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1.
Br J Cancer ; 111(10): 1955-64, 2014 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-25314064

RESUMO

BACKGROUND: Current treatment strategies for head and neck cancer are associated with significant morbidity and up to 50% of patients relapse, highlighting the need for more specific and effective therapeutics. Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) and Smac mimetics (SMs) are promising anticancer agents, but their effect on head and neck squamous cell carcinoma (HNSCC) remains unknown. METHODS: We examined the response of a panel of nine HNSCC cell lines to TRAIL and SMs and investigated the mechanism of cell type-specific response by functional analysis. RESULTS: Head and neck cancer cell lines revealed a converse response pattern with three cell lines being highly sensitive to Smac-164 (SM) but resistant to TRAIL, whereas the other six were sensitive to TRAIL but resistant to SM. Distinct protein expression and activation patterns were found to be associated with susceptibility of HNSCC cell lines to TRAIL and SM. Tumour necrosis factor-related apoptosis-inducing ligand sensitivity was associated with high caspase-8 and Bid protein levels, and TRAIL-sensitive cell lines were killed via the type II extrinsic apoptotic pathway. Smac mimetic-sensitive cells expressed low levels of caspase-8 and Bid but had high TNF-α expression. Smac mimetic-induced cell death was associated with caspase-10 activation, suggesting that in the absence of caspase-8, caspase-10 mediates response to SM. Cotreatment with TNF-α sensitised the resistant cells to SM, demonstrating a decisive role for TNF-α-driven feedback loop in SM sensitivity. CONCLUSIONS: Tumour necrosis factor-related apoptosis-inducing ligand and SMs effectively kill HNSCC cell lines and therefore represent potential targeted therapeutics for head and neck cancer. Distinct molecular mechanisms determine the sensitivity to each agent, with levels of TNF-α, caspase-8, Bid and caspase-10 providing important predictive biomarkers of response to these agents.


Assuntos
Apoptose/efeitos dos fármacos , Compostos Bicíclicos Heterocíclicos com Pontes/farmacologia , Carcinoma de Células Escamosas/tratamento farmacológico , Caspase 10/metabolismo , Caspase 8/metabolismo , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Ligante Indutor de Apoptose Relacionado a TNF/farmacologia , Triazóis/farmacologia , Proteína Agonista de Morte Celular de Domínio Interatuante com BH3/metabolismo , Biomimética , Western Blotting , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Proliferação de Células/efeitos dos fármacos , Ensaio de Imunoadsorção Enzimática , Neoplasias de Cabeça e Pescoço/metabolismo , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Células Tumorais Cultivadas , Fator de Necrose Tumoral alfa/metabolismo
2.
Br J Cancer ; 107(7): 1138-43, 2012 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-22918395

RESUMO

BACKGROUND: Locoregional recurrence is the major cause of treatment failure after surgery for oral squamous cell carcinoma. Molecular diagnostics have the potential to improve on clinicopathological parameters to predict this recurrence and plan adjuvant treatment. The test most frequently applied is based on detecting TP53 mutations, but alternative methodology is required for cases that harbour the wild-type gene. METHODS: One hundred and two cases with tumour-adjacent margins, considered to be clear margins by microscopy, were examined using carefully optimised molecular diagnostics based on detection of the TP53 and Ly-6D markers. The markers were also combined to provide a dual approach. RESULTS: The dual molecular diagnostic identified cases with a significant increase in the probablility of developing locoregional recurrence when tumour-adjacent positive and clear margins were compared (P=0.0001). These tests were most useful when the clearance at the resection margins was 5 mm or less. The TP53-based diagnostic was a better predictor of locoregional recurrence than established clinicopathological parameters. CONCLUSION: The optimised TP53-based diagnostic rapidly identifies an important subgroup of cases with close margins that will benefit from new treatment modalities to reduce the risk of recurrence.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/genética , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/genética , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/genética , Patologia Molecular/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/patologia , Feminino , Genes p53 , Neoplasias de Cabeça e Pescoço/sangue , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/patologia , Estudos Prospectivos
3.
Apoptosis ; 17(8): 762-76, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22484480

