Ocorrência de carcinoma espinocelular labial não melanocítico em usuários crônicos de hidroclorotiazida / Occurrence of non-melanoma labial squamous cell carcinoma in chronic users of hydrochlorothiazide

Diversos autores desenvolveram estudos acerca da potencial associação entre a etiocarcinogênese do carcinoma espinocelular não melanocítico (CECNM) labial e o uso crônico da hidroclorotiazida (HCTZ). Objetivo: A atual revisão objetivou investigar a relação do diurético HCTZ e o risco de CECNM labial. Métodos: Realizou-se uma revisão de literatura nas bases de dados LILACS, PUBMED/MEDLINE e Periódico CAPES, em que foram incluídos artigos em inglês, português e francês, publicados no período de 2017 a 2022. Foram propostos 60 documentos e, dentre esses, 30 foram selecionados para compor a amostra no estudo. Resultados: Foi evidenciada uma relação entre o uso da HCTZ e a ocorrência de CENM com relação dose cumulativa devido às alterações provocadas pelo fármaco, no entanto, em virtude da heterogeneidade de desenhos metodológicos e concentração dos estudos em populações semelhantes, existem limitações quanto à confiabilidade dessas informações. Conclusão: Identificou-se uma desproporção entre a ocorrência e relevância do CENM e a produção científica vigente, demonstrando a necessidade de estudos com metodologias padronizadas que abranjam diferentes especificidades socioeconômicas e demográficas.(AU)

Several authors have developed studies about a potential association between the etiocarcinogenesis of non-melanocytic lip squamous cell carcinoma (NMSCC) and the chronic use of hydrochlorothiazide (HCTZ). Objective: The current study aimed to investigate the relation between the diuretic HCTZ and the risk of lip NMSCC. Methods: A literature review was carried out in the LILACS, PUBMED/MEDLINE and CAPES Periodical databases, which included articles in English, Portuguese and French, published between 2017 and 2022. Sixty documents were collected and, among these, 30 were selected to compose the sample in the study. Results: There was evidence of a relationship between the use of HCTZ and the occurrence of MSCC with a cumulative dose relationship due to changes caused by the drug, however, because of the heterogeneity of methodological designs and concentration of studies in similar populations, there are limitations regarding the reliability of this information. Conclusion: A disproportion between the occurrence and relevance of the NMSCC and the current scientific production was identified, demonstrating the need for studies with standardized methodologies that cover different demographic socioeconomic specificities.(AU)

Líquen Plano Oral e seu Potencial de Malignização / Lichen Planus and its potencial for malignancy

Objetivos: Instruir e orientar ao cirurgião dentista e demais profissionais de saúde a importância da detecção e rastreio precoce de lesões pré-malignas. Revisão de Literatura: O Líquen Plano Oral é uma condição dermatológica crônica, de origem auto-imune, relativamente comum na população, que atinge o epitélio de mucosa e pele, sendo considerada, pela Organização Mundial de Saúde (OMS), uma desordem potencialmente maligna quando associado a áreas de ulceração. A revisão de literatura foi realizada nas bases de dados PubMed e Lilacs. Buscamos investigar o potencial de malignização do Líquen Plano Oral associado a condições erosivas, analisando o processo de carcinogênese no processo inflamatório. Conclusão: Conclui-se que o objeto de estudo ainda é um assunto pouco explorado pela literatura, porém há indícios etiopatológicos que enfatizam o processo de malignização oriundo de uma lesão pré-maligna como o Líquen Plano Oral. Além disso, enfatizamos a importância do diagnóstico precoce das lesões estomatognáticas, para que assim possamos aumentar as chances de cura do paciente.(AU)

Objectives: To instruct and guide dentists and other health professionals on the importance of early detection and screening of pre-malignant lesions. Literature Review: Oral Lichen Planus is a chronic dermatological condition, of autoimmune origin, relatively common in the population, which affects the epithelium of the mucosa and skin, being considered, by the World Health Organization (WHO), a potentially fatal disorder. malignant when associated with areas of ulceration. A literature review was performed on the PubMed and Lilacs databases. We sought to investigate the potential for malignancy of Oral Lichen Planus associated with erosive conditions, analyzing the process of carcinogenesis in the inflammatory process. Conclusion: It is concluded that the object of study is still a subject little explored in the literature, but there are etiopathological accusations that emphasize the process of malignancy arising from a pre-malignant lesion such as Oral Lichen Planus. In addition, we emphasize the importance of early diagnosis of stomatognathic lesions, so that we can increase the patient's chances of cure.(AU)

Comparative Assessment of E-cadherin's Expression between the Metastatic and Non-metastatic Oral Squamous Cell Carcinoma: An Immunohistochemical Study

ABSTRACT Objective: To identify the clinicopathological correlation of E-cadherin expression in metastatic and non-metastatic oral squamous cell carcinoma (OSCC). Material and Methods: A total of 90 paraffin-embedded tissue sections of OSCC were retrieved from the registry. The total selected samples were 45 cases each from the primary lesions of metastatic and non-metastatic OSCC. One section was subjected to routine Hematoxylin and eosin stain and another to immunohistochemical analysis for E-cadherin expression. Results: A non-significant (p˃0.05) increased expression is seen in the non-metastatic group compared to the metastatic group, with predominantly membrane as the staining site in either group. However, the expression of E-cadherin did not reveal any statistically significant association with independent variables such as age, gender, and adverse habits of the patients (p>0.05). On the other hand, with respect to the histological differentiation of OSCC, a significant association (p<0.001) was observed with the well-differentiated type of metastatic OSCC. Conclusion: E-cadherin was useful to some extent in predicting regional metastasis. However, further studies using a panel of biomarkers with increased sample size may help us understand the process involved in metastasis.

