SUMMARY Objective Oral lichen planus (OLP) is a chronic inflammatory disease. There are no markers that can be used to identify the risk of a malignant transformation of OLP to oral squamous cell carcinoma (OSCC). Methods Immunohistochemical staining was performed among 56 patients with OLP and 66 patients with OSCC for p53, HSP90 and E-cadherin expression and presence of HPV16/18. Results Significant differences in p53 and HSP90 expression between OLP and OSCC were found ( p = 0.01 and p = 0.006, respectively). A positive correlation between HSP90 and p53 expression was seen in OLP ( p = 0.017). Univariate analysis identified HSP90 expression and HPV16/18 presence as prognostic factors for overall survival time (OS) ( p < 0.05). In multivariate analysis, only HSP90 expression was an independent prediction factor for shorter OS of OSCC patients ( p = 0.016). Conclusions The present study suggests that cooperation between p53 and HSP90 as well as between HPV16/18 and HSP90 exists in OLP and may affect the biological behaviour of OLP. The observed expression of HSP90 and p53 in OLP and their increase in OSCC suggests that these proteins participate in the malignant transformation of OLP. HSP90 may be a potential independent prognostic biomarker that can predict poor prognosis in OSCC.

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Abstract. Background (82.1±83.5 months vs. 43.0±44.4, p<0.01 and 110.7±81.3 months vs. 69.9±52.9 p<0.005, respectively). Survival after pulmonary metastasectomy was 27.2±25.6 months and was longer in obese and overweight patients than in normal weight patients (20.2±18.4 months vs. 29.4±26.5, p<0.05). Conclusion: Being obese or overweight is a favorable prognostic factor in patients after surgical resection of lung metastases of different malignancies.With the increasing epidemic of obesity in the world, the incidence of malignancies related to obesity also increases (1). Obesity-related cancers include breast cancer in postmenopausal women, colon cancer, cancer of the lower esophagus, gastric cancer, liver cancer, gall bladder cancer, pancreatic cancer, uterine cancer, ovarian cancer and renal cancer (2). Obesity is also associated with increased risk of metastases, including lung metastases, in some cancers (3).In the course of some malignancies a paradoxical phenomenon has been observed, indicating that obesity may be an oncogenic factor and -at the same time -may constitute a favorable prognostic factor (4, 5). The dual and opposite influence of obesity on the course of the same disease has been called the obesity paradox and has been described in some chronic diseases, including cardiovascular (6) and cerebrovascular diseases (7). These paradoxical effects of obesity may occur also in patients with metastases, including patients with malignancies not related to obesity. In a recent large-scale study of 4,010 cancer patients in good general condition, with distant metastases, median OS was twice as high in obese patients as in normal weight patients (8). However, there are also reports stating that there is no beneficial effect of obesity on metastatic neoplastic disease (9-11).The problem of the influence of obesity on the course of metastatic malignancies has not yet been unequivocally explained. Especially, there are no studies on the influence of obesity on survival of patients with operable lung metastases. Therefore, this study was undertaken to evaluate the long-term outcome of surgical treatment of obese and non-obese patients who after resection of primary neoplasm had lung metastases removed. Materials and MethodsData from 99 patients who had a resection of lung metastasis from different primary malignancies between 2001 and 2016 were analyzed. The study was retrospective, and the condition for including patients in the study was access to anesthesia documentation containing body weight and height prior to performing pulmonary metastasectomy. Analysis was performed in the groups depending on body mass index (BMI). Underweight was diagnosed when the BMI 197

Recent studies revealed that Sonic Hedgehog (SHH) signaling pathway plays an important role in initiation and tumor progression in various malignancies, however, its role in oral squamous cell carcinoma (OSCC) remains unclear. The objective of this study was to investigate the prognostic significance of SHH expression in patients with OSCC in relation to p53 protein expression and HPV (Human Papilloma Virus) presence. SHH, p53, HPV expression was analyzed in surgical specimens from 70 patients with primary OSCC by immunohistochemistry (IHC) and correlated with clinicopathological parameters. The presence of SHH, p53, HPV was found in 51/70 (72.9%), 32/70 (45.7%), 11/70 (15.7%) cases, respectively. No correlation between SHH, p53 overexpression, and HPV presence was found. SHH expression was associated with tumor stage (p = 0.026). P53 immunoreactivity correlated with tumor grade (p = 0.040). By Kaplan-Meier analysis, SHH expression was significantly associated with shorter overall survival (p = 0.005).Multivariate cox regression analysis showed that SHH was an independent prognostic factor for overall survival (HR = 2.93; 95% CI = 1.40-6.13; p = 0.004). Our findings revealed that the SHH signaling pathway contributes to the poor survival of patients with OSCC and should be considered as a new prognostic biomarker in patients with OSCC. Inhibition of the SHH pathway may be used as a new potential target in cancer therapy.

Pectus excavatum is the most common congenital deformity of the chest. The Nuss procedure is minimally invasive surgical correction of this defect, using retrosternal metal bars. The purpose of the present study was to describe a 15-year experience with the Nuss surgery, and to evaluate the long-term clinical results of the procedure. We retrospectively evaluated 239 patients, aged 14-34, who underwent the Nuss surgery in the years 2002-2016. Postoperative complications were observed in 40/236 (16.9%) patients. The most common complication was pneumothorax in 14/239 patients. Less common were the following: wound infection in 4, pleural effusion in 3, allergy to nickel in 1, lung atelectasis in 1, and ventricular failure in 1 patient. Three patients were treated because of severe postoperative pain, and in one case the implant had to be removed. Postoperative complications associated with the number of bars inserted, but not with the patient age or gender. A satisfactory and long lasting corrective effect of surgery was observed in 231/239 (96.7%) of patients. There was no perioperative mortality. We conclude that the Nuss surgery is a safe surgery that demonstrates excellent and long-lasting esthetic results, with a low risk of severe complications.

Our study revealed that PDGFRα/HER2 and PDGFRα/p53 co-expression exists in poorly differentiated OSCCs, suggesting that cooperation between these proteins might enhance aggressive behavior of tumor.