RESUMO

Apoptin, a protein derived from the chicken anaemia virus, induces cell death in various cancer cells but shows little or no cytotoxicity in normal cells. The mechanism of apoptin-induced cell death is currently unknown but it appears to induce apoptosis independent of p53 status. Here we show that p73, a p53 family member, is important in apoptin-induced apoptosis. In p53 deficient and/or mutated cells, apoptin induced the expression of TAp73 leading to the induction of apoptosis. Knockdown of p73 using siRNA resulted in a significant reduction in apoptin-induced cytotoxicity. The p53 and p73 pro-apoptotic target PUMA plays an important role in apoptin-induced cell death as knockdown of PUMA significantly reduced cell sensitivity to apoptin. Importantly, apoptin expression resulted in a marked increase in TAp73 protein stability. Investigation into the mechanisms of TAp73 stability showed that apoptin induced the expression of the ring finger domain ubiquitin ligase PIR2 which is involved in the degradation of the anti-apoptotic ∆Np73 isoform. Collectively, our results suggest a novel mechanism of apoptin-induced apoptosis through increased TAp73 stability and induction of PIR2 resulting in the degradation of ∆Np73 and activation of pro-apoptotic targets such as PUMA causing cancer cell death.


Assuntos
Apoptose , Proteínas do Capsídeo/fisiologia , Proteínas de Ligação a DNA/metabolismo , Proteínas Nucleares/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Ubiquitina-Proteína Ligases/metabolismo , Proteínas Reguladoras de Apoptose/genética , Proteínas Reguladoras de Apoptose/metabolismo , Proteínas do Capsídeo/biossíntese , Linhagem Celular Tumoral , Proteínas de Ligação a DNA/genética , Pontos de Checagem da Fase G2 do Ciclo Celular , Meia-Vida , Humanos , Proteínas Nucleares/genética , Poli(ADP-Ribose) Polimerase-1 , Poli(ADP-Ribose) Polimerases/metabolismo , Isoformas de Proteínas/metabolismo , Processamento de Proteína Pós-Traducional , Estabilidade Proteica , Proteólise , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas/metabolismo , Proteína Tumoral p73 , Proteína Supressora de Tumor p53/metabolismo , Proteínas Supressoras de Tumor/genética , Ubiquitinação
4.
J Oral Pathol Med ; 40(7): 533-40, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21501232

RESUMO

BACKGROUND: Assessing epithelial dysplasia to predict malignant transformation remains problematic in many tissues because grading systems are poorly structured and individual features poorly defined. Dysplasia grading is criticised for lack of reproducibility and poor predictive value. Grading systems for upper aerodigestive tract dysplasia have evolved over several decades and are not supported by good outcome experimental data. METHODS: This study analysed the individual features of dysplasia in 86 oral dysplastic lesions and determined the reproducibility of scoring for each, and correlated them with other features and clinical factors using complex clustering analyses. RESULTS: A uniform pattern of dysplasia was found in 37 lesions, focal dysplasia in 36 and in 13 lesions dysplasia formed complex discontinuous patterns. There was wide variation in reproducibility of scoring of individual features and many, including thickness, some types of rete morphology, basaloid cell anisonucleosis, basal dyscohesion, and dyskeratosis as deep single cells correlated with sub-sites. Rete morphology, type of keratinisation, hyperchromatism of the basaloid compartment, prickle cell anisonucleosis and extension down salivary ducts correlated with smoking. Conventional grading and oral intraepithelial neoplasia (OIN) grading by 'thirds affected' showed strong correlation overall but scores obtained with the OIN system tended to a higher grade at all sites except soft palate/fauces. There was poor correlation between the systems for moderate dysplasia and also severe dysplasia at some sites. Individual features could not be shown to cluster to form distinct patterns of dysplasia. CONCLUSIONS: These variations may account in part for the lack of reproducibility and poor predictive value of the grading systems in current use and could inform the design of future grading systems.


Assuntos
Neoplasias Bucais/patologia , Lesões Pré-Cancerosas/patologia , Carcinoma in Situ/patologia , Adesão Celular , Núcleo Celular/patologia , Transformação Celular Neoplásica/patologia , Cromatina/patologia , Células Epiteliais/patologia , Epitélio/patologia , Feminino , Humanos , Queratinas , Leucoplasia Oral/patologia , Neoplasias Labiais/patologia , Masculino , Mitose , Soalho Bucal/patologia , Mucosa Bucal/patologia , Gradação de Tumores , Neoplasias Palatinas/patologia , Palato Mole/patologia , Reprodutibilidade dos Testes , Ductos Salivares/patologia , Neoplasias da Língua/patologia
5.
J Oral Pathol Med ; 40(9): 677-83, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21762430