Survival of young and elderly adults with oral squamous cell carcinoma in a population in northeastern Brazil

To compare the profile and overall survival of young adults and elderly people diagnosed with SCC. Methods: A retrospective study was carried out at a High Complexity Oncology Unit, between 2010 and 2016. A descriptive analysis, a bivariate analysis using the chi-square and Fisher's exact test and the Kaplan-Meier estimator were performed. The predictor variables were tested using the log-rank test and those with statistical significance and the literature were maintained for the Cox regression model. Results: 282 cases of SCC were recorded, with only 12.4% diagnosed in young adults. The profile was similar between groups, with the majority of cases of the disease occurring in males, smokers and alcohol consumers. The lesions predominantly located on the tongue and were diagnosed in an advanced stage of the disease, resulting in 35.7% of deaths. The median survival time was 30 months in the elderly and 31 months in young people. In the multivariate analysis, age was not statistically significant, only staging and treatment were predictors of reduced overall survival. Conclusion: Tumor staging, and treatment were prognostic factors for the disease

Estudo da imunoexpressão das proteínas ING3 e ciclina D1 nas displasias epiteliais e carcinomas epidermoides de língua / Study of the immunoexpression of ING3 and cyclin D1 proteins in epithelial dysplasias and squamous cell carcinomas of the tongue

O carcinoma epidermoide oral (CEO) é uma neoplasia maligna de patogenia complexa, já a displasia epitelial oral (DEO) é uma entidade que, na dependência de sua evolução, exibe riscos de transformação maligna para o CEO. A expressão alterada de genes supressores tumorais e proteínas reguladoras do ciclo celular apresentam relação com a etiopatogênese de diferentes cânceres. Entre os genes supressores tumorais destaca-se a família de inibidores de crescimento (inhibitor of growth - ING), que impedem o crescimento celular descontrolado. Dentre as proteínas reguladoras do ciclo celular podemos citar a Ciclina D1, que atua na progressão da fase S para a fase G1, permitindo a proliferação celular. O objetivo do presente estudo foi analisar a imunoexpressão das proteínas ING3 e Ciclina D1 em 28 espécimes de DEO e 25 de CEO localizados em língua, bem como avaliar morfologicamente e reclassificar as lesões segundo os critérios estabelecidos pela Organização Mundial da Saúde (OMS), além de modelo binário (Kujan et al. 2006), para DEO, e modelo buds-depth of invansion (BD) (Almagunsh et al. 2015) para CEO. A imunoexpressão das proteínas foi analisada de forma quantitativa, considerando a localização celular (citoplasmática e/ou nuclear para ING3 e nuclear para Ciclina D1) presentes no componente epitelial. A expressão das proteínas foi comparada entre os dois grupos de lesões, bem como com os parâmetros clínico-patológicos das lesões estudadas, através dos testes estatísticos Mann-Whitney (U) e teste de correlação de Spearman adotando um nível de significância de 5% para todos os testes considerando o valor de p ≤ 0,05. Dos 28 casos de DEO analisados 53,6% apresentaram-se como lesões de alto risco segundo o modelo binário, assim como dos 25 casos de CEO analisados foram considerados escores de alto risco (48%) de acordo com o modelo BD. Não foram encontradas associações estatisticamente significativas entre as variáveis morfológicas das lesões estudadas e as características clínicas (p>0,05). Com relação a expressão de Ciclina D1, esta foi significativamente maior em DEO quando comparada aos casos de CEO (p<0,05). A expressão de ING3 núcleo-citoplasmática foi significativamente menor nos casos de CEO, quando comparada aos casos de DEO (p<0,05), já a expressão de ING3, restrita ao citoplasma, foi maior nos casos de DEO, quando comparadas aos casos de CEO (p<0,05). Os resultados do presente estudo sugerem que a expressão das proteínas não tem relação com as gradações das lesões, porém, há notável diminuição da expressão nuclear de ING3 conforme a progressão maligna, indicando função supressora tumoral alterada desta proteína em DEO e CEOs. Destacamos, ainda, o aumento da expressão de Ciclina D1 em DEOs, mostrando que as lesões detêm uma taxa de proliferação celular significativa (AU).

Oral squamous cell carcinoma (OSCC) is a malignant neoplasm of complex pathogenesis. In turn, oral epithelial dysplasia (OED) is an entity that, depending on its evolution, exhibits varied risks of malignant transformation to OSCC. The altered expression of tumor suppressor genes and cell cycle regulatory proteins are related to the etiopathogenesis of different malignant tumors. Among the tumor suppressor genes, the family of inhibitors of growth (ING) stands out, which prevents uncontrolled cell formation. Amid the cell cycle regulatory proteins, Cyclin D1 acts in the progression from S to G1 phase, allowing cell proliferation. The aim of the present study was to analyze the immunoexpression of ING3 and Cyclin D1 proteins in 28 OED and 25 OSCC specimens, located on the tongue, as well as to morphologically evaluate and to reclassify the lesions following the criteria established by World Health Organization (WHO) and the model proposed by Kujan et al. (2006), for OED; for OSCC, the system proposed by Almagunsh et al. (2015) was used. Protein immunoexpression was quantitatively evaluated, considering the cellular location (cytoplasmic and/or nuclear for ING3 and nuclear for Cyclin D1), present in the epithelial component. Protein expression was compared between the two groups of samples, as well as with the clinical-pathological parameters of the lesions studied, through the Mann-Whitney (U) statistical tests and the Spearman correlation test, adopting a significance level of 5% for all tests considering the value of p≤ 0.05. Of the 28 cases of OED analyzed, 53.6% were high-risk lesions according to the binary model and of the 25 cases of OSCC analyzed, 48% were considered high-risk scores according to the BD model. No statistically significant associations were found between the morphological variables of the lesions studied and the clinical characteristics (p>0.05). A statistically significant difference was observed between the absence of ING3 expression and the grading of OEDs, according to the WHO (p<0.05). Regarding the expression of Cyclin D1, it was significantly higher in OED, when compared to OSCC cases (p<0.05). Nucleocytoplasmic ING3 expression was significantly lower in OSCC cases when compared to OED cases (p<0.05). Cytoplasm-restricted ING3 expression was higher in OED cases when compared to OSCC cases (p<0.05). The results of the present study suggest that, although there is no evidence of a significant relationship between the expression of proteins and the histopathological gradations of the lesions, there is a notable decrease in the nuclear expression of ING3, with an increase in the severity of the lesions, indicating an altered tumor suppressor function of this protein in OED and OSCCs. We also highlight the increased expression of Cyclin D1 in OEDs, showing that these lesions have a significant rate of cell proliferation (AU).

