The Research Of Surgical Molecular Margins In Oral Squamous Cell Carcinoma And The Reconstruction Choice For Oral And Maxillofacial Surgical Defects

Objective:To investigate the mRNA expression of p53, CerbB-2 and EGFR in the linear gradient surgical margins of oral squamous cell carcinoma (OSCC) and discuss the possibility of safe surgical margin identification by fluorescent quantitative real-time PCR technique. To choose the best reconstruction which aims at different oral and maxillofacial defectsMethods:Twenty linear gradient surgical tissue groups in 18 primary OSCC cases were analyzed in the expression of p53, CerbB-2 and EGFR by fluorescent quantitative real-time PCR technique, each group includes tumour tissue and five linear gradient surgical margins with extent of Ocm,0.5cm,1.0cm,1.5cm and 2.0cm to tumour lesion. The results were analyzed by paired t-test. On the other hand, to compare the ways of reconstruction for oral and maxillofacial defects after the OSCC surgery.Results:The highly significant expression discrepancy of p53 was detected in 0cm, 0.5cm,1.0cm,1.5cm and 2.0cm surgical margins compared with tumour location respectively (p<0.01), also,0.5cm surgical margins compared with 0cm surgical margins(p<0.01). Analogously, the highly significant expression discrepancy of EGFR could be detected in 0cm,0.5cm,1.0cm,1.5cm and 2.0cm surgical margins compared with tumour location respectively(p<0.01). For CerbB-2, there is the significant expression discrepancy in tumour location, Ocm,0.5cm,1.0cm,1.5cm surgical margins compared with 2.0cm surgical margins respectively (p<0.05). There are some different flaps of reconstruction for oral and maxillofacial defects after the OSCC surgery.Conclusion:From the expression discrepancies between tumour location and 2.0cm surgical margins in p53, CerbB-2 and EGFR, the fluorescent quantitative real-time PCR technique is possibilly sensitive to identify where is the 'really safe marginal area' in surgery at molecular level. Furtermore,2.0cm margin from tumoure location seems to be safe in OSCC surgery. The relationships among the other linear gradient margin groups in p53, CerbB-2 and EGFR respectively are still not be sure. The flap reconstruction is a versatile way in the reconstruction of oral and maxillofacial defects. It is convenient, safe and reliable.