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Primary intraosseous squamous cell carcinoma of the mandible

中国口腔颌面外科杂志 2008年第B5期6卷 62-63页

作者： ken omura Hiroyuki Harada Hideaki Hirai Department of Oral and Maxillofacial Surgery (Hiroaki Shirmmwto Ken Omura Hiroyuki Harada Hideaki Hirai) TokyoMedical and Dental University Tokyo 1138549 Japan

Purpose: Intraosseous carcinoma was defined as a squamous cell carcinoma arising within the mandible without connection to the oral mucosa。We analyzed clinicopathological findings of intraosseous squamous cell carcinoma of mandible。Patients: There were 13 patients who visited our department from April 2001 to November 2007。They were all males who ranged in age from 34 to 75 years。Eight patients had no lymph node metastasis, and 5 patients had lymph node metastasis。Distant metastasis was not found in all patients。Results: The chief complaint was swelling of mandible in 8 patients, and incomplete healing of extraction socket in 5 patients。Surgery underwent in 5 patients, surgery with radiation therapy in 3 patients, and surgery with radiation and chemotherapy in 5 patients。As surgical treatment for the primary lesion, segmental mandibulectomy was performed in 8 patients and hemimandibulectomy in 5 patients。In 2 patients, excision of skin was carried out in combination with mandibulectomy。The surgical defect was reconstructed with scapular osteocutaneous flap in 7 patients, fibular osteocutaneous flap in one patient and rectus abdominis myocutaneous flap in 5 patients。Ten patients were alive with no evidence of disease, one patient were alive with the disease and two patients died of the disease。Histopathologically, the carcinoma involved the mandibular canal in l0 cases。The carcinoma invaded the muscles around the mandible in 7 cases。Cervical lymph node metastasis was confirmed in 5 of 7 cases in which the carcinoma invaded the muscles。Conclusions: These results suggest that invasion of intraosseous carcinoma to the muscles around mandible is a possible factor of the cervical lymph node metastasis。

关键词：磷片细胞癌治疗方法下颚骨手术治疗

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Malignant Lymphoma with Initial Symptoms in the Mandibular Region

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Journal of Cancer Therapy 2015年第7期6卷 554-565页

作者： Yumi Mochizuki Hiroyuki Harada Kei Sakamoto Kou Kayamori Shin Nakamura Minoru Ikuta Yuji Kabasawa Eriko Marukawa Hiroaki Shimamoto Fumihiko Tushima ken omura Oral and Maxillofacial Surgery Department of Oral Restitution Division of Oral Health Sciences Graduate School Tokyo Medical and Dental University Tokyo Japan Molecular Pathology Department of Oral Restitution Division of Oral Health Sciences Graduate School Tokyo Medical and Dental University Tokyo Japan Oral Radiology Department of Oral Restitution Division of Oral Health Sciences Graduate School Tokyo Medical and Dental University Tokyo Japan

Primary intraosseous lymphoma is rare and there are few case reports manifesting with a mass in the mandible. Thus, we retrospectively reviewed and analyzed the clinical characteristics, treatment, and outcome of extranodal non-Hodgkin’s lymphoma (NHL) with initial mandibular symptoms in our department. At initial treatment of dental clinics, dentists had diagnosed as dental or gingival diseases and had performed dental treatment. Neurological disorder to involvement of the inferior alveolar nerve was present in 80.0% of our cases. On dental or panoramic radiography a specific radiolucent lesion in the mandible was not detected, except for dental lesions. On CT, NHL of the mandible region has no widening and no clear destruction but a slit-like the cortex bone destruction pattern with keeping in shape of the mandibular body (62.5% of CT-examined cases), and extraosseous soft tissue mass are clearer on MRI (100.0% of MRI-examined cases). Histopathologically, 80.0% of our cases were diagnosed as diffuse large B cell lymphoma (DLBCL). One case as B-cell lymphoblastic lymphoma and one case as B-cell lymphoma unclassifiable with features intermediate between DLBCL and Burkitt lymphoma were Stage IV (Ann Arbor staging system) and had poor prognosis. The disease-specific survival rate was 77.8% at 5 years. If unexplained non-specific symptoms such as swelling of the jaw, pain, neurological disorder of the inferior alveolar nerve, tooth mobility are observed, oral surgeons and dentists should not perform dental treatments. CT and MRI show disease specific appearance to be able to give a definitive diasnosis as NHL. PET/CT is useful for scaninng of whole body. A deep bone biopsy is preferred for suspected malignant lymphoma.

