Showing papers by "Johan Lindholm published in 2004"

Human papillomavirus is more common in base of tongue than in mobile tongue cancer and is a favorable prognostic factor in base of tongue cancer patients.

Abstract: The frequency of human papilloma virus (HPV) and its influence on clinical outcome was analyzed retrospectively in pre-treatment paraffin embedded biopsies from 110 patients with tongue cancer. The presence of HPV DNA was examined in 85 mobile tongue tumors and 25 base of tongue tumors by a polymerase chain reaction (PCR) with 2 general primer pairs, GP5+/6+ and CPI/IIG. When HPV-DNA was found, HPV-type specific primers and direct sequencing were used for HPV sub-type verification. Twelve of 110 (10.9%) samples were HPV-positive; 9 for HPV-16, 1 for HPV-33, 1 for HPV-35 and 1 could not be analyzed because of shortage of DNA. HPV was significantly more common in base of tongue tumors (10/25, 40.0%) compared to tumors of the mobile tongue (2/85, 2.3%). The influence of HPV on clinical outcome in mobile tongue cancer could not be studied, due to that HPV was present in too few cases. Of the 19 patients with base of tongue cancer that were included in the survival analysis, however, 7 patients with HPV-positive base of tongue cancer had a significantly favorable 5-year survival rate compared to the 12 HPV-negative patients. In conclusion, HPV is significantly more common in base of tongue cancer than in mobile tongue cancer, and has a positive impact on disease-specific survival in patients with base of tongue cancer.

The γ2 Chain of Laminin-5 as an Indicator of Increased Risk for Recurrence in T1 Stage Tongue Cancer

Abstract: Background: Treatment of small, localized tongue cancer is an act of balance between sufficiently extensive surgery and/or radiotherapy for safe cure, and minimizing treatment-related morbidity. The biological aggressiveness of these cancers is variable and conventional histopathology does not give sufficient information concerning the risk for local or regional recurrence. Laminin-5 is an extracellular matrix protein noted to have special importance for epithelial cell invasion. Patients and Methods: We investigated 43 diagnostic biopsies from patients with T1 tongue cancer treated with wedge excision only. Immunohistochemical analysis was performed using a polyclonal antibody against the A2 chain of laminin-5. Results: Thirty-six specimens were evaluated and 16 patients had a recurrence. A staining pattern of 50% or more was seen in the majority of patients (75%) with tumor recurrence and in fewer patients (45%) without recurrence. Conclusion: In order to optimize treatment for the individual T1 tongue cancer patient, immunostaining against laminin-5 appears to be one possible useful tool. TNM stage, including cervical lymph node status, are well known as important prognostic factors in oral squamous cell carcinoma, and form the basis of treatment decision (1). For small localized tongue cancer, primary local tumor control can be achieved equally with adequate wedge excision or radiation therapy (2-4), but regional as well as local recurrences after treatment still remain a considerable clinical problem. Successful management of local and neck relapse is difficult and salvage rates for this group are extremely poor. When surgery is used as single treatment, the risk for recurrence in patients with early stage (T1-2 N0 M0) tongue carcinomas has been reported to be 9% at the primary site, 26% in the regional neck nodes, and 4% both locally and regionally (5). Ultrasound-guided fine-needle aspiration cytology has brought down the incidence of "occult metastasis", but the management of the neck in clinically node-negative (N0) patients remains a controversial issue (6).