Displaying publications 1 - 20 of 35 in total

Abstract:
Sort:
  1. Ghazali N, Bakri MM, Zain RB
    J Oral Pathol Med, 2003 Aug;32(7):383-92.
    PMID: 12846784
    Some oral verrucal lesions may constitute parts of the clinicopathological spectrum of proliferative verrucous leukoplakia (PVL). Because of its idiopathic yet sinister nature, it is possible that PVL may exist in other populations. The aim of this study was to review the clinicopathological features of persistent, multifocal, oral verrucal lesions in Malaysian population.
  2. Ahmed H, Paterson I, Aziz SA, Cremona O, Robinson M, Carrozzo M, et al.
    J Oral Pathol Med, 2023 Sep;52(8):710-717.
    PMID: 37339783 DOI: 10.1111/jop.13460
    BACKGROUND: Most oral squamous cell carcinoma patients present with late-stage disease. Early detection of the disease is considered to be the most effective way of improving patient outcomes. Several biomarkers have been identified as indicators of oral cancer development and progression; however, none have been translated into clinical practice. In this study, we have investigated the role of Epsin3, an endocytic adaptor protein, and Notch1, a transmembrane signalling protein, in oral carcinogenesis with a view to explore their potential as biomarkers.

    METHODS: Oral cancer cell lines and a normal oral keratinocyte cell line were used together with tissue samples of normal oral mucosa (n = 21), oral epithelial dysplasia (n = 74) and early stage (Stages I and II) oral squamous cell carcinoma (n = 31). Immunocytochemical staining, immunoblotting and real-time quantitative polymerase chain reaction (PCR) were performed to assess protein as well as gene expression levels.

    RESULTS: The expression levels of Epsin3 and Notch1 mRNA and protein are variable across different oral squamous cell carcinoma derived cell lines. Epsin3 was upregulated in oral epithelial dysplasia and oral squamous cell carcinoma tissues compared with normal epithelium. Overexpression of Epsin3 resulted in a significant reduction of Notch1 expression in oral squamous cell carcinoma. Notch1 was generally downregulated in the dysplasia and oral squamous cell carcinoma samples.

    CONCLUSION: Epsin3 is upregulated in oral epithelial dysplasia and oral squamous cell carcinoma and has the potential to be used as a biomarker for oral epithelial dysplasia. Notch signalling is downregulated in oral squamous cell carcinoma, possibly through an Epsin3-induced de-activation pathway.

  3. Goh YC, Siriwardena BSMS, Tilakaratne WM
    J Oral Pathol Med, 2021 Aug 06.
    PMID: 34358362 DOI: 10.1111/jop.13228
    BACKGROUND: Ameloblastoma is an odontogenic tumour exhibiting locally invasive behaviour and high recurrence rate after treatment. Conventional ameloblastoma is reportedly been more aggressive showing infiltrative growth patterns and a tendency for recurrence. This is a retrospective study performed to analyse the relationship between clinicopathological characteristics and treatment modalities in the recurrence of ameloblastoma.

    METHODS: 624 cases of ameloblastoma comprising of 519 non-recurrent ameloblastoma and 105 recurrent ameloblastoma from two main diagnostic centres in Malaysia and Sri Lanka were included. The demographic data, clinical characteristics, histopathological data, treatment modality and episodes of recurrence were extracted and analysed.

    RESULTS: The mean age for recurrent ameloblastoma was 37.23 with a peak occurrence in the third decade of life. Recurrent ameloblastoma was marginally female predominant with male to female ratio of 1:1.3. Mandible was the commonest site for the recurrence with a predilection for more than two segments of left mandible followed by left posterior mandible. Follicular (58.1%) histopathological variant was the most reported type to recur followed by plexiform (17.1%). 49.5% of recurrent cases were treated with conservative approach. 65.7% of recurrent cases demonstrated a single episode of recurrence. Mixed (follicular and plexiform) histopathological variants showed the longest average years (11.5 years) for the single episode of recurrence. Plexiform ameloblastoma treated with conservative approach recurred in the shortest follow-up period. The recurrence of ameloblastoma was significantly associated with age group, sub-site of occurrence and histopathological variants (p<0.05).