RESUMO

OBJECTIVE: The aims of the study were to determine how frequently oral potentially malignant disorders (OPMDs) transform to cancer and to identify clinical and histological factors determining the rates of transformation. METHODS: The study included 1357 patients with biopsy-confirmed OPMDs seen at Guy's Hospital between 1990 and 1999 and followed up until 2005. The patients' details (name, date of birth, gender and any other relevant information) were matched to the Thames Cancer Registry (TCR) database and Office for National Statistics (ONS) to identify patients who subsequently developed oral cancer (ICD-10 C00-C06). From each patient's record, we identified their highest grade of dysplasia, graded as none, mild, moderate or severe. The outcome of principal interest was transformation to oral squamous cell carcinoma. To avoid co-existing malignancies, follow-up was started 6 months after the date of the index biopsy. Kaplan-Meier estimates and Cox proportional hazard analysis were undertaken to explore the factors associated with the time to transformation to oral cancer. RESULTS: One thousand three hundred and fifty-seven patients were included in the study. The majority of patients were women (60.9%), and ∼30% were under 47 years of age. The most common OPMD was lichen planus/lichenoid reaction. Among all OPMDs, 204 (15.1%) had oral epithelial dysplasia (30 severe, 70 moderate and 104 mild). Thirty-five patients developed oral cancer over the follow-up period (2.6%). There was an association between dysplasia grade and time to transformation. Patients with severe dysplasia had a higher risk of transformation to oral cancer [HR 35.4 95% CI (14.2-88.3)] compared to those with no dysplasia. This association remained significant although attenuated [HR 21.6 95% CI (5.8-80.5)] following adjustment for sex, age, anatomical site of OPMD and diagnosis. A significant trend over dysplasia grades was evident (P < 0.0001). Transformation to oral cancer was also associated with increasing age (P = 0.0390). CONCLUSIONS: In 2.6% of cases, OPMDs transformed to invasive cancer for a total person follow-up time of 12,273 years (mean 9.04 years). The severity of dysplasia is a significant predictor for malignant transformation.


Assuntos
Transformação Celular Neoplásica/patologia , Neoplasias Bucais/patologia , Lesões Pré-Cancerosas/patologia , Fatores Etários , Idoso , Biópsia , Candidíase Bucal/patologia , Carcinoma de Células Escamosas/patologia , Estudos de Coortes , Epitélio/patologia , Feminino , Seguimentos , Previsões , Humanos , Hiperplasia , Leucoplasia Oral/patologia , Líquen Plano Bucal/patologia , Erupções Liquenoides/patologia , Londres , Lúpus Eritematoso Discoide/patologia , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Sistema de Registros , Estudos Retrospectivos , Fatores Sexuais , Neoplasias da Língua/patologia
6.
Oral Dis ; 17(6): 564-71, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21332605

RESUMO

OBJECTIVE: WWOX gene is altered in a variety of neoplasms. Wwox is pro-apoptotic through interaction with p73 and may be involved in chromosomal stability by interaction with p73 and p53. The aims of this study were to characterize WWOX transcription, methylation status and immunoexpression in salivary neoplasms and to determine whether these were associated with p73, p53, cell proliferation and DNA ploidy. MATERIALS AND METHODS: Seven malignant and 21 benign fresh salivary neoplasms were included. WWOX expression was determined by RT-PCR and sequencing of transcripts, quantitative PCR and immunohistochemistry. Methylation-specific PCR was used to assess the methylation of its first exon. For p73, ΔNp73, p53 and ki67 immunohistochemistry and ploidy analysis, 29 malignant samples from archives were included. RESULTS: No consistent pattern of WWOX exon 1 methylation was found, but aberrant and novel transcripts were observed in 17/28 neoplasms; 55% of tumours showed reduced WWOX RNA. WWOX RNA levels were associated with p53 immunopositivity. Immunohistochemical Wwox expression did not correlate with methylation status, p53 or p73 expression or proliferation. p73, proliferation and DNA ploidy were associated with malignant phenotype. CONCLUSION: Aberrant WWOX transcription and decreased expression are frequent in salivary neoplasms and WWOX transcription is associated with p53 staining.


