A. Bilde - Academia.edu (original) (raw)
Papers by A. Bilde
Oral Oncology Supplement, 2009
cance. The sensitivity of level I was lower than 50% on CT, MRI and US with 57.1% sensitivity on ... more cance. The sensitivity of level I was lower than 50% on CT, MRI and US with 57.1% sensitivity on PET/CT.
Objectives: p53 is a tumor suppressor gene frequent mutated in oral carcinomas. Clusters of cells... more Objectives: p53 is a tumor suppressor gene frequent mutated in oral carcinomas. Clusters of cells overexpressing p53 is often found in adjacent normal mucosa. This apparent up regulation might indicate early malignant changes. The aim of this study is to investigate whether the p53 gene in these clusters is wild-type or mutated. Methods: Tissues from eighteen patients with oral squamous cell carcinoma (OSCC) were snap frozen. All samples, except four, included adjacent histological normal epithelium. p53 positive cells were identified by immunohistochemestry and collected by Laser Capture Microdissection followed DNA extraction. The region between exon 5-9 of the p53 gene was amplified by polymerase chain reaction. Bands showing mutations were further analysed using Denaturering Gradient Gel Electrophoresis . Results: Cell clusters in normal epithelium overexpressing p53 was seen in 13 out of 14 cases. The positive staining was located to nuclei confined to the basal and parabasal l...
ORL; journal for oto-rhino-laryngology and its related specialties
Management of the clinically N(0) neck in head and neck squamous cell carcinoma is still under de... more Management of the clinically N(0) neck in head and neck squamous cell carcinoma is still under debate. Tumour spread to the neck is the most important prognostic factor in head and neck cancer patients. The sentinel node technique comprises the identification of the sentinel node by means of dye or isotope or a combination, and surgical removal followed by histological examination. We have reviewed the preliminary reports indicating that sentinel node identification is technically feasible in head and neck cancer surgery, i.e. in solitary and unilaterally oral and pharyngeal cancer stages T1 and T2 with clinical N(0). However, the existing reports enrole observational studies, thus randomised trials should be considered to gain maximum valid data to prove that sentinel node biopsy has an effect on parameters such as loco-regional control and survival.
Oral Oncology Supplement, 2009
and AKT phosphorylation, tumor cell growth, migration, and MMP secretion were measured in the pre... more and AKT phosphorylation, tumor cell growth, migration, and MMP secretion were measured in the presence or absence of HA, cisplatin, and inhibitors of Rho kinase and PI-3 kinase.
Oral Oncology Supplement, 2009
Oral Oncology Supplement, 2005
massive hemorrhage, although an CT-investigation at this time detected no sign of intracerebral l... more massive hemorrhage, although an CT-investigation at this time detected no sign of intracerebral lymphoma invasion. Conclusion: The clinical picture of a high malignant lymphoma can be determined first by intraoral findings which are valuable for the hlstopathologlcal diagnosas. According to the classification and tile chmcal stage a conlbined therapy could be reconmlended. Generally speaking the treatment is considerably less successful compared to other system diseases like morbus Hodgkm.
The Laryngoscope, 2008
To determine the predictive value of sentinel node biopsy (SNB)-assisted neck dissection in patie... more To determine the predictive value of sentinel node biopsy (SNB)-assisted neck dissection in patients with oral squamous cell carcinoma (SCC) stage T1 to 2N0M0 and to determine the incidence of subclinical metastases.
