Objectives
The purpose of this retrospective observational study was to evaluate the specificity of the new oral cytodiagnostic criteria and whether the new criteria predict change to oral epithelial dysplasia (OED) and cancerization for leukoplakia and oral lichen planus (OLP).
Study design
Fifty‐three cases of leukoplakia without OED and 126 cases of OLP were included in this study. Liquid‐based cytology (LBC) was performed just before biopsy. We evaluated the specificity of the new oral cytodiagnostic criteria and the rates of change to OED and cancerization for each cytodiagnosis in leukoplakia and OLP.
Results
One hundred and seventy patients were negative for intraepithelial lesion or malignancy (NILM), seven had low‐grade squamous intraepithelial lesions (LSILs), and two were indefinite for neoplasia (IFN). The specificity was 95% and the rates of OED change and cancerization in the observation period were 3.4% and 1.7%. In leukoplakia, there was a significant difference in the rates of change to OED and cancerization between negative for intraepithelial lesion or malignancy (NILM) and LSIL (odds ratio: 12.9; 95% CI: 1.72‐96.73).
Conclusions
The new oral cytodiagnostic criteria have high specificity for oral mucosal lesions. And, it was suggested that the cases diagnosed with LSIL using new criteria have a high possibility of change to OED or cancerization in leukoplakia.
Desmoglein (DSG) 3 is overexpressed in oral squamous cell carcinoma (OSCC). Epidermal growth factor receptor (EGFR) inhibitor cetuximab is widely used for OSCC treatment. Several evidences suggest a correlation between DSG3 and EGFR in epidermal keratinocytes. EGFR inhibition has been shown to enhance cell‐cell adhesion and induce terminal differentiation in epidermal cells. Thus, here we investigated the DSG3‐EGFR interaction in OSCC and its effect on cetuximab treatment. Cell lines established from the primary tumor and metastatic lymph nodes of four OSCC patients and three commercial OSCC cell lines were used for the experiments. Cells from metastatic lymph nodes of each patient expressed increased DSG3 and EGFR than cells from the primary tumor in the same patient. Cetuximab treatment increased DSG3 expression by up to 3.5‐fold in seven of the 11 cell lines. A high calcium concentration increased the expression of DSG3 and EGFR in a dose‐dependent manner. Strikingly, a high calcium‐associated DSG3 induction enhanced cetuximab efficacy by up to 23% increase in cetuximab‐low‐sensitive cell lines. Our findings also suggest a correlation between DSG3 and EGFR in OSCC, and this affects cetuximab treatment efficacy.
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