Biomarcadores da transição epitélio-mesenquimal em desordens potencialmente malignas e carcinoma de células escamosas de língua oral / Biomarkers of epithelial-mesenchymal transition in potentially malignant disorders and squamous cell carcinoma of the oral tongue

Durante a carcinogênese oral, as células malignas adquirem um fenótipo agressivo que resulta em aumento da motilidade individual e na capacidade para invadir tecidos circunvizinhos. Para tanto, as células epiteliais malignas desenvolvem um processo regulatório e programado denominado transição epitélio-mesenquimal (TEM), que é crucial para aquisição deste fenótipo maligno agressivo. O objetivo do presente estudo foi investigar o papel da expressão imunoistoquímica de proteínas sinalizadoras da TEM em displasias epiteliais orais e em carcinomas de células escamosas de língua oral (CCELO), avaliando suas respectivas associações com parâmetros clínico-patológicos e de prognóstico. Inicialmente, objetivando obter uma compreensão aprofundada sobre o tema proposto, foram desenvolvidas duas revisões sistemáticas de literatura avaliando o papel da TEM como possível marcador de prognóstico em casos diagnosticados como displasia epitelial oral e o papel dos fatores de transcrição nuclear associados ao processo de TEM na regulação da plasticidade celular e no compartamento biológico em linhagens celulares de carcinoma de células escamosas em região de cabeça e pescoço. Para o estudo imunoistoquímico, foram selecionados 47 casos de displasias epiteliais orais e 41 casos diagnosticados como CCELO, nos quais foram analisados a imunoexpressão das proteínas Twist1, Snail1, E-caderina e N-caderina. Foram investigadas possíveis associações entre o padrão de expressão destas proteínas com a gradação histopatológica das displasias epiteliais e com os aspectos clínico-patológicos, recidiva e sobrevida em CCELO. Foram observados diferentes padrões de marcação entre os grupos analisados, observando-se uma perda significativa da expressão da E-caderina membranar em casos de CCELO em comparação aos casos de displasias epiteliais orais (p = <0.0001). Foi observado uma pior sobrevida global em casos com baixa expressão da E-caderina membranar (HR = 0.27; p = 0.033) e alta expressão do Twist1 citoplasmático (HR = 3.19; p = 0.010). Ao analisar isoladamente o parâmetro intensidade de expressão, foi observada associação entre a alta intensidade da N-caderina citoplasmática com a sobrevida global (HR = 4.93; p = 0.006). Nossos achados sugerem que a perda da expressão da E-caderina e o aumento da expressão da N-caderina e dos fatores de transcrição nuclear Twist1 e Snail1 estão associados ao desenvolvimento e progressão da carcinogênese oral. Isoladamente, a perda da expressão membranar da E-caderina e o aumento da expressão citoplasmática do Twist1 e da N-caderina foram associados a uma pior sobrevida (AU).

During oral carcinogenesis, malignant cells acquire an aggressive phenotype that results in increased individual motility and the ability to invade surrounding tissues. Therefore, malignant epithelial cells develop a regulatory and programmed process called epithelial-mesenchymal transition (EMT), which is crucial for the acquisition of this aggressive malignant phenotype. The aim of the present study was to investigate the role of immunohistochemical expression of EMT signaling proteins in oral epithelial dysplasias and oral squamous cell carcinomas of the tongue (OTSCC), evaluating their respective associations with clinicopathological and prognostic parameters. Initially, aiming to obtain a deeper understanding of the proposed topic, two systematic literature reviews were developed evaluating the role of EMT as a possible prognostic marker in cases diagnosed as oral epithelial dysplasia and the role of nuclear transcription factors associated with the MET process in regulation of cellular plasticity and biological behavior in head and neck squamous cell carcinoma cell lines. For the immunohistochemical study, 47 cases of oral epithelial dysplasias and 41 cases diagnosed with OTSCC were selected, in which the immunoexpression of Twist1, Snail1, E-cadherin and Ncadherin proteins were analyzed. Possible associations between the expression pattern of these proteins and the histopathological grading of epithelial dysplasias and with the clinicopathological aspects, recurrence and survival in OTSCC were investigated. Different staining patterns were observed between the analyzed groups, with a significant loss of membrane E-cadherin expression in cases of OTSCC compared to cases of oral epithelial dysplasias (p = <0.0001). Worse overall survival was observed in cases with low membrane E-cadherin expression (HR = 0.27; p = 0.033) and high cytoplasmic Twist1 expression (HR = 3.19; p = 0.010). When analyzing the expression intensity parameter alone, an association was observed between high cytoplasmic N-cadherin intensity and overall survival (HR = 4.93; p = 0.006). Our findings suggest that loss of E-cadherin expression and increased expression of N-cadherin and nuclear transcription factors Twist1 and Snail1 are associated with the development and progression of oral carcinogenesis. Alone, loss of membrane expression of E-cadherin and increased cytoplasmic expression of Twist1 and N-cadherin were associated with worse survival (AU).

Biomarcadores salivares do carcinoma de células escamosas / Salivary biomarkers of squamous cell carcinoma

O carcinoma de células escamosas (OSCC) é uma neoplasia maligna que atinge a cavidade oral, lábios e orofaringe com uma das maiores taxa de mortalidade em todo o mundo, quando em comparação com outros carcinomas, o que o torna um problema de saúde pública (MORO, 2018). Devido à sua grande prevalência, os pesquisadores buscam por mecanismos para aprimorar o diagnóstico da doença em sua fase inicial, no intuito de possibilitar melhor qualidade de vida e sobrevida a esses pacientes (CHENG et al., 2014). Tem-se desenvolvido estudos através da expressão de proteínas, envolvendo o mecanismo biomolecular da carcinogênese oral na busca de identificação de biomarcadores que tenham potencial preditivo e um bom prognóstico para OSCC (CARVALHO; OLIVEIRA, 2015; LOUSADA-FERNANDEZ et at., 2018). Em uma revisão sobre o genoma salivar do câncer oral, este destacou-se justamente pelo fato de suas proteínas estarem localmente expressas (SHAH et at., 2011), tornando seus biomarcadores salivares de fácil e rápida coleta, já que a proliferação desordenada de células malignas deixa derivados de DNA, RNA, vesiculas (exossomos) e marcadores proteicos nos fluidos creviculares, podendo demostrar de forma preventiva o câncer. Com isso, esses biomarcadores podem ser identificados na fase inicial da doença, ao contrário do exame clínico, já que as manifestações clínicas são tardias, o que gera um prognóstico ruim (LOUSADA-FERNANDEZ et al., 2018). Diante desse quadro, o objetivo deste trabalho foi fazer uma revisão de literatura acerca do papel dos biomarcadores tumorais e discutir sobre a atual situação do câncer bucal, justificando o uso de biomarcadores salivares e entendendo seu papel no diagnóstico precoce. Para isso foi feita uma busca detalhada nas bases de dados Pubmed-Medline, Biblioteca Virtual em Saúde, Lilacs e Scielo, para identificar os mais recentes biomarcadores citados nas literaturas ultilizando as palavras-chaves: carcinoma, biomarcadores, saliva. Também foram incluídos dados coletados da Organização Mundial da Saúde e do Instituto Nacional do Câncer.