The Laryngoscope, 2011
To examine the prevalence of isolated tumor cells (ITC) and micrometastases (MM) in nonsentinel l... more To examine the prevalence of isolated tumor cells (ITC) and micrometastases (MM) in nonsentinel lymph nodes (NSN) using additional step-serial sectioning and immunohistochemistry (IHC) as for sentinel lymph nodes (SN). Prospective, consecutive, and clinically controlled trial. Fifty-one patients with oral cavity squamous cell carcinoma (OSCC) T1-T2 and clinically N0 neck underwent surgical treatment including sentinel-node biopsy (SNB) assisted selective neck dissection (SND). The location of the SN was determined using dynamic and planar lymphoscintigraphy and SPECT-CT. The harvested NSN from the neck dissections underwent the same histopathologic examinations as the SN using step-serial sectioning (SSS) at 150-micron intervals. Two sections from each level were stained with hematoxylin-eosin (H&E) and cytokeratin antibodies (AE1/AE3) and examined for tumor deposits. Results were compared with the previous routine examination of the NSN. A total of 403 NSN were examined with a median of 8 per patient. A total of 1/51 patients (2%) had involvement of an additional NSN not found on routine examination. This was the only lymph node with involvement not detected previously. However, this patient had metastases in SN and in another NSN detected on routine examination. The overall incidence of occult metastasis (SN + NSN) was 21.6% (11/51) as previously reported. The incidence of occult metastases in NSN after additional SSS and IHC was 2%. The risk of NSN involvement would seem to be extremely low in patients with early OSCC and negative SN. This study further validates SNB as an accurate staging tool for cN0 early OSCC.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2008
We report two rare cases of extranasal heterotopic neuroglial tissue and review the literature on... more We report two rare cases of extranasal heterotopic neuroglial tissue and review the literature on the topic. The clinical, histological, and immunohistochemical features are presented.Both patients had lesions extranasally, even though the sinonasal region is the predominant site for these heterotopias. The first lesion was located in the buccal area in an 8-year-old boy and the second lesion in the tongue of a 2-year-old boy. They had relatively small lesions with few clinical symptoms. Complete excision was made and the follow-up was unremarkable. Heterotopic neuroglial tissue is considered to be a congenital condition. Complete excision of these lesions is recommended in spite of the lack of malignant potential, but because of the possibility of continuous growth. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:e22-e29)
Journal of Oral Pathology & Medicine, 2010
BACKGROUND: The tumour-suppressor protein p53 often accumulates in histologically normal epitheli... more BACKGROUND: The tumour-suppressor protein p53 often accumulates in histologically normal epithelium adjacent to oral squamous cell carcinomas (OSCC). We investigated whether this was associated with mutations in TP53, the gene for p53, and might implicate impending malignancy. METHODS: Specimens from 18 human squamous cell carcinomas were stained with monoclonal p53 antibodies. Positive cells were microdissected with laser-captured microscopy from the tumour and adjacent normal and dysplastic epithelium. DNA was extracted, and exons 5-9 of the TP53 gene were amplified by PCR. Amplified products were separated by denatured gradient gel electrophoresis. Fragments with a deviant DGEE pattern were sequenced. RESULTS: TP53 mutations were found in six of 18 tumours. Fourteen specimens contained histologically normal mucosa adjacent to the tumour; 13 of these showed small clusters of p53 positive cells. Seven specimens contained both histological normal and dysplastic epithelial tissues adjacent to the tumour. A TP53 mutation was found in only one specimen; this mutation appeared in the normal mucosa, the adjacent tumour, and the epithelial dysplasia. CONCLUSION: We found that upregulation of p53 was a frequent event in histological normal mucosa adjacent to OSCC; however, it was rarely associated with a mutation in the TP53 gene.
Annals of Surgical Oncology, 2009
Involvement of the cervical lymph nodes is the most important prognostic factor for patients with... more Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/ oropharyngeal squamous cell carcinoma (OSCC), and the decision of whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method for determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histologic nodal staging and avoids overtreating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This document is designed to outline the current best practice guidelines for the This article
Acta Oto-laryngologica, 2006
SPECT-CT may improve the localization of sentinel nodes (SNs) in patients with oral squamous cell... more SPECT-CT may improve the localization of sentinel nodes (SNs) in patients with oral squamous cell carcinoma (OSCC). Compared with planar lymphoscintigraphy SPECT-CT detected more SNs and provided additional anatomical and spatial information about their localization. New generation SPECT with higher resolution CT scanners are expected to provide more accurate information about the localization of SNs. To assess the role of combined SPECT-CT in SN identification in the clinically negative neck of patients with OSCC. Lymphoscintigraphy comprising planar and SPECT-CT acquisition was performed in 34 consecutive patients with OSCC stage I and II (T1-2N0M0) prior to sentinel node biopsy (SNB) and selective neck dissection. The number of SNs and anatomical location was recorded according to lymphoscintigraphy and operative findings. SNB was conducted in 33 patients. SNs were identified in 94% (32/34) of the patients using SPECT-CT. In 91% (29/32) of the patients SNs were harvested from all of the levels involved on SPECT-CT. SPECT-CT imaging demonstrated extra SNs compared with planar lymphoscintigraphic imaging in 47% (15/32) of patients. In seven cases the anatomical level of SN according to SPECT-CT was reclassified during surgery. The overall incidence of lymph node metastases was 19% (6/32). There were no false negative SNs.
Ugeskrift for laeger, Jan 4, 1999
The achievements of medical students are decisively dependent on the method of evaluation during ... more The achievements of medical students are decisively dependent on the method of evaluation during their education. Frequent testing of these achievements by well-defined (cross-specialized) problems (involving cases) enables the student to quickly correct own knowledge- or skills-deficiencies, while the relevance of the curriculum is further visualized. A differentiated panel of tests evaluates both the students individual study methods and her ability to make clinical inquiry, diagnoses and application of practical skills. An insufficient individual performance graded by known minimal specific standards entails a feedback session with a counsellor who pin-points defects in the student's knowledge and suggests methods for correction. This form of evaluation is expected to be costly, but is a necessity to improve the quality of the graduating medical students.