Assuntos
Apoptose/genética , Proteínas de Ligação a DNA/genética , DNA/genética , Proteínas Nucleares/genética , Oxirredutases/genética , Ploidias , Neoplasias das Glândulas Salivares/genética , Proteína Supressora de Tumor p53/genética , Proteínas Supressoras de Tumor/genética , Adolescente , Adulto , Idoso , Aneuploidia , Proliferação de Células , Metilação de DNA/genética , Diploide , Éxons/genética , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Fenótipo , Reação em Cadeia da Polimerase , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transcrição Gênica/genética , Proteína Tumoral p73 , Oxidorredutase com Domínios WW , Adulto Jovem
7.
Br J Cancer ; 103(9): 1432-42, 2010 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-20859287

RESUMO

BACKGROUND: Oral epithelial dysplasia (OED) is a histologically detectable lesion that may progress to carcinoma but there are no accurate markers that predict progression. This study examined the development of carcinoma from oral dysplastic lesions, and the association between abnormal DNA content and progression to carcinoma. METHODS: Epithelial dysplasias from the Oral Pathology Diagnostic Service were matched against the Ontario Cancer Registry database to identify cases that progressed to carcinoma. A case-control study was conducted to compare DNA image cytometry of dysplasias that progressed with those that have not progressed. For a subset of the progressed dysplasias, DNA content of the carcinoma was also analysed. RESULTS: A total of 8% of epithelial dysplasias progressed to carcinoma after 6-131 months. In all, 28 of 99 dysplasias showed abnormal DNA content by image cytometry. In multivariate analysis of time to progression, abnormal DNA content was a significant predictor with hazard ratio of 3.3 (95% confidence interval: 1.5-7.4) corrected for site and grade of dysplasia. Analysis of sequential samples of dysplasia and carcinoma suggested that epithelial cell populations with grossly abnormal DNA content were transient intermediates during oral cancer development. CONCLUSIONS: Abnormal DNA content is a significant biomarker of a subset of OED that progress to carcinoma.


Assuntos
DNA de Neoplasias/ultraestrutura , Progressão da Doença , Mucosa Bucal/patologia , Neoplasias Bucais/genética , Lesões Pré-Cancerosas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/genética , Feminino , Humanos , Citometria por Imagem , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/metabolismo , Risco
8.
Radiother Oncol ; 145: 146-153, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31981964

RESUMO

PURPOSE: To evaluate whether the 8th staging system is a better discriminator of overall survival (OS) than the 7th edition for oropharyngeal cancer patients after definitive (chemo)radiotherapy (CRT). MATERIAL AND METHODS: Data from oropharyngeal cancer patients treated with CRT with curative intent between 2010 and 2016 at Guy's and St Thomas' Hospitals were reviewed. Human papillomavirus (HPV) status was ascertained in all cases. Patients were staged using the 7th edition and the 8th edition TNM staging system. Demographics, tumor characteristics and treatment response data were included in univariate and multivariate analysis for OS. OS and disease-free survival (DFS) were estimated using the Kaplan-Meier method. In addition, a multivariate survival Cox regression analysis of several clinical variables was performed. RESULTS: A total of 273 patients were included. The median follow-up was 4.7 years. Overall 63 patients died. In multivariate analysis, HPV status, complete response at 3 months and ≤21 units/week alcohol were prognostic for OS. For the entire cohort, the 5-year OS and DFS rates were 78.1% (95% confidence interval CI 0.719-0.831) and 73.9% (95% CI 0.677-0.792), respectively. Better stratification of OS and DFS was recorded by 8th edition for the entire cohort. In HPV-positive cases, risk stratification based on tobacco smoking and nodal stage resulted in statistically higher discrimination in OS rates (5-year OS 90.7% in low risk patients and 84.6% in intermediate risk, p = 0.05) and DFS rates (5-year DFS 91.5% in low risk and 76.1% in intermediate risk, p = 0.001). CONCLUSION: The 8th edition TNM staging system provides better OS stratification in oropharyngeal cancer after definitive CRT compared with the 7th edition. Other clinical variables, such as complete response at 3 months, alcohol and tobacco smoking, should also be considered in future classifications as they provide additional risk stratification information in both HPV-positive and HPV-negative disease.


Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Humanos , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/terapia , Prognóstico , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço
9.
Br J Oral Maxillofac Surg ; 57(10): 1039-1043, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31564483

RESUMO

To validate the use of neck dissection as part of the management of patients with parotid carcinomas, we retrospectively reviewed pathological and clinical data from the head and neck pathology archive at Guy's and St Thomas' Hospital on all patients who had primary parotid carcinomas resected between 1992 and 2014. The main outcome measure was the incidence of metastatic disease. A total of 54 of the 82 patients identified had neck dissections. Nodal metastases were detected in 10 with high-grade, invasive carcinoma ex-pleomorphic adenomas, two with salivary duct carcinomas, one with a high-grade adenocarcinoma not otherwise specified (NOS), one with an adenoid cystic carcinoma, and one with a high-grade acinic cell carcinoma. No metastases were found in those with a low-grade acinic cell carcinoma, low-grade mucoepidermoid carcinoma, epithelial-myoepithelial carcinoma, or non-invasive carcinoma ex-pleomorphic adenoma. The findings of this study support the use of routine neck dissection for the treatment of high-grade, invasive carcinoma ex-pleomorphic adenoma, salivary duct carcinoma, high-grade adenocarcinoma NOS, adenoid cystic carcinoma, and high-grade acinic cell carcinoma.


Assuntos
Adenoma Pleomorfo , Carcinoma Adenoide Cístico , Esvaziamento Cervical , Neoplasias das Glândulas Salivares , Adenoma Pleomorfo/cirurgia , Carcinoma Adenoide Cístico/cirurgia , Humanos , Glândula Parótida/cirurgia , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/cirurgia
10.
Oral Oncol ; 44(3): 227-35, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17604679

RESUMO

Some oral squamous cell carcinomas (OSCCs) overexpress epidermal growth factor receptor (EGFR) but little is known about the receptor system overall during oral carcinogenesis. We studied all four ERBB receptors (EGFR, ERBB2-4) in developing (n=2), normal (n=7), dysplastic (n=23) and malignant (n=26) oral epithelia by means of immunohistochemistry. The investigations were supplemented by conducting reverse transcription-polymerase chain reactions in relation to 13 OSCC samples. All four ERBB receptors were detected in developing oral epithelium and, to a lesser degree, in mature oral epithelium. An increase in EGFR immunoreactivity was seen in 61% and 54% of dysplasias and OSCCs, respectively. The corresponding percentages for ERBB2 were 48 and 12, for ERBB3 48 and 43. ERBB4 nuclear staining was increased in 30% of dysplasias and 26% of OSCCs. Changes in ERBB receptor mRNA levels were not statistically significant. The results show that ERBB receptor profiles are specific to each tumour. Increased nuclear translocation of ERBB4 in some OSCCs may alter transcription of target genes and be associated with cancer progression. This information may be useful for clinicians as EGFR inhibitors are becoming treatment options in modern oncology.


Assuntos
Carcinoma de Células Escamosas/metabolismo , Mucosa Bucal/metabolismo , Neoplasias Bucais/metabolismo , Receptores Proteína Tirosina Quinases/análise , Adulto , Idoso , Carcinoma de Células Escamosas/genética , Receptores ErbB/análise , Genes erbB , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Mucosa Bucal/embriologia , Mucosa Bucal/patologia , Neoplasias Bucais/genética , Ploidias , Lesões Pré-Cancerosas/metabolismo , Lesões Pré-Cancerosas/patologia , RNA Mensageiro/análise , Receptores Proteína Tirosina Quinases/genética , Receptores Proteína Tirosina Quinases/metabolismo , Receptor ErbB-2/análise , Receptor ErbB-3/análise , Receptor ErbB-4 , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Coloração e Rotulagem , Estatísticas não Paramétricas
11.
Br J Oral Maxillofac Surg ; 56(7): 615-620, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30017578

RESUMO

UK national guidelines in 2016 recommended that sentinel lymph node biopsy should be offered to patients with early oral cancer (T1-T2 N0) in which the primary site can be reconstructed directly. This study describes the pitfalls that can be avoided in the technique of biopsy to improve outcomes. We retrospectively analysed the data from 100 consecutive patients and recorded any adverse events. Lymphatic drainage of tracer failed in two patients as a result of procedural errors. Two patients with invaded nodes developed recurrence after total neck dissection, one after micrometastases had been diagnosed, and the other as a result of extranodal spread that had led to understaging and therefore undertreatment. Two results would not have been mistakenly classified as clear if all the harvested nodes had been analysed histologically according to the protocol. The disease-specific (96%) and disease-free (92%) survival were better than expected for a group of whom a third had stage 3 disease. If all harvested nodes had been analysed by the correct protocol then two of the three nodes wrongly designated clear would have been detected, two deaths potentially avoided, and the false-negative rate would have fallen from 8.3% to 2.7%. We conclude that minor deviations from protocol can result in a detrimental outcome for the patient.


