Oral cancer refers to the malignancies that occur in the oral cavity, lip and pharynx with 90% of oral cancers being squamous cell carcinomas (OSCC). OSCC has the highest mortality ratio compared to other carcinomas. Although oral cavity is easily accessible, most oral cancers are detected at a later stage leading to lower survival rates. Early detection of OSCC is a key factor in improving the prognosis and survival rate of the patient. Rapid advancement in the field of diagnosis has enabled early diagnosis of many potentially malignant conditions even before its clinical manifestations. One such diagnostic modality that has gained much relevance in the field of molecular biology has been the discovery of salivary biomarkers (DNA, RNA and protein markers). These salivary biomarkers have been shown to play a non-invasive role in the diagnosis and surveillance of oral cancer. The direct contact between the saliva and the oral cancer lesions makes it a most sensitive and specific, screening method in diagnosis, staging and follow-up. This review aims to discuss the effectiveness and the potential of salivary biomarkers as a screening tool in OSCC.

Loricrin is a terminally differentiating structural protein comprising more than 70% of the cornified envelope. It contributes to the protective barrier function of the stratum corneum. In vivo, loricrin is expressed inall mammalian stratified epithelia with the highest levels of expression in humid tissues such as newborn epidermis, the epithelia of oral and anal mucosa, esophagus, foreskin, vagina and the epidermal parts of sweat ducts. Loricrin is not expressed in non keratinizing epithelia and its expression at these sites actually represents a defensive or protective mechanismof the body. An insight into this protein- “Loricrin” can shed light to its potential as a marker in the early stages of potentially malignant disorders like oral sub mucous fibrosis and leukoplakia. This compilation has been done by taking into account the existing literature, reviews and original studies on loricrin, a major component of the cornifiedcell envelope, its structure and the alterations that result due to its absence or presence of both the epidermis and the oral mucosa.

Tongue is a vital internal organ well encased within the oral cavity and protected from the environment. It has unique features which differ from individual to individual and even between identical twins. The color, shape, and surface features are characteristic of every individual, and this serves as a tool for identification. Many modes of biometric systems have come into existence such as fingerprint, iris scan, skin color, signature verification, voice recognition, and face recognition. The search for a new personal identification method secure has led to the use of the lingual impression or the tongue print as a method of biometric authentication. Tongue characteristics exhibit sexual dimorphism thus aiding in the identification of the person. Emerging as a novel biometric tool, tongue prints also hold the promise of a potential forensic tool. This review highlights the uniqueness of tongue prints and its superiority over other biometric identification systems. The various methods of tongue print collection and the classification of tongue features are also elucidated.

Background: Head and neck squamous cell carcinoma (HNSCC), is a common malignancy in the Indian Population. In locally advanced disease, chemoradiation is the standard of care. Although induction chemotherapy has been much studied, no clear benefit has been identified apart from laryngeal preservation. A few randomized trials have demonstrated improved response rate, disease free survival, and overall survival, with induction chemotherapy. Nimotuzumab is a humanized monoclonal antibody targeting epidermal growth factor receptors (EGFR). Unlike other Anti-EGFR monoclonal antibodies, it is demonstrated to be safer when combined with chemotherapy and/or radiotherapy. Aim: To evaluate the safety and efficacy of concurrently administered nimotuzumab with chemo-radiotherapy in patients with HNSCC in usual health care setting. Methods:This was an open-label, single arm study, with retrospective analysis of results. Patients above 18 years of age, and having histologically confirmed, advanced HNSCC were included in the study. The patients were treated with 3 cycles of induction chemotherapy consisting of modified TPF regimen along with nimotuzumab (200 mg IV) on Day 1, followed by radiotherapy for a dose of 66 Gy along with concurrent weekly cisplatin (30 mg/m 2 ) and nimotuzumab (200 mg) throughout the course of radiation. Patients were evaluated using RECIST criteria, 4 weeks after the last cycle of chemotherapy. Results: Sixteen patients were included in this study, with mean age of 54 ± 11 years. Most common sub-site of cancer was oral cavity in 69% (n = 11), followed by pharynx in 19% (n = 3). Four patients had metastasis at the time of presentation. Six patients (37.5%) had progressive disease and four patients (25%) were lost to follow-up. The combination chemotherapy with nimotuzumab was well tolerated. Addition of nimotuzumab to TPF regimen was not associated with added toxicity. Conclusion: Addition of anti-EGFR monocloncal antibody (nimotuzumab) to induc-* Corresponding author. S. Subramanium et al.147 tion chemotherapy and chemoradiation may be a promising alternative to concurrent chemoradiotherapy in HNSCC due to known over expression of EGFR receptors. The results of this study need further evaluation in a larger study setting.