    CONCLUSION: This study showed that age, sub-site of occurrence and histopathological variants are significant factors responsible for the recurrence of ameloblastoma.

  4. Kallarakkal TG, Zaini ZM, Ghani WMN, Karen-Ng LP, Siriwardena BSMS, Cheong SC, et al.
    J Oral Pathol Med, 2024 Jan;53(1):53-60.
    PMID: 38081145 DOI: 10.1111/jop.13501
    INTRODUCTION: A major pitfall of many of the established oral epithelial dysplasia (OED) grading criteria is their lack of reproducibility and accuracy to predict malignant transformation. The main objective of this study was to determine whether calibration of practicing oral pathologists on OED grading could improve the reproducibility of the WHO 2017 and the binary OED grading systems.

    METHODS: A nationwide online exercise was carried out to determine the influence of calibration on the reproducibility of the WHO 2017 and the binary OED grading systems.

    RESULTS: A significant improvement was observed in the inter-observer agreement for the WHO 2017 OED grading system (K 0.196 vs. 0.448; Kw 0.357 vs. 0.562) after the calibration exercise. The significant difference (p = 0.027) in the level of agreement between those with five or more years and less than 5 years of experience was no more observed (p = 0.426) after the calibration exercise. The percent agreement for binary grading was significantly higher (91.8%) for buccal mucosal lesions as compared to lesions on the tongue after the calibration exercise.

    CONCLUSION: This study validates the significance of calibration in improving the reproducibility of OED grading. The nationwide exercise resulted in a statistically significant improvement in the inter-observer agreement for the WHO 2017 OED grading system among a large number of oral pathologists. It is highly recommended that similar exercises should be organized periodically by professional bodies responsible for continuing education among oral pathologists to improve the reliability of OED grading for optimal treatment of oral potentially malignant disorders.

  5. Goodson ML, Smith DR, Thomson PJ
    J Oral Pathol Med, 2019 Sep;48(8):662-668.
    PMID: 31125457 DOI: 10.1111/jop.12881
    BACKGROUND: Nomograms are graphical calculating devices used to predict risk of malignant transformation (MT) or response to treatment during cancer management. To date, a nomogram has not been used to predict clinical outcome during oral potentially malignant disorder (PMD) treatment. The aim of this study was to create a nomogram for use by clinicians to predict the probability of MT, thereby facilitating accurate assessment of risk and objective decision-making during individual patient management.

    METHODS: Clinico-pathological data from a previously treated cohort of 590 newly presenting PMD patients were reviewed and clinical outcomes categorized as disease free, persistent PMD or MT. Multiple logistic regression was used to predict the probability of MT in the cohort using age, gender, lesion type, site and incision biopsy histopathological diagnoses. Internal validation and calibration of the model was performed using the bootstrap method (n = 1000), and bias-corrected indices of model performance were computed.

    RESULTS: Potentially malignant disorders were predominantly leukoplakias (79%), presenting most frequently at floor of mouth and lateral tongue sites (51%); 99 patients (17%) developed oral squamous cell carcinoma during the study period. The nomogram performed well when MT predictions were compared with patient outcome data, demonstrating good bias-corrected discrimination and calibration (Dxy  = 0.58; C = 0.790), with a sensitivity of 87% and specificity 63%, and a positive predictive value of 32% and negative predictive value 96%.

    CONCLUSION: The "Newcastle Nomogram" has been developed to predict the probability of MT in PMD, based on an internally validated statistical model. Based upon readily available and patient-specific clinico-pathological data, it provides clinicians with a pragmatic diagrammatic aid for clinical decision-making during diagnosis and management of PMD.

  6. Goodson ML, Smith DR, Thomson PJ
    J Oral Pathol Med, 2017 Nov;46(10):896-901.
    PMID: 28833675 DOI: 10.1111/jop.12627
    BACKGROUND: Oral potentially malignant disorders (PMD) harbour unpredictable risk for squamous cell carcinoma development. Current management requires tissue biopsy for histopathology characterisation, dysplasia grading and targeted intervention to "high-risk" lesions, although evidence-based guidelines are limited and diagnoses subjective. This study investigated the use of adjunctive oral brush biopsy techniques during the management of PMD in a UK hospital population.

