Introduction: Identification of serous acinar differentiation is the basic step for the diagnosis of acinic cell carcinoma (ACC). α-amylase was described to be specific for normal acinar cell but its affinity to malignant counterpart is being contentious. Recently discovered marker anoctamin (DOG1) specific for diagnosis of GISTs has been reported for its efficacy to stain the malignant acinar cells and so, it is being of value in ACC diagnosis. On the other hand, negativity of acinar cells to basal cell marker as p63 will give more pronouncement to ACC diagnosis. Objectives: The study were designed to scrutinize the expression of recent marker DOG1 versus α-amylase in ACC diagnosis. Also to correlate between clinical, radiological, histopathological and immunohistochemical findings in ACC cases. Material and methods: Fourteen cases of ACC were obtained and stained immunohistochemically for DOG1, α-amylase and p63. Clinical data as well as radiological findings were obtained from the patients' file to form correlation with immunostaining results. Results: All ACCs (100%) revealed positivity toward DOG1 staining, 6 (44%) cases out of 14 showed α-amylase positivity, and 1 case (7%) showed focal positivity for p63. No significant correlation was found between clinical, radiological and immunostaining results. Significant correlation was obtained between results of DOG1 and α-amylase with p-value=0.034, also significant correlation was obtained between DOG1 and p63 with p-value=0.02. On the other hand, no significant correlation was obtained between results of both α-amylase and p63 with p-value=0.546. Conclusion: DOG1 has a higher efficacy in the diagnosis of ACC than α-amylase and must be used especially for cases with some conflicts as poor tissue sampling or suspicious cases with other carcinomas especially with carcinomas of clear cell features or having a vacuolated cytoplasm.
The surgical remedy of problems related to lower jaw 3 molars is related to common surgical risks like contamination, haemorrhage, pain and swelling. Certain unique risks are related with such surgery, specifically inferior alveolar and lingual nerve harm as these are adjacent vital structures. Risk assessment calls for an entire understanding of dental factors that can impact the care of these characteristic structures. Preoperative radiographic assessment warrants to provide data about the tooth itself, its encompassing bone, the neighbouring dentition, and related anatomical structural systems. Parameters that ought to be assessed are level of impaction, root formulations, angulation of the enamel, number of roots, root morphology, related pathology and, most importantly, the relation some of the crown/roots and the mandibular canal. An appropriate imaging method for 3 molars ought to display the complete 3rd molar and the mandibular canal below it. In this mini review, we elaborate on the generally used radiographic assessment methods of mandibular 3rd molars.
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