Background and Objectives:Biometric authentication is an important process for the identification and verification of individuals for security purposes. There are many biometric systems that are currently in use and also being researched. Tongue print is a new biometric authentication tool that is unique and cannot be easily forged because no two tongue prints are similar. The present study aims to evaluate the common morphological features of the tongue and its variations in males and females. The usefulness of alginate impression and dental cast in obtaining the lingual impression was also evaluated.Materials and Methods:The study sample included twenty participants. The participants were subjected to visual examination following which digital photographs of the dorsal surface of the tongue were taken. Alginate impressions of the tongue were made, and casts were prepared using dental stone. The photographs and the casts were analyzed by two observers separately for the surface morphology including shape, presence or absence of fissures and its pattern of distribution. Three reference points were considered to determine the shape of the tongue.Results:The most common morphological feature on the dorsum of the tongue was the presence of central fissures. Multiple vertical fissures were observed in males whereas single vertical fissure was a common finding in females. The fissures were predominantly shallow in males and deep in females. The tongue was predominantly U shaped in males and females. V-shaped tongue was observed in 25% of females.Conclusion:Tongue prints are useful in biometric authentication. The methodology used in the study is simple, easy and can be adopted by dentists on a regular basis. However, large-scale studies are required to validate the results and also identify other features of the tongue that can be used in forensics and biometric authentication process.

The coarse fibres of areca nut and the continuous friction from occluding teeth are major causes of mechanical stress to the oral mucosa in conditions like oral submucous fibrosis and frictional keratosis. The continuous micro trauma provided in areca nut chewers, creates an environment where the keratinocytes exhibit alteration. Loricrin, is expressed abundantly in keratinizing epithelium in response to mechanical stress. Their expression or absence could play a role in malignant transformation. This study attempts to assess the potential of Loricrin as an early diagnostic marker in patients with chewing habit. Methods: 73 archival samples of formalin fixed, paraffin embedded tissue specimens histopathologically confirmed, were segregated as normal mucosa 11, hyperkeratotic 32 and oral submucous fibrosis 30 and stained with antibodies to Loricrin and graded as negative, mild, moderate and intense based on the staining intensity. Pearson's chi square test was done for statistical analysis. Results: Loricrin expression was observed in all groups with staining in the stratum granulosum showing a significant association to habits (P = 0.000). Conclusion:This prominent staining indicates a compensatory cytoskeletal rearrangement of surface epithelium during cell division in early oral submucous fibrosis showing potential as an early marker of the condition.

Context:Role of nimotuzumab in locally advanced head and neck cancer (HNC) is well established in India; however, no clinical evidence is available for its role in recurrent and/or metastatic HNC.Aims:The aim of this study is to evaluate the efficacy and safety of nimotuzumab when added to standard treatment in unresectable, recurrent, and metastatic squamous cell carcinoma of the head and neck (SCCHN).Settings and Design:Hospital records of 14 patients diagnosed with recurrent and/or metastatic HNC with histologically confirmed squamous cell carcinoma and being treated with nimotuzumab along with standard treatments from December 2010 to December 2016 were retrospectively evaluated.Subjects and Methods:The tumor response rate and overall survival (OS) were analyzed. Toxicity and adverse events (AEs) were assessed as per common terminology criteria for adverse events (CTCAE) v 4.Results:Oral cavity was most commonly involved region followed by hypopharynx and oropharynx. At 24 weeks after completion of treatment, overall response rate (complete response (CR) + partial response (PR)) was 75%. Survival rate at 1, 2, and 3 years was 77.80%, 64.81%, and 64.81%, respectively. At a median follow-up of 15.17 months, median OS was not reached. All AEs were either Grade I (66.7%) or Grade II (33.3%). No Grade III or Grade IV AEs were observed. No added toxicity was observed due to nimotuzumab.Conclusions:In the first of its kind study, the addition of nimotuzumab to standard treatment showed promising response rate as well as survival outcomes in recurrent and/or metastatic SCCHN patients without producing additional toxicity.

We present the 2017 Oncology Gold Standard Practical Consensus Recommendation for use of monoclonal antibodies in the management of advanced squamous cell carcinoma of head neck region.