Perfil epidemiológico do carcinoma de células escamosas de cavidade oral e orofaringe diagnosticados na liga mossoroense de estudos e combate ao câncer / Epidemiologic Profile of squamous cell carcinoma of the oral cavity and oropharynx in the MossoróLeague for Studying and Combating Cancer / Perfil epidemiológico del carcinoma epidermoide de cavidad oral y orofaringe diagnosticado en la Liga Mossoroense de Estudios y Combate al Cáncer

Introdução:O carcinoma de células escamosas de cavidade oral e orofaringe é uma neoplasia epitelial maligna comum, respondendo pela maioria dos casos de tumores de cabeça e pescoço. Ele está relacionado a hábitos comportamentais, como tabagismo e etilismo de longa duração, e à infecção pelo Papilomavírus humano. Objetivos:Esse estudo objetivou descrever o perfil epidemiológico dos pacientes diagnosticados com essa neoplasia na Liga Mossoroense de Estudos e Combate ao Câncer. Metodologia: Foi realizado um estudo observacional com delineamento transversal a partir de dados presentes nos prontuários clínicos e laudos anatomopatológicos e no Sistema de Informações sobre Mortalidade no período entre 2006 a 2018. Os dados foram analisados a partir do Software R, utilizandoo teste de Wilcoxon-Mann-Whitney para as análises inferenciais e o método de Kaplan-Meier para análise da sobrevida. Resultados:225 prontuários foram analisados, sendo 70,22% de homens, 65,33% na faixa etária entre 46-70 anos e cor branca (51,57%). Destes, 25,78% eram tabagistas e 39,11% tabagistas e etilistas. O principal tratamento identificado foi a associação de cirurgia, quimioterapia e radioterapia. Observou-se que 49,10% dos óbitos foram em decorrência dessa neoplasia. O principal estádio patológico encontrado foi o quatro A (34,22%). Foi identificada maior sobrevida nos pacientes acima de 70 anos, cujo tratamento foi exclusivamente cirúrgico. Menor sobrevida foi identificada em indivíduos que tinham associação de hábitos (etilismo e tabagismo). Conclusões:Nossos resultados sugerem que a evolução à óbito foi o principal desfecho clínico e, isso pode estar relacionado aos hábitos comportamentais que influenciam diretamente o curso e prognóstico da doença. Ademais, destaca-se a importância do diagnóstico precoce a fim de reduzir óbitos e melhorar a qualidade de vida dos indivíduos, assim como a necessidade de implementar políticas educativas sobre os principais fatores de risco associados ao desenvolvimento dessa neoplasia (AU).

Introduction: Squamous cell carcinoma of the oral cavity and oropharynx is a common malignant epithelial neoplasm, accounting for most cases of head and neck tumors. It is related to behavioral habits, such as long-standing smoking and alcoholism, as well as to the human Papillomavirus infection. Objectives: This study aimed at describing the epidemiological profile of the patients diagnosed with this neoplasm in the Mossoró League for Studying and Combating Cancer. Methodology:An observational study with a cross-sectional design was carried out based on data present in the medical records and anatomopathological reports and in the Mortality Information System during the 2006-2018 period. The data were analyzed using the R Software, resorting to the Wilcoxon-Mann-Whitneytest for the inferential analyses and to the Kaplan-Meier method for survival analysis. Results: 225 medical records were analyzed: 70.22% belonging to men, 65.33% aged between 46 and 70 years old and white-skinned (51.57%). Of these, 25.78% were smokers and 39.11% were smokers and alcoholics. The main treatment identified was the association of surgery, chemotherapy and radiotherapy. It was observed that 49.10% of the deaths were due to this neoplasm. The main pathological stage found wasfour A(34.22%).Longer survival was identified in patients over 70 years of age, whose treatment was exclusively surgical. Shorter survival was identified in individuals who had associated habits (alcoholism and smoking). Conclusions:Our results suggest that evolution to death was the main clinical outcome; this can be related to the behavioral habits that exert a direct influence on the course and prognosis of the disease. Furthermore, the importance of early diagnosis is highlighted in order to reduce the number of deaths and improve the individuals' quality of life, as well as the need to implement educational policies on the main risk factors associated with the development of this neoplasm (AU).

Introducción: El carcinoma de células escamosas de la cavidad oral y la orofaringe es una neoplasia epitelial maligna común, que representa la mayoría de los casos de tumores de cabeza y cuello. Se relaciona con hábitos de comportamiento, como el tabaquismo y el alcoholismo, y la infección por el virus papiloma humano. Objetivos:Este estudio tuvo como objetivo describir el perfil epidemiológico de los pacientes diagnosticados con esta neoplasiaen la Liga Mossoroense de Estudios y Combate al Cáncer. Metodología: Se realizó un estudio observacional, transversal a partir de los datos presentes en las historias clínicas e informes patológicos y en el Sistema de Información de Mortalidad en el período 2006-2018. Los datos se analizaron mediante el Software R, con utilización de la Prueba de Wilcoxon-Mann-Whitney para análisis inferencial y el método de Kaplan-Meier para análisis de supervivencia. Resultados:Se analizaron 225 historias clínicas, 70,22% en hombres, 65,33% con edades entre 46-70 años y blancos (51,57%). De estos, 25,78% eran fumadores y 39,11% eran fumadores y alcohólicos. El principal tratamiento identificado fue la asociación de cirugía, quimioterapia y radioterapia. 49,10% de las muertes se debieron a esta neoplasia. El principal estadio patológico encontrado fue cuatro A (34,22%). Se identificó mayor sobrevida en pacientes mayores de 70 años, cuyo tratamiento fue exclusivamente quirúrgico. Se identificó una menor sobrevida en personas que tenían hábitos asociados. Conclusiones:Nuestros resultados sugieren que la evolución hacia la muerte fue el principal resultado clínico y esto puede estar relacionado con hábitos de comportamiento que influyen directamente en el curso y pronóstico de la enfermedad. Además, se destaca la importancia del diagnóstico precoz para reducir las muertes y mejorar la calidad de vida, así como la necesidad de implementar políticas educativas sobre los principales factores de riesgo asociados al desarrollo de esta neoplasia (AU).