Assuntos
Carcinoma de Células Escamosas/patologia , Metástase Linfática/patologia , Erros Médicos/estatística & dados numéricos , Neoplasias Bucais/patologia , Biópsia de Linfonodo Sentinela/efeitos adversos , Adulto , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/cirurgia , Protocolos Clínicos , Feminino , Humanos , Masculino , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/cirurgia , Esvaziamento Cervical , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Complicações Pós-Operatórias , Estudos Retrospectivos , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X
12.
Oral Oncol ; 43(3): 310-6, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16931117

RESUMO

Proliferative verrucous leukoplakia (PVL) is a clinicopathologically distinctive form of oral leukoplakia presenting with multifocal flat, nodular and verrucous lesions that progress inexorably to squamous carcinoma. The aims of this investigation were to describe the clinical and histopathological features of six cases of PVL and to determine whether lesional epithelium demonstrates DNA ploidy anomalies prior to malignant transformation. The clinical and pathological features of six patients were reviewed and all biopsy specimens were subjected to image-based DNA ploidy analysis. The female:male ratio was 5:1 and the average age on first biopsy was 66 years. Only one patient reported both tobacco smoking and alcohol intake. The most frequently affected sites were alveolar ridge and/or gingiva (6/6), buccal mucosa (3/6), palate (3/6), tongue (2/6), buccal sulcus (2/6), and lip (1/6). Three patients developed multiple primary carcinomas, either invasive or verrucous. A ploidy anomaly at any oral site would have predicted malignant transformation in four cases and probably in a fifth for whom DNA ploidy failed to meet diagnostic criteria but was suspicious of aneuploidy. The site of transformation was predicted by ploidy and histopathology for three carcinomas and a further carcinoma showed severe dysplasia and a suspicious ploidy result in adjacent tissue. Both conventional histopathology and DNA ploidy proved effective in predicting the site of transformation in this limited series.


Assuntos
Carcinoma Verrucoso/genética , DNA de Neoplasias/genética , Leucoplasia Oral/genética , Ploidias , Idoso , Idoso de 80 Anos ou mais , Aneuploidia , Carcinoma Verrucoso/patologia , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/patologia , Diploide , Feminino , Neoplasias Gengivais/genética , Neoplasias Gengivais/patologia , Humanos , Leucoplasia Oral/patologia , Neoplasias Labiais/genética , Neoplasias Labiais/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias da Língua/genética , Neoplasias da Língua/patologia
13.
Int J Oral Maxillofac Surg ; 36(12): 1183-92, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17822878

RESUMO

The aim of this study was to investigate the feasibility of reconstructing critical size continuity osteoperiosteal defects of the mandible using a composite of recombinant BMP-7 contained in a bovine type-1 collagen carrier wrapped in a pedicled sterno-occipitalis muscle flap. At 3 months following surgery, bridging of the surgical defect was noted in three subjects (60%). Histologically, the induced bone regenerate showed maturation from woven to lamellar bone. Islands of cartilage were distributed throughout the defect. Replacement ossification of the degenerated muscle was a common feature in all specimens. Microradiography showed a gradual increase in the calcification of mineralized tissue from the margin to the centre of the newly generated bone. This research represents a proof of the concept that bone can be satisfactorily formed within a muscular scaffolding at the site of the created defect in a one-stage procedure.


Assuntos
Proteínas Morfogenéticas Ósseas/uso terapêutico , Regeneração Óssea/efeitos dos fármacos , Mandíbula/cirurgia , Músculos do Pescoço/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Fator de Crescimento Transformador beta/uso terapêutico , Animais , Proteína Morfogenética Óssea 7 , Estudos de Viabilidade , Mandíbula/diagnóstico por imagem , Microrradiografia/métodos , Proteínas Recombinantes/uso terapêutico , Ovinos
14.
Biochim Biophys Acta ; 971(3): 266-74, 1988 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-2844290

RESUMO

Neutrophil polymorphonuclear leucocytes kill bacteria by oxygen-dependent and oxygen-independent mechanisms. Many potentially toxic mechanisms have been described, but the complexity of the phagosomal environment and the synergy between oxidative and non-oxidative systems hamper the investigation of individual bactericidal mechanism in whole cells. Neutrophil cytoplasts are greatly depleted of granule proteins and permit the investigation of the bactericidal effects of the respiratory burst in isolation. In this study they have been used to examine the role of the respiratory burst and myeloperoxidase in oxygen-dependent killing of Staphylococcus aureus. Cytoplasts generated oxygen radicals at comparable rates to human neutrophils and phagocytosed but did not kill S. aureus. The selective reconstitution of the myeloperoxidase-hydrogen peroxide-halide system by coating bacteria with myeloperoxidase conferred on cytoplasts the ability to kill intracellular bacteria. However, extracellular killing by diffusible bactericidal factors was not detected in this system.


