Abstract Objective To assess whether the neutophil to lymphocyte ratio ( NLR ) and platelet to lymphocyte ratio ( PLR ) before complete surgical staging will provide information on lymph node metastasis ( LNM ) in oral squamous cell carcinoma ( OSCC ) patients and to evaluate the relation of NLR and PLR with the various clinicopathologic characteristics. Methods The clinicopathological data and the preoperative complete blood investigation details were obtained from 68 OSCC patients who underwent surgical treatment. Receiver operating characteristics ( ROC ) curve analysis was used to evaluate cut‐off, sensitivity, and specificity values for preoperative NLR and PLR in order to predict LNM . Results Lymph node involvement was detected in 24 (35%) patients. The best cut‐off value for predicting LNM was 128.5 for the PLR , with 75% sensitivity and 70.45% specificity ( P < 0.05). Fifty‐five percent of patients had PLR ≤ 128.5 and 45% had PLR > 128.5. The PLR was higher in the lymph‐node‐positive group than in the negative group (147.63 ± 35.49 vs. 120.51 ± 42.5) ( P < 0.05). There was an association between PLR cut‐off and tumor stage. The best cut‐off value for predicting LNM was 1.77 for NLR , with sensitivity of 87.5% and 25% specificity ( P = 0.92). Conclusion Preoperative PLR is directly associated with nodal involvement status of OSCC . Preoperative PLR is superior to NLR for predicting LNM in OSCC .
The keratocystic odontogenic tumor (KCOT), earlier considered as the odontogenic keratocyst (OKC), is now classified as a benign neoplasm owing to its aggressive nature which includes a high recurrence rate. This case report describes a symptomatic large intraosseous odontogenic cystic neoplasm in the left mandible presenting radiographically as a large multilocular radiolucency and associated with an impacted tooth. The typical clinical and distinguishing histological features of KCOT morphed by the presence of inflammation are discussed here together with an intriguing clear cell component and epithelial theques and their clinical relevance. The newly acknowledged neoplastic potential serving significant role in treatment planning has also been addressed. Various lesions can present intraosseously as large multilocular radiolucencies in the jaws. Histopathological examination remains the mainstay for the diagnosis of such lesions.
Gingival growths are one of the frequently encountered types of lesion in the oral cavity. It is the common site for neoplastic and nonneoplastic lesions. Peripheral ossifying fibroma (POF) is one of the inflammatory reactive hyperplasias of the gingiva. It represents a separate clinical entity with diverse histopathological features. Even after adequate surgical excision of the lesion, repeated recurrence is not uncommon. Studies show a recurrence rate of 16-20% in these lesions. The suggested etiology for POF is low-grade irritation due to plaque and calculus. Proper excision of such overgrowths and appropriate oral hygiene instructions will ensure that the lesion does not recur. This case report is of a large, solitary gingival swelling in the maxilla of a 36-year-old male patient that had recurred for the third time after the surgical excision.
Background: Secretor status may possibly be one of the factors in the etiopathogenesis of oral precancerous lesions and subsequently cancer. Studies have shown the relationship between the pathogenesis of disease and secretor status. They have made known that secretor status is a possible factor influencing disease status. Studies have revealed the association between blood groups and specific diseases. Aims: To assess any association of ABO blood grouping with oral potentially malignant disorders (OPMDs) and to examine whether there is any difference in the saliva secretor status in the patients with OPMDs and healthy controls. Materials and Methods: The study consisted of 90 subjects, with 45 patients assigned to two groups (a) Patients with potentially malignant disorders and (b) healthy controls. ABO blood grouping was done and 1 ml of unstimulated saliva was collected in a sterile test tube.The Wiener agglutination test was performed to analyze the secretor status in both the groups. Chi-square test and odd ratio were used to assess the relationship between ABO blood group and OPMDs. Chi-square test was performed to assess the relationship between secretor status and OPMDs. Probability level was fixed at <0.05. Results: The results demonstrated a statistically significant relation between OPMDs and secretor status (P = 0.00). Eighty-seven percent of patients with OPMDs were nonsecretors, while in the control group sixteen percent of them were nonsecretors. There was no statistically significant relationship between ABO blood groups and OPMDs (P > 0.05). Conclusions: The study confirms the inability to secrete blood group antigens in the saliva of patients with OPMDs which could be regarded as a host risk factor. Results could not propose a relationship between ABO blood group and OPMDs.
