RESUMO
BACKGROUND: Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease that may affect the oral mucosa. The variable spectrum of oral lesions observed in SLE can pose challenges in diagnosis, particularly when the lesions occur in isolation. The aim of this study was to describe the oral lesions occurring in patients with SLE from Latin America. METHODS: This collaborative record-based study involving 11 oral and maxillofacial pathology and medicine services across Venezuela, Argentina, Chile, Brazil, and Mexico describes the clinicopathological profile of SLE-related oral lesions. RESULTS: Seventy patients with SLE and oral lesions were included in the study. The majority were females (75.7%; female/male ratio: 3.1:1) and white (62.1%), with a mean age of 38.4 years (range: 11-77 years). The most common site of oral lesions was the hard/soft palate (32.0%). Clinically, oral lesions predominantly presented as ulcers (26.6%), erosions (26.6%), and white lesions (23.4%). Isolated oral lesions occurred in 65.2% of individuals, while cutaneous manifestations occurred in 80.3%. The main clinical diagnostic hypothesis in 71.4% of cases was an immune-mediated disease. Oral biopsies followed by histopathological analysis were performed in 50 cases. CONCLUSION: Oral lesions of SLE exhibit a variety of clinical and histopathological features. A key point in diagnosis is that unusual oral changes without an obvious local cause may indicate a possible systemic condition presenting with oral lesions. A multidisciplinary approach, which includes regular oral examination, is warranted to identify oral lesions and provide treatment.
Assuntos
Lúpus Eritematoso Sistêmico , Doenças da Boca , Humanos , Lúpus Eritematoso Sistêmico/epidemiologia , Lúpus Eritematoso Sistêmico/diagnóstico , Feminino , Masculino , Adulto , Adolescente , Pessoa de Meia-Idade , Adulto Jovem , Criança , Doenças da Boca/epidemiologia , Doenças da Boca/etiologia , Doenças da Boca/patologia , Idoso , América Latina/epidemiologia , Mucosa Bucal/patologia , BiópsiaRESUMO
The presence of multiple primary oral squamous cell carcinomas (SCCs) in a single patient is rare in dental practice. A 63-year-old man was referred for evaluation of a single tongue lesion. No lymphadenopathy was detected on extraoral examination. However, multiple asymptomatic ulcerated and crusted lesions were observed on the vermilion border of the lower lip. The intraoral examination revealed an extensive, painful endophytic ulcer of 3 months' duration on the right lateral border of the tongue. No additional findings were observed. Incisional biopsies were performed, and the histopathologic analysis confirmed the diagnosis of SCCs. The patient was referred for oncologic therapy. Surgery was the treatment of choice for both the extraoral and intraoral lesions. No disease was found after 5 months of follow-up. Although uncommon, multiple oral SCC lesions can appear to be clinically similar to deep infectious disease. Metachronous tumors were diagnosed in this patient in light of the probable course of onset of the lesions. A rigorous clinical examination that includes the lips is essential to make an accurate diagnosis and refer the patient for appropriate treatment.
Assuntos
Carcinoma de Células Escamosas , Neoplasias Labiais , Doenças da Língua , Carcinoma de Células Escamosas/diagnóstico , Humanos , Lábio , Neoplasias Labiais/diagnóstico , Masculino , Pessoa de Meia-Idade , Língua , Doenças da Língua/diagnóstico , ÚlceraRESUMO
BACKGROUND: Focal adhesion kinase (FAK) phosphorylation contributes to the regulation of growth factors that promote cellular adhesion, mobility, and survival, being a key factor in tumor development. The objective of this study was to evaluate the immunohistochemical expression patterns of FAK and its phosphorylated forms, FAK Tyr-576 and FAK Tyr-925, in head and neck squamous cell carcinoma and non-neoplastic adjacent epithelial tissue (AE). METHODS: The percentage of immunohistochemistry stained cells and its correlation with clinicopathological variables and prognosis were determined using samples from 54 patients. RESULTS: FAK, FAK Tyr-576, and FAK Tyr-925 overexpression was observed in tumor zones and AE. FAK Tyr-576 immunostaining showed a relationship with tumor clinicopathological parameters. Moreover, positive immunostaining of FAK Tyr-576 in AEsue was associated with patients prognoses. CONCLUSIONS: Increased expression of FAK Tyr-576 could enable identification of tumors with a more aggressive behavior and epithelial alterations before the appearance of clinical or histological manifestations.