Oral Oncology Supplement, 2009
cance. The sensitivity of level I was lower than 50% on CT, MRI and US with 57.1% sensitivity on ... more cance. The sensitivity of level I was lower than 50% on CT, MRI and US with 57.1% sensitivity on PET/CT.
Objectives: p53 is a tumor suppressor gene frequent mutated in oral carcinomas. Clusters of cells... more Objectives: p53 is a tumor suppressor gene frequent mutated in oral carcinomas. Clusters of cells overexpressing p53 is often found in adjacent normal mucosa. This apparent up regulation might indicate early malignant changes. The aim of this study is to investigate whether the p53 gene in these clusters is wild-type or mutated. Methods: Tissues from eighteen patients with oral squamous cell carcinoma (OSCC) were snap frozen. All samples, except four, included adjacent histological normal epithelium. p53 positive cells were identified by immunohistochemestry and collected by Laser Capture Microdissection followed DNA extraction. The region between exon 5-9 of the p53 gene was amplified by polymerase chain reaction. Bands showing mutations were further analysed using Denaturering Gradient Gel Electrophoresis . Results: Cell clusters in normal epithelium overexpressing p53 was seen in 13 out of 14 cases. The positive staining was located to nuclei confined to the basal and parabasal l...
ORL; journal for oto-rhino-laryngology and its related specialties
Management of the clinically N(0) neck in head and neck squamous cell carcinoma is still under de... more Management of the clinically N(0) neck in head and neck squamous cell carcinoma is still under debate. Tumour spread to the neck is the most important prognostic factor in head and neck cancer patients. The sentinel node technique comprises the identification of the sentinel node by means of dye or isotope or a combination, and surgical removal followed by histological examination. We have reviewed the preliminary reports indicating that sentinel node identification is technically feasible in head and neck cancer surgery, i.e. in solitary and unilaterally oral and pharyngeal cancer stages T1 and T2 with clinical N(0). However, the existing reports enrole observational studies, thus randomised trials should be considered to gain maximum valid data to prove that sentinel node biopsy has an effect on parameters such as loco-regional control and survival.
Oral Oncology Supplement, 2009
and AKT phosphorylation, tumor cell growth, migration, and MMP secretion were measured in the pre... more and AKT phosphorylation, tumor cell growth, migration, and MMP secretion were measured in the presence or absence of HA, cisplatin, and inhibitors of Rho kinase and PI-3 kinase.
Oral Oncology Supplement, 2009
Oral Oncology Supplement, 2005
massive hemorrhage, although an CT-investigation at this time detected no sign of intracerebral l... more massive hemorrhage, although an CT-investigation at this time detected no sign of intracerebral lymphoma invasion. Conclusion: The clinical picture of a high malignant lymphoma can be determined first by intraoral findings which are valuable for the hlstopathologlcal diagnosas. According to the classification and tile chmcal stage a conlbined therapy could be reconmlended. Generally speaking the treatment is considerably less successful compared to other system diseases like morbus Hodgkm.
The Laryngoscope, 2008
To determine the predictive value of sentinel node biopsy (SNB)-assisted neck dissection in patie... more To determine the predictive value of sentinel node biopsy (SNB)-assisted neck dissection in patients with oral squamous cell carcinoma (SCC) stage T1 to 2N0M0 and to determine the incidence of subclinical metastases.