Influence of nicotine dependence, current smoking status and gender on CYP1A1, CYP1B1 and CYP2A6 expression in oral squamous cell carcinoma / Influência da dependência nicotínica, parâmetros de consumo de tabaco e gênero na expressão de CYP1A1, CYP1B1 e CYP2A6 em carcinoma de células escamosas oral

Objective: Tobacco smoke is composed of cancer-causing chemicals referred to as carcinogens. These carcinogens are metabolized by the enzymes of the cytochrome P450 (CYP) family. Our objective was to evaluate the correlation of tobacco consumption parameters with CYP1A1, CYP1B1 and CYP2A6 expression using qRT-PCR in samples of oral squamous cell carcinoma (OSCC). Material and Methods: The sample was divided into 2 groups: Cancer (36 subjects) and non-Cancer (12 subjects). The smokers' participants (36) were evaluated regarding their Nicotine dependence (ND) was assessed by the Fagerström test for cigarette dependence (FTCD). Questions regarding tobacco consumption like the number of cigarettes/day (CPD), duration of use, and pack-years were also evaluated. The Mann-Whitney and Spearman correlation tests were used at a significance level of 5%. Results: 48 participants were included, 32 men (66.7%), 36 smokers (75%) and 27 smokers with OSCC (56.3%). Samples of OSCC expressed more CYP1A1, CYP1B1, and CYP2A6. Especially, the CYP1B1 gene was significantly expressed in OSCC samples, regardless gender or tobacco use. No women expressed CYP2A6, as well as, non-smokers did not express the CYP1A1 and CYP2A6 genes. CYP1A1 gene was higher among men (P = 0.021). Conclusion: Lack of exposure to tobacco may justify the absence of CYP1A1 and CYP2A6 expression in non-smokers. The CYP1B1 gene was significantly expressed in the cancer presence despite gender or tobacco use. The assessment of ND and quantification of tobacco consumption are important instruments in monitoring smokers with benign oral lesions and, especially, in the presence of cancer.(AU)

Objetivo: A fumaça do tabaco é composta de substâncias químicas cancerígenas conhecidas como carcinógenos. Esses carcinógenos são metabolizados pelas enzimas da família do citocromo P450 (CYP). Nosso objetivo foi avaliar a correlação dos parâmetros do consumo de tabaco com a expressão de CYP1A1, CYP1B1 e CYP2A6 por qRT-PCR em amostras de carcinoma de células escamosas bucal (CCEB). Material e Métodos: A amostra foi dividida em 2 grupos: Câncer (36 indivíduos) e sem Câncer (12 indivíduos). Os participantes fumantes (36) foram avaliados quanto à dependência nicotínica (DN) pelo teste de Fagerström para dependência de cigarro (TFDC). Questões relacionadas ao consumo de tabaco como número de cigarros / dia (CPD), tempo de uso e anos-maço também foram avaliadas. Os testes de correlação de Mann-Whitney e Spearman foram utilizados com nível de significância de 5%. Resultados: foram incluídos 48 participantes, 32 homens (66,7%), 36 fumantes (75%) e 27 fumantes com CCEB (56,3%). Amostras de CCEB expressaram mais CYP1A1, CYP1B1 e CYP2A6. Especialmente, o gene CYP1B1 foi significativamente expresso em amostras de CCEB, apesar do sexo ou uso de tabaco. Nenhuma mulher expressou CYP2A6, assim como, não fumantes não expressaram os genes CYP1A1 e CYP2A6. O gene CYP1A1 foi maior entre os homens (P = 0,021). Conclusão: A falta de exposição pode justificar a ausência da expressão dos genes CYP1A1 e CYP2A6 entre não fumantes. O gene CYP1B1 foi significativamente expresso na presença de câncer, independentemente do sexo ou do uso de tabaco. A avaliação da DN e a quantificação do consumo de tabaco são importantes instrumentos no acompanhamento de fumantes com lesões bucais benignas e, principalmente, na presença de câncer (AU)

p53 & Cyclin D1 expression in surgically resected clear margins of oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is one of the most well-known malignancies that affect the human population worldwide. The early diagnosis and early intervention of OSCC help improve the survival rate of the patients. The tumour free surgical margins are a positive prognostic factor for recurrence-free survival. The molecular markers can be used to detect the tumour free surgical margins. Aim: The aim of the study is to evaluate the expression of p53 & Cyclin D1 marker in resected surgical apparently clear margins and to correlate the p53 & Cyclin D1 expression with clinicopathological characteristics and patient outcome. Methods: The study population included retrospective cases of OSCC with apparently clear margins (2017-18) n=10 and Clinicopathological variables relevant to survival analysis were recorded. Finally, two margins were selected from each case, a total of 20 margins were included in this study. Paraffin-embedded wax blocks retrieved and tissue sections were made. Expression of cyclin D1 and p 53 was assessed by the immunohistochemical staining procedure Results: Positive expressions Cyclin D1 in 40% of mild dysplasia margins and 60% in clearance adequate margins were present. p53 expression was seen in 16% of mild dysplasia margins and 84% in clearance adequate margins. The expression of p53 and Cyclin D1 molecular markers are noted in the basal & parabasal layer of epithelium. Conclusion: Molecular markers could play a more reliable method for the assessment of dysplasia at the margins

Survival analysis of different methods for classification of lymph node metastases in patients with oral squamous cell carcinoma / Análise de sobrevida com diferentes métodos de classificação de metástases em linfonodos em pacientes com carcinoma espinocelular oral

Introdução: Apesar dos avanços no estadiamento clínico do carcinoma espinocelular (CEC) oral a partir de sua extensão pelo sistema TNM, ainda há necessidade de métodos que classifiquem melhor a doença para predizer o prognóstico e indicar terapia adjuvante. Objetivos: Analisar a influência do número de linfonodos positivos (PN), razão de linfonodos (LNR) e probabilidade log de linfonodos positivos (LODDS) na sobrevida de pacientes com CEC de boca. Pacientes e Métodos: Dados clínico-patológicos de pacientes com CEC de boca tratados com fins curativos por cirurgia e esvaziamento cervical (ND) associado ou não a terapias adjuvantes de 1991 a 2015 foram avaliados retrospectivamente. O impacto do PN, LNR, LODDS e outras variáveis na sobrevida global (OS) e sobrevida livre de doença (DFS) foi avaliado por meio de análises univariada e multivariada. Resultados: Cento e dezenove pacientes foram incluídos neste estudo. Na análise univariada, o PN teve um impacto significativo na OS (p = 0,001) e DFS (p = 0,020), e o LNR teve um impacto estatisticamente significante na OS (p = 0,042). Na análise multivariada com outras variáveis clínicopatológicas relevantes, o PN foi o único fator significativamente independente com influência na OS (p = 0,017), mas não na DFS (p = 0,096). Conclusões: O estudo sugere que a NP é um indicador prognóstico independente para OS e DFS em pacientes com CEC de boca e tem o potencial de complementar a classificação AJCC (2017). O LNR tem potencial para ser um importante indicador prognóstico, mas os métodos para essa classificação requerem mais estudos. O LODDS não demonstrou potencial prognóstico(AU)

