Morphological Changes and Apoptosis of Buccal Mucosa Basal Epithelium in Heads and Necks during Cancer Radiotherapy

Christiana Cahyani Prihastuti, A. Haris Budi Widodo, Nabila Prandita Bagasworo, Arundito Widikusumo, Dody Novrial, Daniel Joko Wahyono, Tirta Wardana

Abstract


Background: Radiotherapy is generally used to treat head and neck malignancy through high radiation, focusing on killing cancer cells. However, some adverse effects in oral mucosal tissue, including cell morphology changes and apoptosis, are commonly found. This study aims to determine the morphological changes and apoptosis of buccal mucosa epithelium after radiotherapy in head and neck cancer (HNC) patients.

Methods: This study involved 8 subjects of patients diagnosed with HNC. Buccal mucosal smear samples were collected using cytobrush two times, before and after radiotherapy, with a dose of 70 Gy in 7 weeks. The specimens were prepared and stained using Feulgen and Rosenbeck technique. Observations were made using a light microscope with a count per 1000 epithelial cells. Statistical analysis was performed using statistical software with Pearson’s correlation test and significance t-test (p < 0.05) between irradiated and non-irradiated samples.

Results: Data analysis showed significant changes in cell morphological damage and apoptosis in patients before and after radiotherapy. It increases in the number of micronuclei (p = 0.001), broken egg (p = 0.001), binuclei (p = 0.003), pyknosis (p = 0.033), karyorrhexis (p = 0.020), and karyolysis (p = 0,004).

Conclusions: The effects of radiation reflect morphological changes and apoptosis in the buccal mucosa basal epithelium in HNC patients.


Keywords


Morphology, apoptosis, radiotherapy, effect, head and neck cancer.

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DOI: 10.33371/ijoc.v17i1.944

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References


Viallard C, Larrivée B. Tumor angiogenesis and vascular normalization: alternative therapeutic targets. Angiogenesis. 2017;20:409–26.

Wardana T, Gunawan L, Herawati C, et al. Circulation EBV mir-bart-7 relating to clinical manifestation in nasopharyngeal carcinoma. Asian Pacific J Cancer Prev. 2020;21(9):2777–82.

Stewart BW, Wild CP. World cancer report 2014. Lyon: International Agency for Research on Cancer; 2014.

Salehiniya H, Mohammadian M, Mohammadian-Hafshejani A, Mahdavifar N. Nasopharyngeal cancer in the world: epidemiology, incidence, mortality and risk factors. World Cancer Res J. 2018;5(1):e1046.

Kementerian Kesehatan Republik Indonesia. Laporan nasional riskesdas 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan; 2019.

Kumar M, Nanavati R, Modi T, Dobariya C. Oral cancer: Etiology and risk factors: A review. J Cancer Res Ther. 2016;12(2):458–63.

Kim DWN, Cho LC, Straka C, et al. Predictors of rectal tolerance observed in a dose-escalated phase 1-2 trial of stereotactic body radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2014;89(3):509–17.

Martin OA, Martin RF. Cancer Radiotherapy: Understanding the Price of Tumor Eradication. Front Cell Dev Biol. 2020;8:261.

Sholikhah DU, Sudiana IK, Kurniawati ND. The Effectiveness Chewing gum versus Cryotherapy on Salivary Volume among Patient with Head and Neck Cancer undergoing Radiotherapy. J Ners. 2020;15(1):91.

Setyowati, W., Purnomosari, D., Susilowati R. Prosedur Kerja Baku Pewarnaan Fast Green Laboratorium Histologi dan Biologi Sel, Fakultas Kedokteran. Yogyakarta: Fakultas Kedokteran Universitas Gadjah Mada; 2011. 10–12 p.

Flores-García A, Torres-Bugarín O, Velarde-Félix JS, et al. Micronuclei and other nuclear anomalies in exfoliated buccal mucosa cells of Mexican women with breast cancer. J BUON. 2014;19(4):895–9.

Orlandi E, Iacovelli NA, Tombolini V, et al. Potential role of microbiome in oncogenesis, outcome prediction and therapeutic targeting for head and neck cancer. Oral Oncol. 2019;99:104453.

Yang H, Villani RM, Wang H, et al. The role of cellular reactive oxygen species in cancer chemotherapy. J Exp Clin Cancer Res. 2018;37(266).

Wang W, Nag SA, Zhang R. Targeting the NFκB Signaling Pathways for Breast Cancer Prevention and Therapy. Curr Med Chem. 2014;22(2):264–89.

Blowman K, Magalhães M, Lemos MFL, et al. Anticancer Properties of Essential Oils and Other Natural Products. Evid Based Complement Alternat Med. 2018 Mar 25;2018:3149362.