Assuntos
Neutrófilos/fisiologia , Consumo de Oxigênio , Peroxidase/sangue , Fagocitose , Membrana Celular/fisiologia , Humanos , Técnicas In Vitro , Cinética , Microscopia Eletrônica , Neutrófilos/enzimologia , Neutrófilos/ultraestrutura , Staphylococcus aureus , Superóxidos/sangue
15.
Oral Oncol ; 41(4): 416-22, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15792614

RESUMO

Oral squamous carcinomas appear heterogeneous on DNA ploidy analysis. However, this may be partly a result of sample dilution or the detection limit of techniques. The aim of this study was to determine whether oral squamous carcinomas are heterogeneous for ploidy status using image-based ploidy analysis and to determine whether ploidy status correlates with histological parameters. Multiple samples from 42 oral squamous carcinomas were analysed for DNA ploidy using an image-based system and scored for histological parameters. 22 were uniformly aneuploid, 1 uniformly tetraploid and 3 uniformly diploid. 16 appeared heterogeneous but only 8 appeared to be genuinely heterogeneous when minor ploidy histogram peaks were taken into account. Ploidy was closely related to nuclear pleomorphism but not differentiation. Sample variation, detection limits and diagnostic criteria account for much of the ploidy heterogeneity observed. Confident diagnosis of diploid status in an oral squamous cell carcinoma requires a minimum of 5 samples.


Assuntos
Carcinoma de Células Escamosas/genética , Heterogeneidade Genética , Neoplasias Bucais/genética , Ploidias , Carcinoma de Células Escamosas/patologia , DNA de Neoplasias/genética , Humanos , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Bucais/patologia
16.
Int J Oral Maxillofac Surg ; 34(3): 287-93, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15741038

RESUMO

Osteoinductive bone morphogenetic proteins (BMPs) have been used extensively in experimental and clinical orthopaedic research. It is a natural progression for these growth regulators to be tested in the craniofacial region. The aim of this investigation was to analyse the mechanical properties of the sheep mandibles reconstructed using recombinant human osteogenic protein type 1 (rhOP-1). A unilateral 35 mm osteoperiosteal continuity defect was created at the parasymphyseal region of the mandible in six adult sheep. The animals were sacrificed 3 months after surgery and mechanical properties of the regenerated bone at the operated sides (OS) were compared to the corresponding bone at the non-operated side (NOS). The regenerated tissue at the OS were then submitted for histological and histomorphometric analysis. Although all the animals achieved complete bony union, a wide range of mechanical properties was found. The rhOP-1-induced bone achieved a mean of 36% of the strength of the bone at the NOS (P < 0.05). The mean value of the stiffness of the OS was 24% of the NOS (P < 0.05). While half of the samples of the OS had 'weak' mechanical properties (9-25% strength compared to NOS) and a low stiffness (6-18%), the rest showed relatively higher strength (47-63%) and were stiffer (35-47%). Unlike the NOS, the operated sides failed under tensile stresses and cracks initiated at the superior border of the mandible. The wide mechanical variations suggest that further basic bone biology research is needed to provide better understanding of the cellular and molecular events which take place during the process of osteoinduction.


Assuntos
Receptores de Ativinas Tipo I/farmacologia , Proteínas Morfogenéticas Ósseas/farmacologia , Regeneração Óssea/efeitos dos fármacos , Mandíbula/cirurgia , Proteínas/farmacologia , Fator de Crescimento Transformador beta/farmacologia , Animais , Fenômenos Biomecânicos , Proteína Morfogenética Óssea 7 , Análise do Estresse Dentário , Feminino , Humanos , Implantes Experimentais , Modelos Animais , Maleabilidade , Proteínas Recombinantes/farmacologia , Ovinos , Carneiro Doméstico , Resistência à Tração
17.
Int J Surg Case Rep ; 13: 43-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26101054