Percutaneous thermal ablation is widely adopted as a curative treatment approach for unresectable liver neoplasms. Accurate immediate assessment of therapeutic response post-ablation is critical to achieve favourable outcomes. The conventional technique of side-by-side comparison of pre- and post-ablation scans is challenging and hence there is a need for improved methods, which will accurately evaluate the immediate post-therapeutic response.This review summarizes the findings of studies investigating the feasibility and efficacy of the fusion imaging systems in the immediate post-operative assessment of the therapeutic response to thermal ablation in liver neoplasms. The findings could potentially empower the clinicians with updated knowledge of the state-of-the-art in the assessment of treatment response for unresectable liver neoplasms.A rapid review will be performed on publicly available major electronic databases to identify articles reporting the feasibility and efficacy of the fusion imaging systems in the immediate assessment of the therapeutic response to thermal ablation in liver neoplasms. The risk of bias and quality of articles will be assessed using the Cochrane risk of bias tool 2.0 and Newcastle Ottawa tool.Being a review, we do not anticipate the need for any approval from the Institutional Review Board. The outcomes of this study will be published in a peer-reviewed journal.Evaluation of the therapeutic response in liver neoplasms immediately post-ablation is critical to achieve favourable patient outcomes. We will examine the feasibility and technical efficacy of different fusion imaging systems in assessing the immediate treatment response post-ablation. The findings are expected to guide the clinicians with updated knowledge on the state-of-the-art when assessing the immediate treatment response for unresectable liver neoplasms.
Abstract Background Percutaneous thermal ablation has become the preferred therapeutic treatment option for liver cancers that cannot be resected. Since ablative zone tissue changes over time, it becomes challenging to determine therapy effectiveness over an extended period. Thus, an immediate post‐procedural evaluation of the ablation zone is crucial, as it could influence the need for a second‐look treatment or follow‐up plan. Assessing treatment response immediately after ablation is essential to attain favorable outcomes. This study examines the efficacy of image fusion strategies immediately post‐ablation in liver neoplasms to determine therapeutic response. Methodology A comprehensive systematic search using PRISMA methodology was conducted using EMBASE, MEDLINE (via PUBMED), and Cochrane Library Central Registry electronic databases to identify articles that assessed the immediate post‐ablation response in malignant hepatic tumors with fusion imaging (FI) systems. The data were retrieved on relevant clinical characteristics, including population demographics, pre‐intervention clinical history, lesion characteristics, and intervention type. For the outcome metrics, variables such as average fusion time, intervention metrics, technical success rate, ablative safety margin, supplementary ablation rate, technical efficacy rate, LTP rates, and reported complications were extracted. Results Twenty‐two studies were included for review after fulfilling the study eligibility criteria. FI's immediate technical success rate ranged from 81.3% to 100% in 17/22 studies. In 16/22 studies, the ablative safety margin was assessed immediately after ablation. Supplementary ablation was performed in 9 studies following immediate evaluation by FI. In 15/22 studies, the technical effectiveness rates during the first follow‐up varied from 89.3% to 100%. Conclusion Based on the studies included, we found that FI can accurately determine the immediate therapeutic response in liver cancer ablation image fusion and could be a feasible intraprocedural tool for determining short‐term post‐ablation outcomes in unresectable liver neoplasms. There are some technical challenges that limit the widespread adoption of FI techniques. Large‐scale randomized trials are warranted to improve on existing protocols. Future research should emphasize improving FI's technological capabilities and clinical applicability to a broader range of tumor types and ablation procedures.
Biochemical changes occur in biological fluids and tissues of different types of malignancies. Tumor markers in serum, tissue, and other body fluids during neoplastic process are of clinical value in the management of patients with cancers. Serum alkaline phosphatase (ALP) activity is potentially a useful indicator for detection of malignancies, but its status in oral squamous cell carcinoma (OSCC) is less explored.The aim of this study is to evaluate the serum level of ALP in OSCC patients and assess its relation with the clinicopathological features.A total of 175 participants (145 OSCC patients and 30 healthy controls) were included in the study. One hundred and forty-five patients with OSCC who underwent treatment at our institution were included to obtain the clinicopathological data.Fasting blood ALP activity was evaluated using ALP assessment kit and biochemistry analyzer.The data were analyzed by SPSS-21 software (SPSS Statistics for Windows, Version 21.0, Armonk, NY, USA), using t-test, Mann-Whitney U, and Kruskal-Wallis tests.Raised ALP was seen in 24% of OSCC patients. The mean ALP in OSCC was significantly higher than the control. ALP level in patients with advanced stage was significantly higher than with early stage. The serum ALP level in OSCC patients with bone involvement (BI) by local extension of tumor was significantly higher than without BI.ALP showed statistically significant differences in relation to tumor stages and BI. Hence, ALP could be useful in advanced stage disease for expressing the endurance of patient and tumor expansion. Elevated ALP in OSCC patients may indicate BI.
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