Expression of matrix metalloproteinase-9 in high-grade salivary gland carcinomas is associated with their metastatic potential.

OBJECTIVE: The aim of this study was to investigate the role of matrix metalloproteinase (MMP)-9 protein in high-grade malignant tumors of salivary gland origin as well as its utility as a prognostic marker. METHODS: Four micrometer sections from 27 malignant salivary neoplasms were immunostained using a specific antibody against MMP-9. The staining results (proportion of the stained tumor cells and intensity of tumor stainings) were correlated with the clinical data and with patient outcomes. RESULTS: Immunostaining for MMP-9 was observed in 17 cases, predominantly localized in the tumor cells and occasionally in the inflammatory stroma cells. MMP-9 protein expression correlated with N (P = .04), M (P = .02), and TNM stages (P = .03). MMP-9 expression was prognostic for shortened survival (P = .01). Our results show that the invasiveness and prognosis of high-grade salivary gland cancers may depend on their MMP-9 expression profile.

Immunoexpression and prognostic significance of TIMP-1 and -2 in oral squamous cell carcinoma.

Matrix metalloproteinases (MMPs) are proteolytic enzymes that are capable of degrading different substrates within the extracellular matrix, and which are believed to be crucial for tumor invasion and metastasis. Tissue inhibitors of MMPs (TIMPs) can inhibit the action of MMPs but also can show a paradoxical poor prognostic effect. In order to evaluate the prognostic significance of TIMPs, we studied the expression of TIMP-1 and -2 in series of 68 oral squamous cell carcinomas (OSCC) by immunohistochemistry. Expression of TIMP-1 was detected in 45 cases (66.2%). In all of these TIMP-1 was expressed in tumoral tissue, and in 19 of them also in the surrounding stroma. In cancer tissue, TIMP-1 was observed in three patterns: homogeneous, central and irregular. Immunoreactivity for TIMP-2 was detected in 38 cases (56%) in tumoral tissue and 9 (13.2%) in the stroma. The expression pattern of TIMP-2 was the same three as TIMP-1 and one more: invasive front of tumoral nests. TIMP-1 expression was not correlated with clinical or pathological parameters. However, TIMP-2 was significantly correlated with T stage (p=0.03), TNM stage (p=0.01), local recurrence (p=0.04), and poor survival (p=0.03, odds ratio=2.75). TIMP-1 and TIMP-2 were significantly correlated with cyclin D1 (p=0.04; p=0.015, respectively) and p53 expressions (p=0.02; p=0.04, respectively). Finally, TIMP-1 but no TIMP-2 was associated with the nuclear antigen Ki-67 (p=0.001). These results suggest that TIMP-1 and -2 are expressed in tumoral and stromal tissue in OSCC. TIMP-2 is related to advanced disease, recurrence and poor prognosis.

Expression of cyclin D1 and Ki-67 in squamous cell carcinoma of the oral cavity: clinicopathological and prognostic significance.

The prognostic and clinicopathologic significance of cyclin D1 and Ki-67 expressions was studied in oral squamous cell carcinomas. We performed an immunohistochemical study to determine the level of expression of cyclin D1 and Ki-67 labelling index in tumor specimens obtained from 35 patients, of whom 14 died as a result of recurrent disease, and 20 were free of recurrence at the end of the follow-up period. Overexpression of cyclin D1 was significantly associated with regional lymph node metastases (P=0.00005) and advanced tumor stage (P=0.0007). The relative risk for nodal metastases in the cases that overexpressed cyclin D1 was 2.6. The Ki-67 labelling index was significantly (P=0.001) higher in tumors with poor histologic grade of differentiation. Our results showed that cyclin D1 is a useful prognostic factor, and suggested it could be a marker to help determine the appropriate treatment for patients with oral squamous cell carcinoma. Cyclin D1 and Ki-67 overexpression were positively correlated.

Chronic sclerosing sialadenitis of the parotid gland.

Chronic sclerosing sialadenitis (Küttner's tumor) is a benign and chronic inflammatory condition of the submandibular gland that clinically cannot be easily distinguished from salivary malignant neoplasia. This is a report of a case of chronic sclerosing sialadenitis located as a solitary mass in an accessory parotid gland.

Neck schwannomas.

Schwannomas are peripheral nerve tumours of nerve sheath origin. Twenty-five to 45 percent of extracranial schwannomas occur in the head and neck region. We present 2 cases of schwannomas that arise from the vagus and cervical plexus. These lesions are uncommon and most often present as asymptomatic solitary neck mass. Preoperative diagnosis can be difficult and conservative surgical excision remains the treatment of choice, often requiring sacrifice of a portion of the nerve.

Prognostic significance of p53 expression in oral squamous cell carcinoma without neck node metastases.

BACKGROUND: Aberrations of the p53 gene and overexpression of its protein are widely recognized markers of malignancy including oral squamous cell carcinomas. This study was performed to evaluate the relationship of immunoexpression of p53 protein in series of 91 squamous cell carcinomas of the oral cavity with clinicopathologic parameters and to investigate whether p53 immunoexpression might influence the clinical outcome of the disease. METHODS: From a group of 287 consecutive patients, 91 surgically treated ones were randomly selected. P53 protein expression was investigated by means of immunohistochemistry. Clinical and histopathologic data were gathered, and the patient survival was analyzed. RESULTS: Of the oral carcinomas, 52.7% (n = 48) overexpressed p53, using a threshold of 10% stained cell nuclei. There was a negative correlation of p53 immunoexpression with a histologic grade of differentiation (r = -0.236, p =.06) but not with clinical variables. Overall survival rate was 59% at 5 years. In univariate analysis, tumor size, node status, and advanced clinical stage were significantly associated with shortened overall survival. In patients without neck node metastases, p53 showed a strong correlation with survival (p =.01). In multivariate analysis performed only on N0 patients, tumor extension and p53 immunoexpression were found to be the only independent prognostic parameters with relative risks of 1.9 and 4.3, respectively. CONCLUSIONS: A strong relationship was observed between p53 immunoexpression and poor prognosis in patients with oral squamous cell carcinomas without neck node metastases.