Assuntos
Carcinoma de Células Escamosas/metabolismo , Proteína-Tirosina Quinases de Adesão Focal/metabolismo , Neoplasias de Cabeça e Pescoço/metabolismo , Adulto , Idoso , Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Epitélio/metabolismo , Feminino , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
PURPOSE: We hypothesized that fragmentation of the cystic capsule during surgery would influence the recurrence rate of odontogenic keratocysts (OKCs) regardless of the treatment modality chosen. MATERIALS AND METHODS: We reviewed, in a retrospective study, cases diagnosed as OKCs on histopathologic examination at the oral pathology department between 1991 and 2013. Fragmentation data were obtained from the records of the oral surgical department. RESULTS: Fragmentation of the capsules of OKCs during surgery did not affect recurrence, irrespective of the chosen treatment modality. The addition of techniques such as cryotherapy lowered the risk of recurrence of OKCs (P = .013) compared with after enucleation alone. Furthermore, patients with associated nevoid basal cell carcinoma syndrome had a greater recurrence rate than that of those with no associated syndrome (P = .033). CONCLUSIONS: Fragmentation of the cystic capsule does not play an important role in the rate of OKC recurrence. The rate of recurrence can be modified by using additional strategies such as cryotherapy.
Assuntos
Cistos Odontogênicos/cirurgia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cistos Odontogênicos/patologia , Cistos Odontogênicos/prevenção & controle , Recidiva , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
The objective of this study was to discuss the importance of performing histopathological examination of pericoronal follicles as a routine procedure, so as to enable the early identification of odontogenic lesions. We describe two clinical cases with histopathological diagnoses of ameloblastomas who did not show clinical or radiographic signs of disease before microscopic examination.
Assuntos
Ameloblastoma/patologia , Diagnóstico Precoce , Gengiva/patologia , Neoplasias Maxilomandibulares/patologia , Mandíbula/patologia , Adolescente , Adulto , Feminino , Humanos , MasculinoRESUMO
The objective of this study was to assess the association between the histopathological diagnoses of dentigerous cysts and pericoronal follicles and the positions of impacted third molars. The sample comprised 151 cases, diagnosed as dentigerous cysts and pericoronal follicles. Most patients were female (70.9%), white (90.1%), and age 20 years or older (63.6%). Ninety-eight cases (64.9%) were diagnosed as pericoronal follicles and 53 (35.1%) as dentigerous cysts. Teeth that developed dentigerous cysts were predominantly located in the mandible (84.9%), in a mesioangular position (49.1%), and in the 20- to 29-year age group (66.0%). The mandible seems to be the most frequent location of impacted teeth, probably because mandibular tooth eruption is more difficult, as well as dentigerous cysts, probably because the long duration of impaction increases the exposure to inflammatory stimuli and, thus, the potential for formation of dentigerous cysts. The findings also suggest that the incidence of dentigerous cysts tends to increase with age, especially for mandibular teeth in mesioangular positions.