RESUMO

INTRODUCTION: Thyroglossal duct cysts (TDC) are common midline neck swellings resulting from embryological remnants of the thyroglossal duct. They often contain ectopic thyroid tissue and malignant transformation has been reported, most commonly to papillary thyroid carcinoma. Mucoepidermoid carcinoma (MEC) usually occurs in the salivary glands and only rarely in the thyroid. This is the first case of a MEC occurring within a thyroglossal duct remnant. PRESENTATION OF A CASE: A 73 year old lady presented with a thyroglossal duct cyst. She declined surgical excision, as she was adamant she wanted to avoid surgery. The neck mass rapidly enlarged at two years following initial diagnosis. Fine needle aspiration cytology was suspicious for carcinoma. She underwent total thyroidectomy and selective central compartment neck dissection with adjuvant radiotherapy. She remains alive and well two years post treatment. DISCUSSION: Mucoepidermoid carcinoma is the most common malignant neoplasm of salivary glands, although it has rarely been reported in diverse locations including the thyroid, lung and pancreas. To the best of our knowledge, this is the first reported case of mucoepidermoid carcinoma arising from a thyroglossal duct remnant. CONCLUSION: This case adds weight to the literature favouring surgical excision of thyroglossal duct remnants due to the risk of malignant transformation.

18.
Int J Surg Case Rep ; 14: 194-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26298095

RESUMO

INTRODUCTION: Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm that exhibits the potential for recurrence and metastasis but rarely involves the oral cavity. PRESENTATION OF CASE: We report the management and long term follow up of recurrent EHE in a 23- year-old woman. The lesion initially presented as a small area of erythematous gingival swelling with localised bone loss around the lower anterior teeth. It was treated by buccal and lingual stripping of the gingival tissues. The patient suffered local recurrence after 7 years and was treated with a wider surgical excision of the buccal and lingual gingivae, conserving the adjacent teeth and bone with an excellent cosmetic outcome. Over 21 years later, there have been no further recurrences. DISCUSSION: This case highlights the management challenges of EHE and is the only case in the literature to have reported a case of mandibular gingivae with a long review period of 21 years. CONCLUSION: Oral EHE is an unpredictable lesion with a relatively benign course, unlike non-oral EHE where up to one third of cases may metastasise. Because of the propensity to recur locally after excision and curettage, a wide local excision with close clinical follow has been suggested in the literature as the treatment of choice for oral lesions. However, the lack of metastases from oral lesions, the small size, mandibular site and bland histology in this case suggests that a limited soft tissue excision and bone curettage, with long term follow-up would be appropriate for similar gingival lesions in future.

19.
FEBS Lett ; 314(1): 58-60, 1992 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-1333417

RESUMO

EPR (electron paramagnetic resonance) and optical spectroscopy show that human neutrophil myeloperoxidase is converted from ferric high-spin to low-spin by the addition of nitrite. The Soret peak shifts from 429 to 447 nm and new peaks appear in the visible region at 573 and 627 nm; the EPR g-values change from 6.84, 5.02, 1.95 to 2.55, 2.31, 1.82. Small differences are seen in the EPR (but, not optical) spectra of myeloperoxidase isoenzyme I compared to isoenzymes II and III. The reaction with nitrite is detectable by EPR in intact neutrophils and is thus a possible in vivo monitor of NO/nitrite production by these cells.


Assuntos
Nitritos/metabolismo , Peroxidase/metabolismo , Cloretos/metabolismo , Espectroscopia de Ressonância de Spin Eletrônica , Compostos Férricos/metabolismo , Humanos , Neutrófilos/enzimologia , Espectrofotometria
20.
FEBS Lett ; 382(1-2): 175-8, 1996 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-8612745

RESUMO

Human lactoferrin contains a 46 residue sequence named lactoferricin H thought to be responsible for its antimicrobial properties. Synthetic peptides HLT1, corresponding to the loop region of human lactoferricin (FQWQR-NMRKVRGPPVS) and HLT2, corresponding to its charged portion (FQWQRNMRKVR), exerted significant antibacterial effects against E. coli serotype O111 strains NCTC 8007 and ML35. The corresponding sequences in native human lactoferrin were shown to adopt a charged helix and hydrophobic tail within the N-lobe remote from the iron binding site. Sequence similarities between lactoferricin and dermaseptin and magainins suggest that lactoferricin may act as an amphipathic alpha helix.


Assuntos
Antibacterianos/farmacologia , Escherichia coli/efeitos dos fármacos , Lactoferrina/farmacologia , Fragmentos de Peptídeos/farmacologia , Sequência de Aminoácidos , Antibacterianos/química , Apoproteínas/química , Humanos , Lactoferrina/química , Dados de Sequência Molecular , Fragmentos de Peptídeos/síntese química , Conformação Proteica , Homologia de Sequência de Aminoácidos
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