Infección por el virus de la hepatitis C y riesgo de transmisión en cirugía oral / Hepatitis C virus infection and risk of transmission in oral surgery

La hepatitis viral es la principal causa de enfermedad hepatica. Aproximadamente el 85 por ciento de los individuos infectados por el virus de la hepatitis C (VHC) progresa a una infección crónica y, de estos, entre el 1 y el 4 por ciento cada año desarrolla un carcinoma hepatocelular. Además de la lesión hepática, el virus C puede afectar a tejidos y órganos extrahepáticos dando lugar a diferentes manifestaciones, como el líquen plano oral, sialadenitis y quizá cáncer oral.El objetivo de este trabajo es revisar el riesgo ocupacional de la infección por VHC entre dentistas y cirujanos orales. Ambos deben saber como incorporar el diagnóstico de infección por VHC en el plan de tratamiento quirúrgico programado. También se revisarán la historia natural y la transmisión de este virus vehiculizado por la sangre. (AU)

Regeneración ósea tras la extirpación de quistes radiculares con y sin regeneración guiada / Bone regeneration after extirpation of radicular cysts with and without guided regeneration

Con el propósito de determinar el grado de regeneración ósea en quistes odontogenicos usando tecnicas de Regeneración Osea Guiada (ROG), hemos realizado un estudio clínico randomizado, controlado y prospectivo. Treinta pacientes con quistes radiculares fueron divididos en tres grupos. El grupo 1 o grupo control (n=10 pacientes) fue tratado con quistectomía de Parstch II y cierre primario. Los otros dos grupos fueron tratados con quistectomía de Parstch II y ROG, usando una membrana reabsorbible (n=10) y membrana no-reabsorbible (n=10). Las membranas se fijaron mediante tornillos no reabsorbibles Memfix System. El volumen residual y la densidad de los tejidos neoformados se evaluaron mediante Tomografia Axial Computarizada (TAC) y mediante analisis de Imagen Digitalizada y Asistida por Computadora (CADIA) antes de la enucleacion y a los 3 y 6 meses de la intervencion. Al realizar el analisis estadistico intergrupos, no se encontro diferencia estadisticamente significativa a los 6 meses respecto al volumen y densidad residual. Estos resultados sugieren que la ROG usando membranas no contribuye a incrementar la regeneración ósea.

Regeneración tisular en defectos óseos adyacentes a implantes dentales. Estudio morfológico y estructural / Tissue regeneration in bone defects adjacent to dental implants. A morphologic and ultratructural study

Objetivo: este estudio fue realizado para comparar el grado de reparación tisular observado en defectos óseos adyacentes a implantes endostales colocados en tibias de cerdos Material y método: se colocaron 24 implantes en las tibias de tres cerdos, disponiéndose también 24 defectos óseos cilíndricos adyacentes a los 5 mm coronales de cada fijación. De estos defectos, 18 fueron rellenados con hueso liofilizado desmineraliado, hidroxiapatita, o cubiertos con membranas de politetrafluoroetileno expandido. Los animales fueron sacrificados al cabo de 1, 2 y 3 meses. El tejido óseo neoformado fue evaluado mediante análisis morfológico y ultraestructural. Conclusión: los resultados indican que al cabo de 1, 2 y 3 meses de postoperatorio, la densidad ósea fue mayor en defectos óseos tratados con membranas de politetrafluoroetileno expandido (AU)

Schwannomas cervicales / Neck Schwannomas

Los schwannomas son tumores de los nervios periféricos originados a partir de las vainas neurales. Entre el 25 per cent y el 45 per cent de los schwannomas originados en el nervio vago y en el plexo cervical. Estas lesiones son infrecuentes y suelen presentarse como masas cervicales solitarias asintomáticas. El diagnóstico preoperatorio puede ser difícil y la exéresis quirúrgica conservadora constituye el tratamiento de elección, si bien a menudo requiere el sacrificio de una porción del nervio de origen (AU)

Carcinoma fusocelular de la cavidad oral. A propósito de un caso / Spindle cell carcinoma of the oral cavity. Report of a case

El carcinoma fusocelular es una variedad del carcinoma de células escamosas, de infrecuente presentación e histogénesis controvertida. Aunque puede afectar a cualquier parte de la economía, se localiza más frecuentemente en las vías aerodigestivas superiores. La mayoría de los ubicados en la cavidad oral son invasores y tienen mal pronóstico.Presentamos un caso de carcinoma de células fusiformes que afectaba al espacio masticador, encontrándose la mucosa supraadyacente libre de neoplasia. Hacemos especial hincapié en la metodología histológica e inmunohistoquímica (positividad para las citoqueratinas de bajo peso molecular y, con menor intensidad, para las citoqueratinas de alto peso molecular y la vimentina) empleada para su diagnóstico, así como una valoración de los factores pronósticos y las posibilidades terapéuticas que ofrece esta infrecuente neoplasia (AU)