Head and neck squamous cell carcinoma (HNSCC) exhibits considerable variability in patient outcome. It has been reported that SOX2 plays a role in proliferation, tumor growth, drug resistance, and metastasis in a variety of cancer types. Additionally, SOX9 has been implicated in immune tolerance and treatment failures. SOX2 and SOX9 induce treatment failure by a molecular mechanism that has not yet been elucidated. This study explores the inverse association of SOX2/SOX9 and their distinct expression in tumors, influencing the tumor microenvironment and radiotherapy responses. Through public RNA sequencing data, human biopsy samples, and knockdown cellular models, we explored the effects of inverted SOX2 and SOX9 expression. We found that patients expressing SOX2^LowSOX9^High showed decreased survival compared to SOX2^HighSOX9^Low. A survival analysis of patients stratified by radiotherapy and human papillomavirus brings additional clinical relevance. We identified a gene set signature comprising newly discovered candidate genes resulting from inverted SOX2/SOX9 expression. Moreover, the TGF-β pathway emerges as a significant predicted contributor to the overexpression of these candidate genes. In vitro findings reveal that silencing SOX2 enhances tumor radioresistance, while SOX9 silencing enhances radiosensitivity. These discoveries lay the groundwork for further studies on the therapeutic potential of transcription factors in optimizing HNSCC treatment.

Objectives: The purpose of this study was to evaluate how artefacts caused by titanium and zirconia dental implants affect the bone quality assessment in CBCT images. The effect of scan mode and the use of metal artefact reduction (MAR) algorithm on artefacts suppression were taken in consideration. Methods: Titanium and zirconia dental implants were installed in porcine bone samples and scanned with two CBCT devices with adjustments on scan mode and with the use of MAR. The control group consisted of bone sample without implant and scanned with full-rotation scan mode without MAR. Artefacts extension and bone quality around implants were measured by deviation of grey values and bone histomorphometry measurements (trabecular volume fraction, bone specific surface, trabecular thickness, and trabecular separation), respectively. Mean difference among groups was assessed by within ANOVA with Bonferroni correction. Correlation between bone quality measurements acquired in the experimental and control groups was assessed by Spearman correlation test (α = .05). Results: No statistical difference was found for artefacts extension in images acquired by half and full-rotation modes (P = .82). The application of MAR reduced artefacts caused by titanium and zirconia dental implants, showing no statistically significant difference from the control group (titanium: P = .20; zirconia: P = .31). However, there was no correlation between bone quality measurements (P < .05). Conclusions: Bone quality assessment was affected by the presence of artefacts caused by dental implants. Rotation mode did not affect the appearance of artefacts and bone qualitative measurements. MAR was able to decrease artefacts, however, it did not improve the accuracy of bone quality measurements.

The study aimed to investigate oral potentially malignant disorders (OPMDs) diagnosed in an Oral Pathology service in southern Brazil over a span of 56 years and to assess the factors influencing their severity and outcomes. A retrospective analysis of histopathological records from 1965 to 2021 was performed. Lesions diagnosed as leukoplakia, erythroplakia, leukoerythroplakia, or actinic cheilitis were included. Data on age, sex, race, tobacco smoking, alcohol drinking, clinical characteristics, biopsy type, and histopathological diagnosis were collected. Among 32.698 histopathological reports, 2.10% were classified as OPMD. The study included 689 specimens from 602 patients, with a predominance of cases affecting men aged over 51 years, particularly in anatomical sites considered of low risk. White lesions, with leukoplakia as the most common clinical diagnosis were observed. Over time, there was an increase in the incidence of OPMDs among females and in high-risk anatomical sites. The mean follow-up period was 30.28 ± 29.86 months, during which 9.6% of cases exhibited malignant transformation. Lesions diagnosed as leukoerythroplakia and those presenting epithelial dysplasia exhibited a higher risk of malignant transformation, particularly when located in high-risk sites. This underscores the importance of identifying clinical and microscopic features, as well as lesion’s anatomical location, as crucial factors in determining the risk of malignant transformation. These findings provide valuable insights for clinicians managing OPMDs and contribute to the improvement of oral cancer prevention.