Clinical Observation Of 3 Cases Of Oral Multiple Primary Squamous Cell Carcinoma And A Comparative Analysis Of Differential Gene Expression In 1 Case

Objective:Clinical analysis was performed on 3 cases of oral multiple primary squamous cell carcinoma（OMPSCC）,and gene differential expression analysis was performed on one of them.The objective is to explore the clinical features and pathogenesis of multiple primary cancer（MPC）in oral cavity,and to provide guidance for its clinical treatment.Materials and Methods:This article collected a total of 3 patients with well-differentiated OMPSCC（2 males and 1 female）who were treated at Guangxi Medical University–Colleague of Stomatology/Oral and Maxillofacial surgery department.Clinical data of each patient was collected,including:current medical history,previous medical history,family medical history,personal history,pathological diagnosis,clinical treatment plan,exclusion of patients with radiotherapy and chemotherapy history,oral mucosal lesion history,malignant tumors in other parts of the body,etc.Patient’s smoking history,the first primary cancer and the second primary cancer treatment were also reported.1 patient’s DNA of the cancer region tissues with the normal region tissues were analyzed with Exome method to compare whether any different.Result:The three patients in this study all developed OMPSCC in 2different anatomical parts in the oral cavity.Among them,the first case had developed simultaneous occurrence of the right floor of mouth squamous cell carcinoma（SCC）and the left oropharynx SCC.The second case,after the right side of the maxillary SCC,patient’s oral cavity also developed left side of lingua SCC,the interval was 2 months.The third case had developed right-side lower lip SCC at first,then right cheek carcinoma in situ,the interval was 2 years.The tumors of 3 patients all occurred in different anatomical parts in the oral cavity.Of the 3 cases of OMPSCC in this study,only 1 had a history of smoking addiction,but none had alcohol addiction.All patients are over 45 years old.One patient’s sample analyzed results showed the presence of polygenic mutations.All three cases in this study met the OMPSCC standard.All OMPSCC patients in this study received surgery and postoperative chemotherapy.Conclusion:Second primary or multiple primary SCC in oral cavity is much less to develop but the mortality rate is much higher than the single primary SCC^[1].In this study,we might conclude that oral multiple primary well-differentiated squamous cell carcinoma is relatively rare clinically,and its pathogenesis may be related to local factors and multiple mutations of individual genes.Surgery is still the main treatment method of OMPSCC,and its long-term clinical treatment effect needs further observation.