Background: Despite the advances in the classification of oral squamous cell carcinoma (OSCC) based on its extension by the TNM system, there is still a need for methods to better segregate the patients to predict prognosis and indicate adjuvant therapy. Objectives: To analyze the influence of the number of positive lymph nodes (PN), lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) in survival of patients with OSCC Methods: Clinicopathologic data from patients with OSCC who were treated with curative purposes by surgery and neck dissection (ND) with or without subsequent adjuvant therapies from 1991 to 2015 was retrospectively assessed. The impact of the PN, LNR, LODDS, and other variables on overall survival (OS) and disease-free survival (DFS) was analyzed in univariate and multivariate analyses. Results: One hundred nineteen patients were included in this study. In the univariate analysis the PN had a significant impact on OS (p=0.001) and DFS (p=0.020), and the LNR had a significant impact on the OS (p=0.042). In the multivariate analysis with other relevant clinicopathologic variables, the PN was the only significantly independent factor influencing in the OS (p=0.017) but not in DFS (p=0.096). Conclusions: The PN is an independent prognostic indicator for OS and DFS in patients with OSCC and has the potential to aggregate the current AJCC classification. The LNR has potential to be an important prognostic indicator, but the methods for this classification require lapidation. The LODDS did not demonstrate prognostic potential(AU)

Sex, pain, alcoholism and anxiety symptoms are predictive for systemic cortisol levels in oral cancer patients / Sexo, dor, etilismo e sintomas de ansiedade são preditivos para níveis sistêmicos de cortisol em paciente com câncer de boca

Pacientes com câncer podem apresentar uma desregulação do eixo hipotálamohipófise-adrenal (HPA) e secreção aumentada do hormônio cortisol. Níveis elevados de cortisol têm sido associados a pior prognóstico de diferentes tipos de câncer. Embora alterações psicológicas como ansiedade e depressão possam deflagrar uma secreção anormal de cortisol, pouco se sabe sobre a influência destas desordens emocionais na desregulação do eixo HPA em pacientes com câncer quando avaliadas em conjunto com variáveis demográficas, clinicopatológicas e biocomportamentais. Este estudo transversal avaliou os níveis plasmáticos de cortisol em 133 pacientes com carcinoma espinocelular (CEC) de boca e sua associação com variáveis demográficas, clínicopatológicas, biocomportamentais e psicológicas. Os níveis plasmáticos de cortisol foram mensurados por eletroquimioluminescência, e os níveis de ansiedade e depressão foram avaliados pelo Inventário de Ansiedade (BAI) e de Depressão (BDI) de Beck, respectivamente. Os dados demográficos, clinicopatológicos e biocomportamentais foram coletados dos prontuários dos pacientes. Os resultados da análise multivariada mostraram que homens com CEC de boca apresentaram 4,5 vezes mais chances de terem níveis elevados de cortisol plasmático do que as mulheres com a doença (OR=4,472; p=0,018). A presença de dor relacionada ao tumor primário também foi preditivo para maiores níveis de cortisol (OR=5,388; p=0,003). A ausência de histórico de consumo crônico de álcool foi um fator protetor para concentrações muito elevadas do hormônio nos pacientes com CEC de boca (OR=0,104; p= 0,004). Sintomas de ansiedade mensurados pelo BAI como "mãos trêmulas" (OR=0,192; p= 0,016) e estar "nervoso" (OR=0,207; p= 0,0004) foram associados a menores níveis de cortisol. Por outro lado, o sentimento de "medo de perder o controle" foi um fator de risco para níveis muito elevados de cortisol plasmático (OR=6,508; p= 0,0004). O score global e os sintomas específicos de depressão mensurados pelo BDI não foram preditivos para os níveis plasmáticos hormonais (p< 0,05). Juntos, os resultados mostram que sexo, dor, consumo de álcool e sintomas de ansiedade são variáveis independentes para os níveis sistêmicos de cortisol nos pacientes com câncer de boca. Portanto, intervenção psicológica, bem como o controle da dor e do alcoolismo devem ser considerados para a prevenção dos efeitos negativos da desregulação da secreção de cortisol nos pacientes diagnosticados com câncer de boca(AU)

Cancer patients may have a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and abnormal secretion of cortisol. Increased cortisol levels have been associated with worse prognosis in different types of cancer. Although anxiety and depression can trigger an abnormal cortisol secretion, little is known regarding the influence of these emotional disorders on HPA axis dysregulation in cancer patients when evaluating together with demographic, clinicopathological and biobehavioral variables. This crosssectional study analyzed the plasma cortisol levels of 133 patients with oral squamous cell carcinoma (OSCC) and its association with demographic, clinicopathological, biobehavioral and psychological variables. Plasma cortisol levels were measured by electrochemiluminescence, and anxiety and depression symptoms were assessed using Beck Anxiety Inventory (BAI) and Depression (BDI), respectively. Demographic, clinicopathological and biobehavioral data were collected from patients' medicalrecords. Results from multivariate analysis showed that men with OSCC were 4.5 times more likely to have higher plasma cortisol levels than women (OR = 4.472, p = 0.018). The presence of cancer-induced pain was predictive for higher cortisol levels (OR = 5.388, p = 0.003). The absence of chronic alcohol consumption history was a protective factor for highest hormonal concentrations in oral cancer patients (OR = 0.104, p = 0.004). Anxiety symptoms measured by BAI as "hands trembling" (OR = 0.192, p = 0.016) and being "nervous" (OR = 0.207, p = 0.0004) were associated with lower cortisol levels. In contrast, the feeling of "fear of losing control" was a risk factor for highest systemic levels cortisol (OR = 6.508, p = 0.0004). The global score and specific symptoms of depression measured by the BDI were not predictive for plasma hormone levels (p < 0.05). Together, our results show that sex, pain, alcohol consumption and anxiety symptoms are independent variables for systemic cortisol levels in patients with oral cancer. Therefore, psychological intervention, as well as control of pain and alcohol consumption, should be considered to prevent the negative effects of cortisol secretion dysregulation in patients with oral câncer(AU)

Polymorphisms of matrix metalloproteinase-7 and -9 are associated with oral tongue squamous cell carcinoma

Abstract Matrix degradation is an important event in the progression, invasion and metastasis of malignant head and neck lesions. Imbalances, mutations and polymorphisms of MMPs and their inhibitors are observed in several cancer subtypes. The aim of this study was to evaluate the association of the MMP-7 gene promoter (181 A/G) and MMP-9 (-1562 C/T) polymorphisms in oral tongue squamous cell carcinoma (OTSCC). MMP-7 (rs11568818) and MMP-9 (rs3918242) single-nucleotide polymorphisms (SNPs) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis in 71 cases of OTSCC. Normal tissue specimens were obtained from 60 healthy volunteers to serve as the control. The MMP-7 G allele and MMP-9 T allele were more frequent in the OTSCC group than the control group, but only when these two SNPs were taken together was a significant association found with the nodal metastasis of OTSCC (p < 0.001). Based on our results, SNPs in the promoter region of MMP-7 and MMP-9 appear to be associated with greater risk of developing OTSCC, and with a higher propensity to form metastatic tumors. In this respect, molecular studies investigating polymorphisms may be useful in predicting tumor behavior.

