GTSP1 expression in non-smoker and non-drinker patients with squamous cell carcinoma of the head and neck.

INTRODUCTION: The main risk factors for head and neck squamous cell carcinoma (HNSCC) are tobacco and alcohol consumption and human papillomavirus (HPV) infection. However, in a subset of patients, no risk factors can be identified. Glutathione S-transferase π (GTSP1) is a carcinogen-detoxifying enzyme that is activated by exposure to carcinogens, and it is associated with a reduction in response to toxic therapies. We studied the expression of GTSP1 in tumor and non-tumor tissue samples from patients with and without these risks to identify whether GTSP1 expression differs according to exposure to carcinogens. MATERIALS AND METHODS: Non-smoker/non-drinker (NSND) and smoker/drinker (SD) patients were matched according to age, gender, tumor site, TNM stage, grade and histological variants to establish 47 pairs of patients who have been previously tested for HPV. GTSP1 immunostaining was analyzed using a semi-quantitative method with scores ranging from 0 to 3 according to the area of immunostaining. RESULTS: GTSP1 expression was detected in the tumors of both groups. GTSP1 expression was higher in the non-tumor margins of SD patients (p = 0.004). There was no association between GTSP1 expression and positivity for HPV. No differences in survival were observed according to GTSP1 staining in tumors and non-tumor margins. CONCLUSION: This study showed that GTSP1 was expressed in tumors of HNSCC patients regardless of smoking, drinking or HPV infection status. The difference in GTSP1 expression in non-tumor margins between the two groups may have been due to two possible reasons. First, elevated GTSP1 expression in SD patients might be the result of activation of GTSP1 in response to exposure to carcinogens. Second, alternatively, impairment in the detoxifying system of GTSP1, as observed by the reduced expression of GTSP1, might make patients susceptible to carcinogens other than tobacco and alcohol, which may be the underlying mechanism of carcinogenesis in the absence of risk factors.

Paralisia de prega vocal secundária a invasão do nervo vago por metástases linfonodais de carcinoma tireóideo - relato de caso / Vocal fold paralysis due to vagus nerve invasion by lymph node metastasis from thyroid carcinoma - case report

Introdução: As neoplasias tireóideas têm uma prevalênciacrescente nos últimos anos, apresentando-se em 10-15% doscasos como doença localmente avançada. A disfonia e a paralisiade prega vocal no pré-operatório sugerem invasão do nervolaríngeo recorrente, todavia outras etiologias para tais achadosclínicos devem ser pesquisadas. Objetivo: Relatar um caso depaciente com paralisia de prega vocal decorrente à invasão denervo vago por metástases linfonodais de carcinoma tireóideo.Relato de Caso: Paciente masculino, portador de carcinomapapilífero de tireoide, com paralisia de prega vocal esquerdadevido à infiltração do nervo vago por conglomerado linfonodalipsilateral. Conclusão: Invasão do nervo vago em qualquer níveldo pescoço deve ser considerada no diagnóstico diferencial dasparalisias de pregas vocais em p