Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

More than 90% of intra-oral malignancies are squamous cell carcinomas. Oral cancer is far more frequent in developing countries than in developed ones. This has probably to do with the differences in the use of tobacco and alcohol and with factors such as oral hygiene, nutrition and general resistance. Through an increased interest for epidemiological studies certain factors are suspected as carcinogenic. They can grossly be divided into chemical, physical and biological. Even though it is often hard to prove the real relation of cause to effect, one can no longer deny the detrimental role of tobacco, of many alcoholic drinks, of poor oral hygiene, of nutritional deficiencies, of short wave irradiation, and possibly of certain viruses. These factors must further be investigated because the overall prognosis of oral cancer is not very good. Determinant in survival are the volume of tumor present (surface and depth), its growth pattern, its localisation, eventual lymph node involvement and general hematogenic metastases, ... The overall five-year survival seems to range between 10% for T4N3 and 95% for T1N0 cases. Early detection and efficient prevention must therefore be encouraged.
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PMID:[Oral cancer: epidemiology and prognosis]. 777 Jun 56

The accuracy of preoperative diagnosis of cervical lymph-node metastasis in oral cancer was assessed by comparing the histopathologic findings in 136 sides of neck dissection with physical examination under anaesthesia (EUA) and computerized tomography (CT) assessments of the metastatic status. The overall accuracy of EUA and CT assessments was 72% and 73%, respectively, and a combination of both methods resulted in sensitivity and specificity rates of 55% and 78%, respectively. Twenty-three of the 51 histologically positive necks had been assessed as negative on both EUA and CT. Six of these contained only micro-metastases, and in another 10, the largest positive node was 1.5 cm or less. Extracapsular spread of metastatic carcinoma was found in 12 of the 23 EUA and CT false-negative dissections. Most of the 21 histologically positive necks which had been correctly assessed as positive on both EUA and CT contained enlarged metastatic nodes, fused nodal masses, extensive extracapsular spread, or more than one of these features. Three of the 85 histologically negative necks had been assessed as positive on both EUA and CT; eight had been positive on EUA alone, and another eight on CT alone. Reactive nodal hyperplasia or sialadenitis was seen in most false-positive dissections. We conclude that the accuracy of preoperative diagnosis of metastasis by routine methods remains poor, and that EUA and CT are reliable only in patients with bulky metastatic deposits.
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PMID:Correlation of histopathologic findings with clinical and radiologic assessments of cervical lymph-node metastases in oral cancer. 778 38

Oral cancer currently strikes about 31,000 Americans each year. Survival rates are approximately 50%. However, early detection followed by appropriate treatment can increase cure rates to about 80%, and greatly improves the quality of life by minimizing extensive, debilitating treatments. An early oral cancer can appear as an innocuous red or white change, an ulcer, or a lump, mimicking many benign lesions. Additionally, when the discomfort is minimal, professional consultation is often delayed, increasing the chance for local spread and regional metastases. Vital staining with toluidine blue and exfoliative cytological examination can aid early detection by accelerating the biopsy of lesions that cannot be classified adequately or made to disappear.
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PMID:Oral cancer. 806 Aug 25

A series of 86 patients presenting with oral cancer underwent neck dissection (114 sides of neck), after preoperative staging by palpation under general anaesthesia and CT imaging. Detailed histopathological assessment of the surgical neck dissection specimens showed the incidence of clinically false-negative and false-positive assessments was 27% and 40%, respectively. Extranodal spread of metastatic carcinoma was present in 16% of clinically negative necks. The pathological findings provided plausible explanations for the clinical misdiagnosis in all 19 of the false-positive necks and in 13 of the 18 false-negative necks, where micrometastases or metastasis to nodes measuring less than 1.7 cm accounted for five and seven misdiagnosed cases, respectively. We conclude that the most stringent clinical protocols, even when supplemented by CT scanning, cannot be expected to achieve 100% accuracy. Detailed histopathological assessment provides the most reliable, currently available method of diagnosing cervical metastatic disease.
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PMID:Pathological findings in clinically false-negative and false-positive neck dissections for oral carcinoma. 807 84

Smokeless tobacco usage, particularly by young men and boys, has increased dramatically in the United States. To assess their possible risk, we reviewed the records of 128 patients with oral carcinoma who had used smokeless tobacco exclusive of other carcinogens. Most were elderly white women (average age, 78 years), 78% of whom had used smokeless tobacco for 40 or more years. The median duration of symptoms before presentation was only 3 months, yet initially 42% of these patients had T3 or T4 lesions and 30% had nodal metastases. Forty-two percent had posttreatment recurrence at the presenting site (average, 8.2 months); 26% had a second oral-cavity tumor at a new site more than 24 months after treatment (average, 49.3 months), indicative of a field cancerization phenomenon. Forty-seven percent were alive after 3 years and 37% after 5 years. These findings emphasize that strong preventive programs are needed if today's young users of smokeless tobacco are not to form future oral cancer patient populations.
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PMID:Smokeless tobacco usage associated with oral carcinoma. Incidence, treatment, outcome. 835 93