关键词： Mandible Diffuse Large B Cell Lymphoma B-Cell Lymphoma Unclassifiable with Features Intermediate between DLBCL and Burkitt Lymphoma B-Cell Lymphoblastic Lymphoma The Inferior Alveolar Nerve

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Evaluation of an oral moisture-checking device for screening dry mouth

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Open Journal of Stomatology 2013年第8期3卷 440-446页

作者： Yosuke Fukushima Tetsuya Yoda Shoichiro Kokabu Ryuichiro Araki Tsubasa Murata Yoshimasa Kitagawa ken omura Shuji Toya Kayoko Ito Saori Funayama Hiroshi Iwabuchi Kazuhiro Asano Yutaka Imai Akihide Negishi Satoshi Yokoo Goichi Matsumoto Eiro Kubota Hideki Watanabe Mikio Kusama Kojiro Onizawa Takuya Goto Seiji Nakamura Ryuichi Nakazawa Kiyoshi Harada Takashi Fujibayashi Community Health Science Center Saitama Medical University Saitama Japan Department of Dentistry and Oral Surgery Tochigi National Hospital Tochigi Japan Department of Oral and Maxillofacial Surgery Division of Medicine Interdisciplinary Graduate School of Medicine and Engi- neering Univer-sity of Yamanashi Kofu and Tamaho Japan Department of Oral and Maxillofacial Surgery Dokkyo Medical University School of Medicine Tochigi Japan Department of Oral and Maxillofacial Surgery Faculty of Medicine Sai-tama Medical University Saitama Japan Department of Oral and Maxillofacial Surgery Institute of Clinical Medicine University of Tsukuba Tsukuba Japan Department of Oral and Maxillofacial Surgery Jichi Medical University Tochigi Japan Department of Oral and Maxillofacial Surgery Kanagawa Dental College Yokosuka Japan Department of Stomatology and Oral Surgery Gunma University Graduate School of Medicine Maebashi Japan Division of Gereatric Dentistry Niigata University Medical & Dental Hospital Niigata Japan Oral and Maxillofacial Surgery Dry Mouth Clinic The Nippon Dental University Niigata Hospital Niigata Japan Oral Diagnosis and Medicine Department of Oral Pathobiological Science Graduate School of Dental Medicine Hokkaido University Sapporo Japan Oral Surgery Department of Oral Restitution Division of Oral Health Sciences Graduate School Tokyo Medical and Dental University Tokyo Japan Section of Oral and Maxillofacial Oncology Division of Maxillofacial Diagnostic and Surgical Sciences Faculty of Dental Science Kyushu University Fukuoka Japan

Objective: This multicenter clinical study was to assess the clinical usability of an oral moisture-checking device in detecting the dry mouth patients and evaluating the optimal measurement site. Materials and Methods: The study group comprised 250 patients with dry mouth and 241 healthy volunteer subjects at 13 medical centers. This device was used to measure the moisture degrees of the lingual mucosa and the buccal mucosa. Subjective oral dryness, objective oral dryness, and saliva flow rates were also compared between the two groups. For statistical analysis, receiver-operating characteristic analysis was performed to calculate the area under the curve (AUC). Results: The moisture degree of the lingual mucosa was significantly lower in the dry mouth group (27.2 ± 4.9) than that in the healthy group (29.5 ± 3.1, AUC = 0.653). When a lingual mucosa moisture degree of 31.0 or higher was defined as normal, less than 27.0 as dry mouth, and 27.0 to less than 31.0 as borderline zone of dry mouth, both the sensitivity and the specificity for the diagnosis of dry mouth were close to 80%. Conclusion: These results suggest that the oral moisture-checking device is a usable screening device for dry mouth.