    METHODS: Retrospective review of a 310 PMD patient cohort presenting to Maxillofacial Surgery in Newcastle upon Tyne with new, single-site lesions between December 2009 and May 2014. Patients underwent Orcellex® brush biopsy and liquid-based cytology examination in addition to conventional biopsy techniques, with management proceeding along established care pathways. Patient demographics, cytology data, most significant histopathology diagnoses and clinical outcome were all documented at the study census date (31.12.15).

    RESULTS: A total of 170 male & 140 female patients (age range 18-91 years), exhibiting primarily leukoplakia (86.5%) at floor of mouth and ventrolateral tongue sites (44.9%), were identified. Management comprised: observation (49.7%), laser surgery (44.9%), antifungal treatment (3.5%) and Head & Neck clinic referral following cancer diagnosis (1.9%). Clinical outcomes were as follows: disease free (51.3%), persistent PMD (42.3%) and malignant transformation (6.4%). Histology and cytology diagnoses strongly correlated (r = .305). Treatment modality, lesion site, histology and cytology diagnoses were the best predictors of clinical outcome.

    CONCLUSIONS: Orcellex® brush cytology provides reliable diagnoses consistent with conventional histopathology and offers less invasive, adjunctive assessment appropriate for long-term monitoring of patients in specialist clinics.

  7. Karajacob AS, Al-Maleki AR, Tay ST
    J Oral Pathol Med, 2022 Jan;51(1):98-105.
    PMID: 34859509 DOI: 10.1111/jop.13266
    BACKGROUND: Oral thrush, a clinical condition due to an overgrowth of Candida yeasts in the oral cavity, is prominent in patients with immunosuppression. As recent updates on oral thrush in South-East Asian (SEA) countries are lacking, this review aimed to address the epidemiology, clinical features and distribution of Candida species, based on published studies in SEA countries over the last two decades.

    METHODS: Published studies on oral candidiasis (2000-2020) were retrieved from PubMed, Scopus, ISI Web of Science and Google Scholar databases to provide information on the incidence and factors affecting oral thrush cases in SEA countries.

    RESULTS: A total of 22 cross-sectional studies involving 3697 subjects from five SEA countries were reviewed in this study. The most frequently reported population were human immunodeficiency virus (HIV)-infected patients. The overall incidence rates amongst HIV-infected patients ranged from 20.7% to 97.0%, while incidence rates ranging from 0% to 72.7% were recorded for non-HIV-infected populations. Pseudomembranous candidiasis and erythematous candidiasis were the most common clinical presentations of oral thrush lesions. Candida albicans was the most common species identified in SEA studies. As oral thrush assessments were made merely based on clinical diagnosis, culture results were not available for most studies.

    CONCLUSION: This review highlights that most studies reporting on oral candidiasis in SEA countries were based on HIV-positive patients. Data are still lacking on oral candidiasis amongst non-HIV immunocompromised and immunocompetent patients. Increasing awareness on the diagnosis, treatment and consequences of this infection, and improved laboratory methods are essential for the management of oral candidiasis in this region.

  8. Thomson PJ, Goodson ML, Smith DR
    J Oral Pathol Med, 2018 Jul;47(6):557-565.
    PMID: 29663518 DOI: 10.1111/jop.12716
    BACKGROUND: Clinically identifiable potentially malignant disorders (PMD) precede oral squamous cell carcinoma development. Oral lichenoid lesions (OLL) and proliferative verrucous leukoplakia (PVL) are specific precursor lesions believed to exhibit both treatment resistance and a high risk of malignant transformation (MT).

    METHODS: A retrospective review of 590 PMD patients treated in Northern England by CO2 laser surgery between 1996 and 2014 was carried out. Lesions exhibiting lichenoid or proliferative verrucous features were identified from the patient database and their clinicopathological features and outcome post-treatment determined at the study census date of 31 December 2014.

