Malignant and premalignant conditions affecting the genital area
Shiv Shanker Pareek in The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
Squamous cell carcinoma is the most frequently occurring penile cancer. It may be present on the glans penis, prepuce or shaft of the penis and is slow growing initially, without affecting erectile function, ejaculation or urination. Consequently, many patients do not seek medical attention immediately. Several risk factors are associated with the premalignant condition, possibly predisposing the patient to squamous cell carcinoma: Bowen’s disease of the glans penis (also called Queyrat’s erythroplasia).bowenoid papulosis.human papillomavirus.balanitis xerotica obliterans (also called lichen sclerosus; previously lichen sclerosus et atrophicus).leukoplakia – a precancerous oral lesion.phimosis.
CRM Trials for Assessing Toxicity and Efficacy
John Crowley, Antje Hoering in Handbook of Statisticsin Clinical Oncology, 2012
Here, we consider the implementation of a TriCRM design in a mock trial in the setting of head and neck cancer. Patients with head and neck cancer have a global cancer predilection throughout the oropharyngeal mucosa. Oral leukoplakia is an established precursor lesion to oropharyngeal cancer. Current management options include watchful waiting, laser ablation, or aggressive surgical resection. Photodynamic therapy (PDT) coupled with a photosensitizing agent (Aminolevulinic Acid HCL, ALA) could potentially permit a targeted therapy approach to high-risk mucosal lesions. Typically, extremely high energies with spot sizes of 1–2 mm are used to coagulate blood vessels in the vocal cord, with no adjuvant drug. In this mock trial, assume that equivalent or superior clinical outcomes at much lower laser energy densities could potentially be obtained through the introduction of the photosensitizing agent, ALA. We describe here a dose-finding clinical trial design that attempts to determine the safety and tolerability of the optimal laser dose (PDT) needed to activate ALA in the oral cavity among subjects with premalignant oral lesions.
Head and neck
Tor Wo Chiu in Stone’s Plastic Surgery Facts, 2018
Chemoprevention is not yet a reality, but the aim(s) would be to Treat premalignant conditions such as leukoplakia. Some trials show that carotene may help in clinical resolution, but other studies show no reduction in the rate of malignant transformation (nor have studies with bleomycin or vitamin A) (see premalignant conditions).Prevent second primary (5% risk per year) – there is evidence of reduced risk of a second primary (4% vs. 24% in placebo) or recurrence using retinoids, e.g. 13-cRA seen in early studies (Hong WK, N Engl J Med, 1990) but have been difficult to confirm in larger studies. Furthermore, ~1/3 need to stop due to side effects particularly with high-dose regimes.High-risk population – there is no evidence for any benefit from taking vitamins, retinoids or carotene. In fact, β-carotene (taken during cancer prevention trials undertaken based on early 1980s epidemiology) may increase risk of lung cancer in smokers and those with asbestos exposure. A Cochrane review (2007) demonstrated 1%–8% increased mortality, though some dispute the methodology of these meta-analyses.
Diagnostic and prognostic role of protein and ultrastructural alterations at cell–extracellular matrix junctions in neoplastic progression of human oral malignancy
Published in Ultrastructural Pathology, 2022
Harsh Nitin Dongre, Snehal Mahadik, Chetan Ahire, Pallavi Rane, Shilpi Sharma, Fatima Lukmani, Asawari Patil, Devendra Chaukar, Sudeep Gupta, Sharada Suhas Sawant
Early diagnosis of oral potentially malignant lesions (OPMLs) as well as detection of invasive features in non-metastatic tumors is of paramount clinical importance, as mortality is often high in the late stages.1 Several attempts have been made to establish early diagnostic and prognostic markers for oral cancer, however, so far none has made any impact in routine clinics, mainly due to lack of clinical validation.2,3 Development of oral precancerous lesions/conditions is very common in southern Asia including the Indian subcontinent.4 In the Indian scenario, leukoplakia is the most common OPML contributing to the high incidence of oral cancer.5 As per the latest World Health Organization (WHO) grading system, leukoplakia is a clinical diagnosis for which the histopathological diagnosis may be hyperplasia, dysplasia (mild, moderate, severe), or carcinoma that is characterized by cellular atypia and loss of normal maturation and stratification.6 Although, all leukoplakia lesions do not transform into malignancy, follow-up studies indicate that 4–18% of cases of oral squamous cell carcinomas (OSCC) arise from preexisting lesions including leukoplakia and have the potential to progress into an invasive malignancy.7
A genomic sequence of the type II-A clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated system in Mycoplasma salivarium strain ATCC 29803
Published in Journal of Oral Microbiology, 2022
Harumi Mizuki, Yu Shimoyama, Taichi Ishikawa, Minoru Sasaki
The genome size of Mycoplasma spp. is extremely small, ranging from 580 to 1,360 kbp, and the number of protein-coding sequences in the genomes is also small, ranging between 475 and 1,545 in 38 strains from 22 spp. studied [11]. Most Mycoplasma spp. are considered to be parasites and certain Mycoplasma spp. have developed mechanisms to enter host cells that are not naturally phagocytic [8]. Immunohistochemistry and immunoelectron microscopy experiments have shown that M. salivarium often colonizes in the epithelial cells of oral leukoplakia [12,13]. Oral leukoplakia is an oral potentially malignant disorder characterized by various site-specific chromosomal abnormalities and gene alterations in epithelial cells [14–17]; however, its underlying mechanism has not yet been clarified. The relationship between M. salivarium in epithelial cells and the development and/or progression of oral leukoplakia is also unknown.
Determination and diagnostic value of CA9 mRNA in peripheral blood of patients with oral leukoplakia
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2018
Manuel Torres López, Mario Pérez Sayáns, Cintia Chamorro Petronacci, Francisco Barros Angueira, Pilar Gándara Vila, Alejandro Lorenzo Pouso, Abel García García
At present, biopsy and histopathological analysis remain the "gold standard" of diagnostic tests. Due to the great potential for malignant transformation of oral leukoplakia, it is essential to search for prognostic biomarkers, objectively agreeing on the results, to help identify the evolution of the lesions and to help the clinician to better manage them. It is also necessary to evolve towards a less invasive method to conduct these studies. Liquid biopsy is a non-invasive tool for the discovery of biomarkers that is generating great expectations. Liquid biopsies (in blood, urine, saliva, etc.), due to their minimally invasive nature, are associated with significantly lower morbidity and can be performed more frequently to obtain a better follow-up of the disease8.
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