Biological effects of formulation containing curcuminoids and Bidens Pilosa L. in oral carcinoma cell line

Abstract: FITOPROT, which contains curcuminoids and Bidens pilosa L. extract, is an innovative mucoadhesive formulation indicated for the topical treatment of chemoradiotherapy-induced oral mucositis (OM) in patients with advanced and visible oral squamous cell carcinoma. The formulation is used as a mouthwash directly on tumor tissue of patients with advanced neoplasms, without triggering cancer cell proliferation or tumor invasiveness. Thus, the aim of this study was to evaluate the biological effects of FITOPROT on an oral squamous cell carcinoma cell line (SCC-4). The viability of SCC-4 cells was assessed after exposure to FITOPROT using MTT reduction assay. The effects of the mucoadhesive formulation on cell cycle progression and cell death parameters were evaluated using flow cytometry. In addition, the inflammatory profile of the tumor cells was evaluated using the cytometric bead array (CBA) assay. FITOPROT promoted a concentration-dependent decrease in cell viability and cell cycle arrest at the G2/M phase (p < 0.05). Mitochondrial membrane potential was also altered after exposure to the formulation (p < 0.05), in parallel with a reduction in VEGF and IL-8 production (p = 0.01 and p = 0.05, respectively). In summary, the results indicate that FITOPROT reduces SCC-4 cell viability, promotes cell cycle arrest, modulates mitochondrial membrane potential, and exhibits antiangiogenic and anti-inflammatory properties, thus indicating its potential for topical use in patients with OM and visible tumors in the mouth.

Alteration in Serum Lipid Profile Pattern in Oral Squamous Cell Carcinoma and Potentially Malignant Disorders

ABSTRACT Objective: To evaluate and compare lipid profile level in oral submucous fibrosis (OSMF), oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) patients. Material and Methods: Thirty histopathologically diagnosed subjects each of OL, OSMF, OSCC were recruited along with 30 healthy controls. 5ml of venous blood is collected and estimated using standard diagnostic kits. Results: The mean of Total cholesterol level in controls was 219.03 mg%, in OSCC, OL and OSMF was 142.89 ± 10.21mg%, 155.44 ± 17.63 mg% and 180.60 ± 13.25 mg%, respectively. The mean low-density lipid level in controls was 137.24 mg and in OSCC, OL and OSMF groups were 109.28 ± 2.16 mg%, 126.63 ± 0.85 mg% and 119.15 ± 0.93 mg%, respectively. The mean of high-density lipid level in controls, OSCC, OL and OSMF was 42.87 ± 0.42 mg%, 36.50 ± 2.31 mg%, 21.13 ± 0.77 mg% and 28.37 ± 1.11mg%, respectively. The mean of very low density lipids level in controls, OSCC, OL and OSMF was 30.12 ± 1.51 mg%, 17.24 ± 0.80 mg%, 22.25 ± 0.93 mg% and 25.89 ± 0.43 mg%, respectively. The mean triglyceride level in controls, OSCC, OL and OSMF was 118.80 ± 9.47 mg%, 91.2 ± 3.03 mg%, 105.05 ± 2.96 mg% and 106.19 ± 3.09 mg%, respectively. Conclusion: Lipid profile levels could be early indicators of precancer and cancer.

Correlation Between Clinical and Histopathologic Diagnosis of Oral Potentially Malignant Disorder and Oral Squamous Cell Carcinoma

ABSTRACT Objective: To determine the frequency of oral potentially malignant disorders and Oral Squamous Cell Carcinoma (OSCC) and evaluate the consistency between their clinical and pathological features. Material and Methods: This retrospective study was conducted on records with a diagnosis of oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, lichen planus, and OSCC in the Pathology Department of Kerman dental school from September 1997 to September 2017. Data were analyzed in SPSS 21 at the significance level of ≤5%. Results: There were 378 cases of oral potentially malignant disorders and 70 cases of OSCC with a mean age of 46.82 ± 15.24 years. Buccal mucosa was the most frequent site, and lichen planus the most common lesion. Females were significantly older than males in leukoplakia and carcinoma in situ lesions. Clinical diagnosis and histopathology were consistent in 69.03% of cases. Conclusion: Clinical and histopathological diagnoses were consistent in 69.03% of records. The highest degree of clinical compliance with histopathology was observed in OSCC. Dentists should pay attention to oral potentially malignant disorders for early diagnosis to prevent their transformation to malignancy.

Relationship between anemia and oral cancer: a case-control study

Abstract The aim of this study was to investigate the occurrence, type and severity of anemia at the time of diagnosis of oral cancer, and its potential association with the degree of tumor cell differentiation. This case-control study used 366 medical records of patients treated at two referral centers for oral cancer diagnosis, specifically: cases (n=70) with a histopathological diagnosis of oral squamous cell carcinoma (OSCC) of the oral cavity, and controls (n=296) with benign oral lesions. Sociodemographic, behavioral, and clinical variables of both groups, as well as complete blood count values, were analyzed by descriptive statistics and crude/adjusted logistic regression. Anemia was detected in 15.7% of the cases and 11.8% of the controls. The presence of anemia had an OR=1.64 (odds ratio) (95%CI 0.54-5.00) for OSCC, with no significantly statistical association. Normocytic anemia was the most prevalent form of anemia when oral cancer was diagnosed (91.4% of the controls and 72.7% of the cases), and moderate to severely low hemoglobin levels were associated with OSCC diagnosis (OR 6.49; 95%CI 1.18-35.24), albeit data on hematological examinations were missing.