    RESULTS: One hundred and 98 patients were identified as follows: 118 OLL and 80 PVL, most frequently leukoplakia at ventrolateral tongue and floor of mouth sites, equally distributed between males and females. Most exhibited dysplasia on incision biopsy (72% OLL; 85% PVL) and were treated by laser excision rather than ablation (88.1% OLL; 86.25% PVL). OLL were more common in younger patients (OLL 57.1 year; PVL 62.25 years; P = .008) and more likely than PVL to present as erythroleukoplakia (OLL 15.3%; PVL 2.5%; P = .003). Whilst no significant difference was seen between OLL and PVL achieving disease-free status (69.5% and 65%, respectively; P = .55), this was less than the overall PMD cohort (74.2%). MT was identified in 2 OLL (1.7%) and 2 PVL (2.5%) during follow-up.

    CONCLUSION: One-third of PMD cases showed features of OLL or PVL, probably representing a disease presentation continuum. Post-treatment disease-free status was less common in OLL and PVL, although MT was infrequent.

  9. Thomson PJ, Goodson ML, Smith DR
    J Oral Pathol Med, 2017 Nov;46(10):888-895.
    PMID: 28833670 DOI: 10.1111/jop.12625
    BACKGROUND: Oral potentially malignant disorders harbour variable and unpredictable risk for squamous carcinoma development. Whilst current management strategies utilise histopathological diagnoses, dysplasia grading and targeted intervention for "high-risk" lesions, clinicians are unable to predict malignant potential.

    METHODS: Detailed, retrospective clinico-pathological analysis of potentially malignant lesions undergoing malignant transformation, from a 590 patient cohort treated by interventional laser surgery and followed for a mean of 7.3 years, was undertaken. Clinical outcome was documented at study census date (31 December 2014).

    RESULTS: A total of 99 patients (16.8%) developed cancer: 71 (12%) seen "unexpectedly" upon excision and 28 (4.8%) progressing to malignancy at a median of 87.3 months post-surgery. Thirty "unexpected" excisions were micro-invasive (42.3%) arising primarily in severely dysplastic precursors (75%) at ventro-lateral tongue and floor of mouth sites (54.5%); 1 patient (1.4%) had a cancer-related death, whilst 58 (81.7%) were disease free. A total of 19 of 28 "progressive" cancers (67.9%) arose at new sites, with erythroleukoplakia a significant predictor of malignancy (P = .0019). Nine (32.1%) developed at the same precursor site, with 6 (77.7%) on the ventro-lateral tongue and floor of mouth. Three (10.7%) were micro-invasive, 9 patients (32.1%) died from metastatic disease and 12 (42.9%) were disease free (P < .001).

    CONCLUSION: Squamous carcinoma may arise at the site of a precursor lesion as transformation or new-site development via field cancerisation. Whilst interventional surgery facilitates early diagnosis and treatment of occult disease, thus reducing risk from same-site transformation, new-site cancer is a significant long-term risk for patients with potentially malignant disorder.

  10. Thomson PJ, Goodson ML, Smith DR
    J Oral Pathol Med, 2017 Nov;46(10):902-910.
    PMID: 28891106 DOI: 10.1111/jop.12641
    BACKGROUND: Contemporary potentially malignant disorder management is based upon provisional histological diagnosis followed by interventional surgery to excise or ablate 'high-risk' mucosal lesions. Although the majority of patients achieve disease-free status post-treatment, others develop further or persistent disease unresponsive to intervention.

    METHODS: A detailed, retrospective clinico-pathological review of treatment resistant potentially malignant lesions, from a 590 patient cohort treated by CO2 laser surgery and followed for a mean of 7.3 years, was undertaken. Clinical outcome was determined at study census date (31 December 2014).

    RESULTS: A total of 87 patients (15%) exhibited PMD disease resistant to treatment: 34 (6%) became disease free following further treatment, whilst 53 (9%) had persistent disease despite intervention. Disease-free patients were younger, changed lesion appearance from erythroleukoplakia to leukoplakia (P = .004), developed further lesions at new sites, demonstrated reduction in dysplasia severity with time and required multiple treatments to achieve disease-free status (P = .0005). In contrast, persistent disease patients were older, male, often presented with proliferative verrucous leukoplakia (PVL) on gingival and alveolar sites, displayed less severe dysplasia initially and underwent laser ablation rather than excision (P = .027).