Evidence from several laboratories suggests that HPV plays a role in the etiology of squamous cell carcinomas of the oral cavity. A multifactorial risk factor profile for the development of oral cancer may include HPV in addition to well-established risk factors such as tobacco and alcohol use. The prevalence of oral carcinomas reported to be associated with HPV has varied widely due to differences in the sensitivity of the assay used for HPV detection. The aims of this study were: (1) to ascertain the prevalence of HPV DNA in oral squamous cell carcinomas using the most sensitive technique available, the polymerase chain reaction; (2) to determine the type of HPV in the tumors; and 3) to correlate the virologic data with other risk factor data obtained from patients' records. Fourteen (78%) of 18 primary tumors, 6 (67%) of 9 normal epithelial tissues from the patients and 5 (100%) of 5 neck metastases were HPV DNA-positive. Of the 14 HPV DNA-positive primary tumors, specific typing revealed HPV 16 in 2, HPV 18 in 2, HPV 16 and 18 in 5, HPV 6/11, 16 and 18 in 4, and HPV 6/11 in 1. HPV types in the normal or metastatic tissue were usually the same as those in the respective primary tumor. There was no significant association between HPV presence and any of 12 factors or patient characteristics studied.
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PMID:Analysis of human papillomavirus DNA in oral squamous cell carcinomas. 838 92

To investigate the effect of matrix-degrading enzymes on the malignant potential of oral squamous cell carcinoma, the expression of matrix metalloproteinase-2 (MMP-2/72-kD gelatinase/type IV collagenase) in 46 patients who had neck surgery for oral cancer was studied immunohistochemically. In 20 of 26 patients (76.9%) with lymph node metastases, proMMP-2 was strongly expressed, whereas the production of proMMP-2 in tissue was detected only in 5 of 20 patients (25%) who had no lymph node metastases. In tissue specimens, proMMP-2 was expressed in a diffuse invasive mode and in the advancing front of cancer. Because MMP-2 can degrade type IV collagen composed of basement membrane, these results suggest that the in vivo production of the enzyme by cancer is an indicator of the degree of malignancy, and that the analysis of proMMP-2 expression is useful to evaluate the malignant potential in individual oral squamous cell carcinoma.
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PMID:Expression of matrix metalloproteinase-2 related to lymph node metastasis of oral squamous cell carcinoma. A clinicopathologic study. 842 10

During the past year, several areas of head and neck surgery have had notable refinements and advancements. In the area of early laryngeal cancer, the complementary roles of radiation therapy and surgery have been discussed, as well as refinements in endoscopic laser techniques. Issues of the incidence of nodal metastasis and the role of in-continuity versus discontinuous neck dissection in oral and pharyngeal carcinoma have been considered. Rehabilitation techniques following treatment of oral cancer using free microvascular sensate flap reconstructions have been presented. The role of free jejunal interposition and gastric pull-up for reconstruction in hypopharyngeal cancer have been discussed, as well as their compatibility with postoperative radiotherapy. Finally, the concepts for treatment of neck nodal metastases have been discussed in relation to the roles of radiotherapy, radical neck dissection, and modified neck dissection.
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PMID:Surgery for head and neck cancer. 849 11

Treatment outcome was retrospectively assessed in 106 patients with squamous cell carcinoma of the oral tongue registered in the population-based Manitoba Cancer Registry between January 1979 and December 1992. Twenty-six percent were diagnosed with stage I lesions, while 33%, 16%, and 24% were stage II, III, and IV, respectively. Most patients with stage I and II disease were treated with either surgery alone (57%) or in combination with radiotherapy (29%). Advanced lesions were generally treated with radiotherapy alone (37%) or in combination with surgery (35%). Actuarial survival at 5 years was 44% for all patients, and 64%, 46%, 42%, and 16% for stages I to IV, respectively. Over 90% of the 35 treatment failures occurred within 24 months. The initial sites of recurrence were the neck in 22 patients, the primary site in 16 patients, and distant metastases in 5 patients. At the time of death, disease was present above the clavicles in 62%, and metastases were identified in 22%. Locoregional control remains a significant problem in oral cancer. Elective treatment of the neck, resection of the primary with negative surgical margins, and the use of combined modality treatment in advanced stages of disease may help reduce treatment failure.
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PMID:Treatment outcome of squamous cell carcinoma of the oral tongue. 878 77

We have established human oral-squamous-cancer cell lines, BHY and HN, derived from non-metastatic cancer and metastatic cancer respectively. We examined the expression of matrix-degrading enzymes and their inhibitors in these cell lines. Both cell lines expressed pro-matrix metalloproteinase (MMP)1, proMMP2, proMMP9, membrane-type MMP and urokinase-type plasminogen activator. In addition to these enzymes, BHY cells secreted proMMP7 and procathepsin L, while HN cells secreted a large amount of active MMP2. BHY cells secreted a tissue inhibitor of matrix metalloproteinase, TIMP2, but only a trace level of TIMP1. Contrary to BHY cells, HN cells secreted TIMP1, but only a trace level of TIMP2. When we inoculated these cells into the masseter muscle of nude mice, both types of cell formed solid tumors, whose microscopic appearance was identical to that of the original tumors. BHY tumors were highly differentiated squamous-cell carcinomas, and invasive to the masseter muscle and the mandibular bone. Despite their local aggressiveness, BHY tumors did not metastasize to any distant organs. HN tumors were poorly differentiated squamous-cell carcinomas, weakly invasive to the muscle, but not to the mandibular bone. However, HN tumors frequently metastasized to cervical lymph nodes. These results suggest that the net activity of MMP2 (active MMP2/TIMP2) and cathepsin L secreted from cancer cells may contribute respectively to lymph-node metastasis and to bone invasion by oral cancer cells.
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PMID:Possible contribution of active MMP2 to lymph-node metastasis and secreted cathepsin L to bone invasion of newly established human oral-squamous-cancer cell lines. 898


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