关键词： Dry Mouth Oral Moisture-Checking Device ROC Analysis

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Frequent Copy Gain of the <i>MET</i>Gene in Hypopharyngeal and Laryngeal Cancer in the Japanese Population

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Journal of Cancer Therapy 2015年第12期6卷 1093-1102页

作者： ken Akashi Yasuhiro Ebihara Go omura Yuki Saito Masafumi Yoshida Mizuo Ando Takahiro Asakage Tatsuya Yamasoba Yoshinori Murakami Division of Molecular Pathology Institute of Medical Science The University of Tokyo Tokyo Japan Department of Otolaryngology-Head and Neck Surgery The University of Tokyo Tokyo Japan Department of Head and Neck Surgery Saitama Medical University International Medical Center Saitama Japan Department of Head and Neck Surgery Tokyo Medical and Dental Graduate School of Medicine Tokyo Japan

Molecular targeting therapy to specific genetic alterations has not been established in head and neck squamous cell carcinoma (HNSCC) except for cetuximab treatment. To characterize alterations of actionable oncogenes in HNSCC, we examined the gain of copy and mutation of the MET gene in 54 Japanese HNSCC. Copy gain of the MET was analyzed by droplet digital PCR (ddPCR) and quantitative real time PCR (qPCR) using 2 distinct fragments of the gene, and mutation was examined in exons 14 - 19 of MET by Sanger sequencing. Both ddPCR and qPCR showed significantly correlated results in copy number at two distinct fragments of the MET gene (R = 0.96 and R = 0.78), although ddPCR gave more significant and sensitive results. Copy gain of the MET was detected in 10 of 54 (19%) HNSCCs and more frequently observed in tumors of the hypopharynx (4 of 12;33%) or larynx (5 of 13;38%) than those of the oral cavity (1 of 21;4%) or oropharynx (0 of 8;0%), suggesting the existence of site-specific features in the oncogenic mechanisms of HNSCCs. Copy gain of the MET was also observed preferentially in older patients, although no correlation in other parameters, including clinical stages and overall or recurrence-free survival, was observed. On the other hand, of the two HNSCCs in which nucleotide substitution was detected, one was R1040Q in exon 15 with unknown function, and the other was a silent mutation in exon16. These results suggest that copy gain of the MET can provide an indicator for treatment with tyrosine kinase inhibitors for MET in a subset of hypopharyngeal or laryngeal cancer.

关键词： Head and Neck Squamous Cell Carcinoma MET Copy Gain Mutation Molecular Targeting Therapy

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High Incidence of Null-Type Mutations of the <i>TP</i>53 Gene in Japanese Patients with Head and Neck Squamous Cell Carcinoma

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Journal of Cancer Therapy 2014年第7期5卷 664-671页

作者： Yasuhiro Ebihara Miwako Iwai ken Akashi Takeshi Ito Go omura Yuki Saito Masafumi Yoshida Mizuo Ando Takahiro Asakage Tatsuya Yamasoba Yoshinori Murakami Department of Otolaryngology—Head and Neck Surgery The University of Tokyo Tokyo Japan Division of Molecular Pathology Institute of Medical Science The University of Tokyo Tokyo Japan