Fan C, Zheng W, Fu X, et al. Strategy to enhance the therapeutic effect of doxorubicin in human hepatocellular carcinoma by selenocystine, a synergistic agent that regulates the ROS-mediated signaling. Oncotarget. 2014;5(9):2853–2863.

Lee AWM, Lin JC, Ng WT. Current Management of Nasopharyngeal Cancer. Semin Radiat Oncol. 2012;22(3):233–44.

Wardana T, Herawati C, Oktriani R, et al. Over- and down-expression mir-29c and mir-21 after chemotherapy and radiotherapy in nasopharyngeal carcinomas and the down-regulating proteins encoding eipstein barr virus and c-Myc. J thee Med Sci (Berkala Ilmu Kedokteran). 2016;48(04 (Suplement)):24–5.

Xu T, Tang J, Gu M, et al. Recurrent nasopharyngeal carcinoma: A clinical dilemma and challenge. Curr Oncol. 2013;20(5):e406–e419.

Parliament MB, Scrimger RA, Anderson SG, et al. Preservation of oral health-related quality of life and salivary flow rates after inverse-planned intensity- modulated radiotherapy (IMRT) for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2004;58(3):663–73.

Kaur P, Hurwitz MD, Krishnan S, Asea A. Combined hyperthermia and radiotherapy for the treatment of cancer. Cancers (Basel). 2011;3(4):3799–823.

Baskar R, Dai J, Wenlong N, Yeo R, Yeoh KW. Biological response of cancer cells to radiation treatment. Front Mol Biosci. 2014;1(3):24.

Frey B, Rückert M, Deloch L, et al. Immunomodulation by ionizing radiation—impact for design of radio-immunotherapies and for treatment of inflammatory diseases. Immunol Rev. 2017;280(1):231–48.

Priyanka R. Management of Oral Complications in Patients with Head and Neck Cancer Undergoing Radiotherapy. Adv Med Dent Res. 2016;2(1).

Devi S, Singh N. Dental care during and after radiotherapy in head and neck cancer. Natl J Maxillofac Surg. 2014;5(2):117.

Moore S, Burke MC, Fenlon MR, Banerjee A. The role of the general dental practitioner in managing the oral care of head and neck oncology patients. Dent Update. 2012;39(10):694–702.

Daroit NB, Visioli F, Magnusson AS, et al. Cell phone radiation effects on cytogenetic abnormalities of oral mucosal cells. Braz Oral Res. 2015;29:1–8.

Kam WWY, Banati RB. Effects of ionizing radiation on mitochondria. Free Radic Biol Med. 2013;65:607–19.

Chen T, Chen M, Chen J. Ionizing Radiation Potentiates Dihydroartemisinin-Induced Apoptosis of A549 Cells via a Caspase-8-Dependent Pathway. PLoS One. 2013;8(3):e59827.

Siddiqui WA, Ahad A, Ahsan H. The mystery of BCL2 family: Bcl-2 proteins and apoptosis: an update. Arch Toxicol. 2015;89(3):289–317.

Pandya JA, Srikant N, Boaz K, et al. Post-radiation changes in oral tissues - An analysis of cancer irradiation cases. South Asian J Cancer. 2014;3(3):159–62.

Hseu YC, Lin RW, Shen YC, et al. Flavokawain b and doxorubicin work synergistically to impede the propagation of gastric cancer cells via ros-mediated apoptosis and autophagy pathways. Cancers (Basel). 2020;12(9):1–26.

Simões VL, Alves MG, Martins AD, et al. Regulation of apoptotic signaling pathways by 5α-dihydrotestosterone and 17β-estradiol in immature rat Sertoli cells. J Steroid Biochem Mol Biol. 2013;135(1):15–23.

Kellokumpu-Lehtinen P, Söderström KO, Kortekangas A, Nordman E. Radiation-induced morphological changes and radiocurability in squamous cell carcinoma of the head and neck region: A preliminary report. Acta Oncol (Madr). 1990;29(4):517–20.

Asikainen PJ, Dekker H, Sirviö E, et al. Radiation-induced changes in the microstructure of epithelial cells of the oral mucosa: A comparative light and electron microscopic study. J Oral Pathol Med. 2017;46(10).

Pulito C, Cristaudo A, La Porta C, et al. Oral mucositis: the hidden side of cancer therapy. J Exp Clin Cancer Res. 2020;39(210).

Xanthinaki A, Nicolatou-Galitis O, Athanassiadou P, et al. Apoptotic and inflammation markers in oral mucositis in head and neck cancer patients receiving radiotherapy: preliminary report. Support Care Cancer. 2008;16(1025).


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