    CONCLUSION: Despite clinico-pathological profiling of treatment resistant patients, the precise inter-relationship between the inherent nature of potentially malignant disease and the external influence of treatment intervention remains obscure.

  11. Sinon SH, Rich AM, Parachuru VP, Firth FA, Milne T, Seymour GJ
    J Oral Pathol Med, 2016 Jan;45(1):28-34.
    PMID: 25865410 DOI: 10.1111/jop.12319
    The objective of this study was to investigate the expression of Toll-like receptors (TLR) and TLR-associated signalling pathway genes in oral lichen planus (OLP).
  12. Yaacob HB, Samaranayake LP
    J Oral Pathol Med, 1989 Apr;18(4):236-9.
    PMID: 2769596
    A postal survey of 730 Malaysian dental practitioners was undertaken to assess their awareness and acceptance of the plasma derived hepatitis B vaccine. Only 32% of the 325 practitioners who responded had been vaccinated, 41% intended to be and 15% categorically refused vaccination. The main reservations about vaccine acceptance were fear of side effects including AIDS, cost of the vaccine and lack of information. Vaccine efficacy was not confirmed by serology in two-thirds of the vaccinees and two-fifths of the respondents were unaware that 5% of the vaccinees do not develop a successful antibody response after vaccination. Seventy-eight percent of dentists believed that their risk of contracting hepatitis B was high or very high while 71% recalled having received needle stick injuries in the 3 yr prior to the survey. Only 13% of respondents were aware of delta hepatitis while 63% were aware of non-A non-B hepatitis. The survey has highlighted the need for dissemination of information on hepatitis B vaccine among dentists in Malayasia.
  13. Sathasivam HP, Nayar D, Sloan P, Thomson PJ, Odell EW, Robinson M
    J Oral Pathol Med, 2021 Feb;50(2):200-209.
    PMID: 33151583 DOI: 10.1111/jop.13121
    BACKGROUND: Oral potentially malignant disorders are a clinical conundrum as there are no reliable methods to predict their behaviour. We combine conventional oral epithelial dysplasia grading with DNA ploidy analysis to examine the validity of this approach to risk assessment in a cohort of patients with known clinical outcomes.

    METHODS: Sections from diagnostic biopsies were assessed for oral epithelial dysplasia using the WHO grading system, and DNA ploidy analysis was performed using established methods. Patients reviewed for a minimum of 5 years who did not develop oral squamous cell carcinoma were classified as "non-transforming" cases. Patients that developed oral squamous cell carcinoma ≥ 6 months after the initial diagnostic biopsy were classified as having "malignant transformation."

    RESULTS: Ninety cases were included in the study. Seventy cases yielded informative DNA ploidy results. Of these 70 cases, 31 progressed to cancer. Oral epithelial dysplasia grading and DNA ploidy status were both significantly associated with clinical outcome (P 

  14. Sathasivam HP, Sloan P, Thomson PJ, Robinson M
    J Oral Pathol Med, 2022 Feb;51(2):180-187.
    PMID: 34797585 DOI: 10.1111/jop.13262
    INTRODUCTION: Clinical management of oral potentially malignant disorders relies on accurate histopathological assessment of the presence and grade of oral epithelial dysplasia. While adjunctive laboratory tests have provided useful prognostic information, none are in widespread clinical use. This study was performed to assess the clinical utility of two contemporary oral epithelial dysplasia grading systems.

    METHODS: Patients were identified from a clinical database. Oral epithelial dysplasia grading was performed by three oral and maxillofacial pathologists blinded to clinical outcome using the WHO 2017 system and a binary classification. The primary outcome measure was the development of oral squamous cell carcinoma, termed 'malignant transformation'.