Objective: Molecular targeting therapy has not been generally established in head and neck squamous cell carcinoma (HNSCC) except for cetuximab treatment for targeting epidermal growth factor receptor (EGFR). We analyzed alterations of the TP53, KRAS2, and EGFR genes in Japanese HNSCC to identify subpopulations of tumors potentially susceptible or not susceptible to specific therapy based on their genetic alterations. Materials and Methods: A total of 56 Japanese subjects were included in this study. Genomic DNA of exons 5 - 9 of the TP53, exons 1 and 2 of the KRAS2, exons 19 - 22 of the EGFR, and their flanking sequences were amplified by polymerase chain reaction (PCR) followed by direct sequencing. Splicing variants of EGFR were examined by reverse transcription (RT)-PCR. Results: Mutations of the TP53 and KRAS genes were detected in 25 (45%) and 2 (4%) of 56 HNSCC cases, respectively, while neither mutation nor splicing variant of EGFR was observed. The TP53 mutation did not correlate with clinical stages or primary sites of the tumors. The patterns of nucleotide substitutions specific to HNSCC were not observed. However, the incidence of null-type mutations of the TP53, which cannot be detected as abnormal by conventional immunohistochemical (IHC) studies, was significantly higher (10/25;40%) than that of HNSCC reported in other countries. Conclusion: Frequent TP53 mutations, especially null-type mutations, but infrequent or no alterations of the KRAS and EGFR suggest that the sequencing analysis of theTP53 mutation rather than IHC analysis of p53 provides a potentially useful marker to predict the response of HNSCC to chemotherapy or radiotherapy.

关键词： Head and Neck Squamous Cell Carcinoma TP53 Mutation KRAS EGFR Molecular Marker

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Novel serine/threonine kinase 11 gene mutations in PeutzJeghers syndrome patients and endoscopic management

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World Journal of Gastrointestinal Endoscopy 2013年第3期5卷 102-110页

作者： Hiroyuki Yajima Hajime Isomoto Hiroaki Nishioka Naoyuki Yamaguchi ken Ohnita Tatsuki Ichikawa Fuminao Takeshima Saburo Shikuwa Masahiro Ito Kazuhiko Nakao Kazuhiro Tsukamoto Shigeru Kohno Department of Molecular Microbiology and Immunology Nagasaki University Graduate School of Biomedical SciencesNagasaki University School of MedicineNagasaki 852-8501Japan Department of Gastroenterology and Hepatology Nagasaki University School of MedicineNagasaki 852-8501Japan Department of Pharmacotherapeutics Nagasaki University Graduate School of Biomedical SciencesNagasaki University School of MedicineNagasaki 852-8521Japan Department of Pathology National Nagasaki Medical CenterOmuraNagasaki 856-0835Japan

AIM:To explore mutations in serine/threonine kinase 11(STK11) gene in Peutz-Jeghers syndrome(PJS) with gastrointestinal(GI) hamartomatous ***:Six Japanese PJS patients in 3 families were enrolled in this *** of the cases had hamartomatous polyposis in the gastrointestinal tract,including the small intestine,along with mucocutaneous ***-band imaging(NBI)-magnification endoscopy was employed to detect microvascular and microsurface irregularities in the GI *** magnification findings could be classified into three groups(type A,type B,or type C).Endoscopic polypectomy was performed using double-balloon enteroscopy or *** DNA was extracted from a whole blood sample from each *** of the coding exons of STK11 gene,its boundary regions,and the promoter region containing the polymorphic regions were amplified by polymerase chain reaction,and direct sequencing was performed to assess the germline ***:NBI-magnification endoscopic observation could detect the abnormalities in microvessels and microsurface structures of GI ***,we found 5 cases of type A and one case without the examination for the gastric polyps,while there were 4 cases of type B and 2 case of type A for the colorectal ***-nine small-bowel and 115 colorectal polyps over 27 sessions for each were resected endoscopically without significant *** only delayed complication included the occurrence of bleeding in a case,and this was successfully managed with *** polyps contained no malignant *** on mutation analysis,all 3 cases in Family I exhibited the +658C>T nonsense mutation in exon 5,which resulted in the production of a truncated protein(Q220X).In Family II,a case had-252C>A and-193C>A in the promoter *** Family III,a case was found to have the +1062C>G(F342L) mutation in exon ***:We found two novel mutations of STK11 in association with ***

关键词： Peutz-Jeghers syndrome Serine/threonine kinase 11 Gastrointestinal hamartomatous polyps Double-balloon enteroscopy Narrow-band imaging

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