificity of carcinoma detection within OPMD was improved to 100%and 88.1%,respectively.Conclusions:This large-scale diagnostic study established a risk model based on DNA aneuploidy that consisted of a noninvasive strategy with lateral/ventral tongue and non-homogenous features.The results showed favorable diagnostic efficacy for detecting carcinoma within OPMD,irrespective of the clinical and pathological diagnoses of OPMD.Multicenter validation and longitudinal studies are warranted to evaluate community practices and clinical applications.

Difficult and complicated oral ulceration:an expert consensus guideline for diagnosis

The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists.The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers,based on factors such as detailed clinical medical history inquiry,histopathological examination,and ulceration-related systemic diseases screening.Not only it can provide a standardized procedure of oral ulceration,but also it can improve the diagnostic efficiency,in order to avoid misdiagnosis and missed diagnosis.

Treatment of exfoliative cheilitis with Traditional Chinese Medicine：a systematic review

OBJECTIVE:To systematically review treatments of exfoliative cheilitis based on symptom patterns in terms of Traditional Chinese Medicine.METHODS:Pub Med, Cochrane Central Register of Controlled Trials and Wanfang data were screened for case reports, case series or clinical trials that were published in English or Chinese from January,1973 to September, 2015.The keyword of "exfoliative cheilitis or scaling cheilitis or factitious cheilitis" was used.Effectiveness or ineffectiveness was investigated as outcome for Meta analysis, which is based on effective index in each study.Response to treatment was described for case reports or case series.RESULTS:From 38 screened studies, 17 were randomized controlled trials(RCTs), 5 were single-arm trials, and 16 were case reports or case series.Three RCTs were eligible for Meta analysis and all of them compared managements between Traditional Chinese Medicine and corticosteroids for exfoliative cheilitis, which involved 223 participants.Interestingly, data of Meta analysis showed similar effect of Traditional Chinese Medicine and corticosteroids for patients with exfoliative cheilitis [relative risk ratio:1.10; 95% CI(1.00-1.21), P = 0.06].CONCLUSION:Traditional Chinese Medicine might be a substitute for corticosteroids on exfoliative cheilitis.However, the evidence and recommendation of exfoliative cheilitis managements need to be taken with caution because of the low quality of evidence in the studies obtained.

Qilan preparation(芪蓝颗粒) inhibits proliferation and induces apoptosis by down-regulating microRNA-21 in humaqin Tca8113 tongue squamous cell carcinoma cells

OBJECTIVE: The aim of this study was to examine the antitumor effects of Qilan preparation(芪蓝颗粒) on oral squamous cell carcinoma(OSCC) in vitro and to investigate its underlying mechanisms of action. METHODS: Cell proliferation, cell cycle distribution and apoptosis were examined using cell counting kit-8(CCK8) and flow cytometry(FCM). The expression of PTEN and PDCD4 were determined by western blot. Changes in miR-21 levels were quantified using Taq Man stem-loop real-time PCR. After miR-21 was transiently transfected into Tca8113 cells using Lipofectamine?3000, cell proliferation, apoptosis and miR-21 and PDCD4 expression levels were measured. RESULTS: Qilan preparation inhibited Tca8113 cell growth in a dose-and time-dependent manner by inducing apoptosis and cell cycle arrest in S-phase, decreasing miR-21 levels and increasing PTEN and PDCD4 expression. Mi R-21 overexpression reversed the Qilan preparation-induced suppression of cell proliferation and induction of apoptosis while also blocking the increase in PDCD4.CONCLUSIONS: Our study revealed, for the first time, the ability of Qilan preparation to suppress TSCC cell growth and elucidated that Qilan preparation elicits its anti-cancer actions via either the miR-21/PDCD4 or PTEN pathway.