Association of Socio-Demographic and Clinicopathological Risk Factors with Oral Cancers: A 19-Year Retrospective Study

ABSTRACT Objective: To determine the association of socio-demographic and clinic-pathological risk factors with oral cancer in Kelantan, Malaysia. Material and Methods: A 19-year cross-sectional survey was performed in Hospital Universiti Sains Malaysia (HUSM), Malaysia. Medical record of 301 oral cancer patients was retrieved from the Medical Records office. Results: The majority of the oral cancer cases were male (62.8%), non-smokers (57.5%), non-alcohol consumers (83.4%), non-betel quid chewers (96.7%), and belonged to Malay ethnicity (68.8%). At the time of diagnosis, most of the patients were at stage II (38.9%). Approximately one-third (30.6%) of the total OC patients experienced loco-regional/distant metastasis, whereas no metastasis was detected in around two-thirds of cases (69.4%). A combination of surgery and radiotherapy was the most commonly employed treatment modality (27.2%). At the time of this study, the survival status of most of the patients was alive (69.1%). The most frequently encountered oral cancer in the Kelantanese population was oral squamous cell carcinoma (70.1%), with the tongue being the most frequently involved oral cavity site (35.5%). Conclusion: More than three-fourths of the cases were alive at follow-up, which included the cases that did not undergo any form of treatment.

Anti-micro rna-221 a promising genetic therapy of oral squamous cell carcinoma (scc-25)

Abstract Micro-RNA-221(miR-221) is one of oncogenic miRNAs that plays a vital role in the development and progression of oral cancers. The aim of this study is to introduce a new gene therapy for oral squamous cell carcinoma by blocking the expression of oncogenic miR-221 by its inhibitor. The present work was performed on squamous cell carcinoma cell line SCC-25 and anti-miR-221 was delivered to the cells using an ultrasound micro bubbles. Assessment of the effect of miR-221 inhibitor on SCC-25 cells was done using MTT assay, cell cycle analysis and apoptosis detection. In addition, reverse transcription-polymerase chain reaction was also used to detect the expression -miR-221 and its target genes. Using ANOVA, statistical analysis of the results showed significant inhibition of cell viability with and induction of cell apoptosis of SCC-25 cell line after transfection. Moreover, the expression of miR-221, Epidermal growth factor receptor (EGFR) and CDKNIB/p27 were downregulated without significant difference. Transfection of SCC-25 by inhibitor of miR-221 resulting in blockage of its expression leading to arresting of tumor growth. These results proved the effective role of micro-RNA inhibitors as novel therapeutic agent for oral cancers.

Resumo Micro-RNA-221 (miR-221) é um dos miRNAs oncogênicos que desempenham um papel vital no desenvolvimento e progressão de carcinomas orais. O objetivo deste estudo é apresentar uma nova terapia gênica para o carcinoma epidermóide oral por meio do bloqueio da expressão do miR-221 oncogênico por seu inibidor. O presente trabalho foi realizado na linhagem de células de carcinoma de células escamosas SCC-25 e o anti-miR-221 foi administrado às células usando micro-bolhas de ultrassom. A avaliação do efeito do inibidor miR-221 em células SCC-25 foi feita usando ensaio de MTT, análise do ciclo celular e detecção de apoptose. Além disso, a reação em cadeia da polimerase com transcrição reversa também foi usada para detectar a expressão -miR-221 e seus genes-alvo. Usando ANOVA, a análise estatística dos resultados mostrou inibição significativa da viabilidade celular e indução da apoptose celular da linhagem celular SCC-25 após a transfecção. Além disso, a expressão de miR-221, receptor do fator de crescimento epidérmico (EGFR) e CDKNIB/p27 foram regulados para baixo sem diferença significativa. A transfecção de SCC-25 por inibidor de miR-221 resultou no bloqueio de sua expressão, levando à interrupção do crescimento do tumor. Esses resultados comprovaram o papel eficaz dos inibidores de micro-RNA como novo agente terapêutico para carcinomas orais.

Role of twist and podoplanin in partial epithelial-mesenchymal transition in oral squamous cell carcinoma

Abstract The aim of this study was to perform a comparative analysis of podoplanin (PDPN) and Twist immunoexpressions in lower lip and oral tongue squamous cell carcinomas (LLSCC and OTSCC, respectively). PDPN and Twist immunoexpressions were semi-quantitatively evaluated by analyzing the invasion front, the compressive areas, the large islands and nests and dissociated cells of the chosen carcinomas. Their statistical associations and correlations with clinical-pathological characteristics were verified by the Mann-Whitney and Spearman's test. Twist expression was low in both carcinomas, with <25% labeling on the invasive front. Significant differences were observed for LLSCC (p=0.032) and OTSCC (p=0.025) regarding PDPN immunoexpression in relation to the worst invasion patterns determined by a histological malignancy gradation system. Statistically significant negative correlations between PDPN membrane expression and general (r=-0.356, p=0.024) and cytoplasmic Twist expressions (r=-0.336; p=0.034) in LLSCC were also observed. Twist and PDPN are suggested to be associated to a more aggressive invasion pattern in both LLSCC and OTSCC cases but not related to the different biological behaviors on these anatomical sites. Also, it was seen that PDPN membrane expression is inversely related to general and cytoplasmic Twist expression in LLSCC cases.

Resumo O objetivo deste estudo foi realizar uma análise comparativa das imunoexpressões de podoplanina (PDPN) e Twist em carcinomas de células escamosas de lábio inferior e língua oral (CCELI e CCELO, respectivamente). As imunoexpressões de PDPN e Twist foram avaliadas semi-quantitativamente através da análise do front invasivo, das áreas compressivas, das grandes ilhas e ninhos e das células dissociadas dos carcinomas escolhidos. Suas associações estatísticas e correlações com características clínico-patológicas foram verificadas pelos testes de Mann-Whitney e Spearman. A expressão de Twist foi baixa nos dois carcinomas, com marcação <25% no front invasivo. Diferenças significativas foram observadas para CCELI (p=0,032) e CCELO (p=0,025) em relação à imunoexpressão de PDPN em relação aos piores padrões de invasão determinados por um sistema de gradação histológica de malignidade. Também foram observadas correlações negativas estatisticamente significantes entre a expressão membranar de PDPN e as expressões geral (r=-0,356, p=0,024) e citoplasmática do Twist (r=-0,336; p=0,034) no CCELI. Sugere-se que o Twist e o PDPN estejam associados a um padrão de invasão mais agressivo nos casos de CCELI e CCELO, mas não relacionados aos diferentes comportamentos biológicos nesses sítios anatômicos. Também foi observado que a expressão membranar de PDPN está inversamente relacionada à expressão geral e citoplasmática de Twist em casos de CCELI.