The Laryngoscope, 2011
To examine the prevalence of isolated tumor cells (ITC) and micrometastases (MM) in nonsentinel l... more To examine the prevalence of isolated tumor cells (ITC) and micrometastases (MM) in nonsentinel lymph nodes (NSN) using additional step-serial sectioning and immunohistochemistry (IHC) as for sentinel lymph nodes (SN). Prospective, consecutive, and clinically controlled trial. Fifty-one patients with oral cavity squamous cell carcinoma (OSCC) T1-T2 and clinically N0 neck underwent surgical treatment including sentinel-node biopsy (SNB) assisted selective neck dissection (SND). The location of the SN was determined using dynamic and planar lymphoscintigraphy and SPECT-CT. The harvested NSN from the neck dissections underwent the same histopathologic examinations as the SN using step-serial sectioning (SSS) at 150-micron intervals. Two sections from each level were stained with hematoxylin-eosin (H&E) and cytokeratin antibodies (AE1/AE3) and examined for tumor deposits. Results were compared with the previous routine examination of the NSN. A total of 403 NSN were examined with a median of 8 per patient. A total of 1/51 patients (2%) had involvement of an additional NSN not found on routine examination. This was the only lymph node with involvement not detected previously. However, this patient had metastases in SN and in another NSN detected on routine examination. The overall incidence of occult metastasis (SN + NSN) was 21.6% (11/51) as previously reported. The incidence of occult metastases in NSN after additional SSS and IHC was 2%. The risk of NSN involvement would seem to be extremely low in patients with early OSCC and negative SN. This study further validates SNB as an accurate staging tool for cN0 early OSCC.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2008
We report two rare cases of extranasal heterotopic neuroglial tissue and review the literature on... more We report two rare cases of extranasal heterotopic neuroglial tissue and review the literature on the topic. The clinical, histological, and immunohistochemical features are presented.Both patients had lesions extranasally, even though the sinonasal region is the predominant site for these heterotopias. The first lesion was located in the buccal area in an 8-year-old boy and the second lesion in the tongue of a 2-year-old boy. They had relatively small lesions with few clinical symptoms. Complete excision was made and the follow-up was unremarkable. Heterotopic neuroglial tissue is considered to be a congenital condition. Complete excision of these lesions is recommended in spite of the lack of malignant potential, but because of the possibility of continuous growth. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:e22-e29)
Journal of Oral Pathology & Medicine, 2010
BACKGROUND: The tumour-suppressor protein p53 often accumulates in histologically normal epitheli... more BACKGROUND: The tumour-suppressor protein p53 often accumulates in histologically normal epithelium adjacent to oral squamous cell carcinomas (OSCC). We investigated whether this was associated with mutations in TP53, the gene for p53, and might implicate impending malignancy. METHODS: Specimens from 18 human squamous cell carcinomas were stained with monoclonal p53 antibodies. Positive cells were microdissected with laser-captured microscopy from the tumour and adjacent normal and dysplastic epithelium. DNA was extracted, and exons 5-9 of the TP53 gene were amplified by PCR. Amplified products were separated by denatured gradient gel electrophoresis. Fragments with a deviant DGEE pattern were sequenced. RESULTS: TP53 mutations were found in six of 18 tumours. Fourteen specimens contained histologically normal mucosa adjacent to the tumour; 13 of these showed small clusters of p53 positive cells. Seven specimens contained both histological normal and dysplastic epithelial tissues adjacent to the tumour. A TP53 mutation was found in only one specimen; this mutation appeared in the normal mucosa, the adjacent tumour, and the epithelial dysplasia. CONCLUSION: We found that upregulation of p53 was a frequent event in histological normal mucosa adjacent to OSCC; however, it was rarely associated with a mutation in the TP53 gene.
Annals of Surgical Oncology, 2009
Involvement of the cervical lymph nodes is the most important prognostic factor for patients with... more Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/ oropharyngeal squamous cell carcinoma (OSCC), and the decision of whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method for determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histologic nodal staging and avoids overtreating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This document is designed to outline the current best practice guidelines for the This article
Acta Oto-laryngologica, 2006
SPECT-CT may improve the localization of sentinel nodes (SNs) in patients with oral squamous cell... more SPECT-CT may improve the localization of sentinel nodes (SNs) in patients with oral squamous cell carcinoma (OSCC). Compared with planar lymphoscintigraphy SPECT-CT detected more SNs and provided additional anatomical and spatial information about their localization. New generation SPECT with higher resolution CT scanners are expected to provide more accurate information about the localization of SNs. To assess the role of combined SPECT-CT in SN identification in the clinically negative neck of patients with OSCC. Lymphoscintigraphy comprising planar and SPECT-CT acquisition was performed in 34 consecutive patients with OSCC stage I and II (T1-2N0M0) prior to sentinel node biopsy (SNB) and selective neck dissection. The number of SNs and anatomical location was recorded according to lymphoscintigraphy and operative findings. SNB was conducted in 33 patients. SNs were identified in 94% (32/34) of the patients using SPECT-CT. In 91% (29/32) of the patients SNs were harvested from all of the levels involved on SPECT-CT. SPECT-CT imaging demonstrated extra SNs compared with planar lymphoscintigraphic imaging in 47% (15/32) of patients. In seven cases the anatomical level of SN according to SPECT-CT was reclassified during surgery. The overall incidence of lymph node metastases was 19% (6/32). There were no false negative SNs.
Ugeskrift for laeger, Jan 4, 1999
The achievements of medical students are decisively dependent on the method of evaluation during ... more The achievements of medical students are decisively dependent on the method of evaluation during their education. Frequent testing of these achievements by well-defined (cross-specialized) problems (involving cases) enables the student to quickly correct own knowledge- or skills-deficiencies, while the relevance of the curriculum is further visualized. A differentiated panel of tests evaluates both the students individual study methods and her ability to make clinical inquiry, diagnoses and application of practical skills. An insufficient individual performance graded by known minimal specific standards entails a feedback session with a counsellor who pin-points defects in the student's knowledge and suggests methods for correction. This form of evaluation is expected to be costly, but is a necessity to improve the quality of the graduating medical students.