    RESULTS: One hundred thirty-one cases satisfied the inclusion criteria, of which 23 underwent malignant transformation. There was substantial inter-rater agreement between the study pathologists for both grading systems, measured using kappa statistics (κ = 0.753 - 0.784). However, there was only moderate agreement between the consensus WHO 2017 dysplasia grade for the study against the original grade assigned by a pool of six pathologists in the context of the clinical service (κ = 0.491). Higher grade categories correlated with an increased risk of developing cancer using both grading systems.

    CONCLUSION: This study demonstrates that the WHO 2017 and binary grading systems are reproducible between calibrated pathologists and that consensus reporting is likely to improve the consistency of grading. The WHO and binary systems were prognostically comparable. We recommend that institutions implement consensus oral epithelial dysplasia grading and prospectively audit the effectiveness of risk stratifying their patients with oral potentially malignant disorders. (249 words).

  15. Bakri MM, Cannon RD, Holmes AR, Rich AM
    J Oral Pathol Med, 2014 Oct;43(9):704-10.
    PMID: 24931506 DOI: 10.1111/jop.12193
    The aim of this study was to investigate the relationship between expression of Candida albicans alcohol dehydrogenases (ADH) genes in archival formalin-fixed paraffin-embedded (FFPE) samples from biopsies of leukoplakia.
  16. Prime SS, Cirillo N, Hassona Y, Lambert DW, Paterson IC, Mellone M, et al.
    J Oral Pathol Med, 2017 Feb;46(2):82-88.
    PMID: 27237745 DOI: 10.1111/jop.12456
    There is now compelling evidence that the tumour stroma plays an important role in the pathogenesis of cancers of epithelial origin. The pre-eminent cell type of the stroma is carcinoma-associated fibroblasts. These cells demonstrate remarkable heterogeneity with activation and senescence being common stress responses. In this review, we summarise the part that these cells play in cancer, particularly oral cancer, and present evidence to show that activation and senescence reflect a unified programme of fibroblast differentiation. We report advances concerning the senescent fibroblast metabolome, mechanisms of gene regulation in these cells and ways in which epithelial cell adhesion is dysregulated by the fibroblast secretome. We suggest that the identification of fibroblast stress responses may be a valuable diagnostic tool in the determination of tumour behaviour and patient outcome. Further, the fact that stromal fibroblasts are a genetically stable diploid cell population suggests that they may be ideal therapeutic targets and early work in this context is encouraging.
  17. Siar CH, Ishak I, Ng KH
    J Oral Pathol Med, 2015 May;44(5):378-85.
    PMID: 25155411 DOI: 10.1111/jop.12247
    The ameloblastoma is a benign but locally aggressive odontogenic neoplasm with a high recurrence rate. While significant progress has been made in our understanding regarding the role of tumoral vasculature relative to the diverse behavioral characteristics of this tumor, no attention has been paid to a distinct subset of blood vessels entrapped within its epithelial compartment. As vascular niches are known to influence tumoral growth, clarification of these vessels is important. The objectives of this study were to investigate the morphologic characteristics of intra-epithelially entrapped blood vessels (IEBVs) in ameloblastoma and to speculate on their relevance.
  18. Siar CH, Ishak I, Ng KH
    J Oral Pathol Med, 2015 Jan;44(1):51-8.
    PMID: 25059841 DOI: 10.1111/jop.12203
    Ameloblastoma is a benign but locally infiltrative odontogenic epithelial neoplasm with a high risk for recurrence. Podoplanin, a lymphatic endothelium marker, putatively promotes collective cell migration and invasiveness in this neoplasm. However, its role in the recurrent ameloblastoma (RA) remains unclear. As morphological, signaling, and genetic differences may exist between primary and recurrent tumors, clarification of their distribution patterns is of relevance.
  19. Siar CH, Ng KH
    J Oral Pathol Med, 2014 Jan;43(1):45-52.
    PMID: 23560539 DOI: 10.1111/jop.12065
    Epithelial-to-mesenchymal transition (EMT) via the mechanism of transcription repression is a crucial process for the induction of invasiveness in many human tumors. Ameloblastoma is a benign odontogenic epithelial neoplasm with a locally infiltrative behavior. Twist, an EMT promoter, has been implicated in its invasiveness. The roles of the other transcription factors remain unclarified.
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links