Adrenocortical Neoplasms: Role of Prognostic Markers MIB-1, P53, and RB

Oral cancer ranks sixth most prevalent type of cancer worldwide due to its alarming increase every year. Progression of oral cancer depends on various heterogeneity pathways, but their exact mechanism remains unclear. Genetic aberrations on oral cancer cells set back the effectiveness of existing therapies and make it more challenging by triggering drug resistance. To understand the intricate details of oral cancer pathogenesis and for advancing current therapies, genetic modifications are the most promising approach. In this review, we tabulated the information on genetic alterations, microbial associations, aberrant signalling pathways and their clinicopathological characters on the pathogenesis of oral cancer. We primarily discussed the pitfalls of the current treatment regimen and its associated drug resistance pattern, which will provide a clear insight into developing new drugs. We also highlighted the genetic-molecular targets with their current clinical status on drug development and its outcome.

Genetic alterations and clinical dimensions of oral cancer: a review.

p16 is overexpressed in oral squamous cell carcinoma patients who are positive for human papilloma virus. The p53 tumor suppressor gene is commonly mutated in human cancer. The aim is to correlate clinical and pathological features with p16 and p53 expression. This is a prospective, observational study of 50 consecutive cases (43 males and 7 females) who underwent surgery for oral cancer. p16 and p53 were determined by immunohistological staining. The results were obtained and analyzed using chi-square test (Statistical Software SPSS 21.0 version); p value ≤ 0.05 was considered significant. Of the 50 cases, p16 and p53 were overexpressed in 30% and 54% of patients, respectively. Overexpression of p16 was not significantly associated with age, subsites of oral cavity, or degree of differentiation. However, smokeless tobacco was significantly associated with p16 expression (p = 0.012). Similarly, overexpression of p53 was not correlated with age, subsites of oral cavity, or degree of differentiation. Seventy-five percent of poorly differentiated cancers had overexpression of p53 though this did not reach statistical significance (p = 0.279). p53 was overexpressed in smokers (80.95%) and those consuming alcohol (60%).

Clinical and Histopathological Correlation of p16 and p53 Expression in Oral Cancer.

Mutations of p53 gene is one of the most common events in human cancers including oral squamous cell carcinoma (OSCC). However, its role in carcinogenesis and association with regard to prognosis is still under investigation and unclear. The aim was to study the expression of p53 in patients of OSCC and correlation with clinical presentation and prognosis. In this retrospective observational pilot study, we examined expression of p53 in 50 histologically diagnosed cases of OSCC and correlated it with initial clinical presentation and clinical events in follow up period. p53 expression was significantly negative (94%) in patients with history of only oral tobacco consumption while cases with additional history of smoking or alcohol were positive (p = 0.0001 and 0.011). On the other hand, aggressive course of the disease was found to be significant with p53 positivity in the form of lymph nodal extension (13 out of 17 cases) (p = 0.011) and recurrence (6 out of 10 cases) (p = 0.024). p53 was overexpressed (positive) in predisposing factors like smoking and alcohol but not in OSCC associated with chewing tobacco. p53 overexpression is also associated with advanced TNM stage. To the best of our knowledge, this is the first report where association of p53 overexpression and oral tobacco consumption associated OSCC was not observed and we recommend that carcinogenic events in chewing tobacco induced OSCC should be studied separately for its unique set of mutations.

Correlation of p53 expression with Clinical Presentation and Prognosis of Oral Squamous Cell Carcinoma Patients: A Pilot Study

Adrenocortical carcinomas (ACC) are rare tumours responsible for only 0.02% of the total number of malignant diseases. However the ACC are aggressive with a mean fiveyears survival of 20-50% and are often associated with increased production of adrenocortical hormones. The effect of the treatment is controversial and often based on small retrospective series or expert opinions. Centralization, international attention and collaboration in the treatment of ACC are mandatory. Randomized clinical trials are needed to determine the best treatment strategy in order to increase survival in patients with ACC.

Treatment of adrenocortical carcinomas is challenging

Background : Oral cancer is the sixth most common cancer in the world. P53 mutations are associated with the development of oral squamous cell carcinomas. This study is to determine the presence of p53 oncogene expression in cases of oral malignant, premalignant and benign lesions and to show association of p53 oncogene and lymph node enlargement in malignant lesion. Materials and Methods : Four to five micron-thick sections of formalin fixed, paraffin embedded biopsy material from various intra-oral sites of 50 patients were collected, in the series of 50 cases, 35 oral squamous cell carcinoma, 10 dysplastic lesions and 05 hyperplastic lesions were assessed for p53 expression. The tissue sections were immunohistochemically analyzed for the expression of p53 gene. Results : Out of 50; 22/35 (63%) cases of squamous cell carcinoma, 02/10 (20%) cases of dysplasia (20%), were positive for p53. Five hyperplastic lesions were negative for p53. The P53 protein was not identified in benign lesion. Conclusion : Results indicate that p53 over-expression is seen in oral squamous cell carcinomas. It is a significant marker of carcinogenesis and can be considered as an important marker for clinical evaluation, diagnosis as well as prognosis of disease. Journal of Pathology of Nepal (2015) Vol. 5, 747-751

p53 Expression in Oral cancer: A study of 50 cases

Background: Adrenal cortical carcinoma is a rare malignant tumor. Several systems were proposed for diagnosis and evaluation of adrenocortical tumors.Weiss system is most commonly used method for assessment of malignancy, but only few studies has applied this criteria, for assesement of prognosis. The aim of this study was to analyzethe histological features & immunostaining status of adrenocortical carcinoma diagnosed according to Weiss criteria and correlate the data with patient clinical finding and outcomes. Materials and Methods: In this study clinicopathological features of 12 cases were reviewed and diagnosed as adrenocortical carcinoma on the basis of Weiss criteria and immunostaining. Grading was done according to the nine histopathological criteria of Weiss and is applied for assessment of prognosis. Each tumor was labeled malignant, when it scored ≥4 point of this histological criteria, tumors with ≤3 points were considered as adenoma and not included in the series. Immunostains applied were, Vimentin, Cytokeratin, synaptophysin, chromogranin, Vinyl mandilic acid, epithelial membrane antigen and Melan A. Results: All cases studied, presented at least four of the Weiss criteria and thus diagnosed as adrenocortical carcinoma. Patients with 7 and more score of Weiss criteria is considered as high grade carcinoma. Immunostains, have role in the diagnosis of adrenal cortical tumor, but does not have any significant clinical outcome. Conclusion: Weiss criteria was found to be a good prognostic factor in adrenal cortical carcinoma. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6020 JPN 2012; 2(3): 193-197

/pdf/nonfunctioning-adrenocortical-carcinoma-a-study-of-12-cases-27ihsdh0x6.pdf

A Ghanghoria

Papers

p53 Expression in Oral cancer: A study of 50 cases

Nonfunctioning adrenocortical carcinoma: a study of 12 cases