Assuntos
Cisto Dentígero/complicações , Dente Serotino/patologia , Dente Impactado/complicações , Adolescente , Adulto , Fatores Etários , Criança , Cisto Dentígero/diagnóstico , Cisto Dentígero/patologia , Feminino , Humanos , Masculino , Mandíbula , Dente Impactado/diagnóstico , Dente Impactado/patologia , Adulto JovemRESUMO
AIM: To evaluate the proliferative potential and the cell proliferation rate of odontogenic epithelial cells. MATERIALS AND METHODS: Forty-two cases of pericoronal follicles of impacted third molars were submitted to silver impregnation technique for quantification of argyrophilic nucleolar organizer regions (AgNOR) and immunohistochemical staining for EGFR and Ki-67. For AgNOR quantification, the mean number of active nucleolar organizer regions per nucleus (mAgNOR) and the percentage of cells with 1, 2, 3 and 4 or more AgNORs per nucleus (pAgNOR) were quantified. Ki-67 immunolabeling was quantified, whereas for EGFR, a descriptive analysis of staining patterns (membrane, cytoplasm or membrane + cytoplasm positivity) was performed. We evaluated the reduced epithelium of the enamel organ and/or islands of odontogenic epithelium present in the entire connective tissue. RESULTS: mAgNOR were 1.43 (1.0-2.42) and were significantly different among pericoronary follicles from upper and lower teeth (p = 0.041). Immunostaining of Ki-67 was negative in all cases. EGFR immunolabeling was found mainly in the cytoplasm and was more intense in islands and cords when compared to reduced epithelium of the enamel organ. CONCLUSION: Odontogenic epithelial cells of some pericoronal follicles have proliferative potential, suggesting their association with the development of odontogenic lesions. CLINICAL SIGNIFICANCE: The authors suggest that nonerupted, especially of the lower teeth, should be monitored and if necessary removed.
Assuntos
Saco Dentário/citologia , Odontogênese/fisiologia , Adolescente , Adulto , Antígenos Nucleares/análise , Membrana Celular/ultraestrutura , Núcleo Celular/ultraestrutura , Proliferação de Células , Citoplasma/ultraestrutura , Saco Dentário/ultraestrutura , Órgão do Esmalte/citologia , Órgão do Esmalte/ultraestrutura , Células Epiteliais/fisiologia , Células Epiteliais/ultraestrutura , Receptores ErbB/análise , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/análise , Masculino , Região Organizadora do Nucléolo/ultraestrutura , Adulto JovemRESUMO
Pigmentations of the oral mucosa include a range of lesions or conditions that manifest as changes in the color of oral tissues; these changes may show melanocytic activity. A melanotic macule is a small, well-circumscribed melanocytic benign lesion. It can occur on the lips and intraorally and ranges in color from brown to black. Microscopically, it is characterized by elevated levels of melanin production by basal melanocytes, which appear normal in terms of number, morphology, and distribution. A 48-year-old woman sought treatment for a pigmented lesion that had been present for 4 months. Intraoral examination revealed a non-homogenous brownish spot (measuring 0.7 cm) with irregular borders on the left side of the soft palate. Since the lesion had an atypical clinical appearance, melanocytic nevus, oral melanoacanthoma, and oral malignant melanoma were considered in differential diagnoses. After an incisional biopsy, the lesion was diagnosed as a melanotic macule. Due to their varying clinical appearance, benign pigmented lesions can be mistaken for malignant tumors, especially when the lesions exhibit similar coloration, symmetry, and borders. Through this report on a case with atypical clinical characteristics, we aim to reinforce the ubiquitous nature of oral pigmented lesions, and the importance of employing different approaches to diagnosing these lesions.
Assuntos
Melanose/diagnóstico , Doenças da Boca/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Melanose/patologia , Pessoa de Meia-Idade , Doenças da Boca/patologia , Neoplasias Palatinas/diagnóstico , Neoplasias Palatinas/patologia , Palato/patologiaRESUMO
Traditional guidelines for determining the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) are used to make therapeutic decisions. However, only 50% of the patients had lived for more than five years. The present study aimed to analyze the correlation of traditional prognostic factors such as tumor size, histological grading, regional metastases, and treatment with the survival of patients with HNSCC. A total of 78 patients diagnosed with HNSCC were followed up for 10 years after diagnosis and treatment. The health status of the patients was tracked at four time points, and according to the evolution of the patients and their final clinical status, we performed a prognostic analysis based on the clinical outcomes observed during the follow-up period. The final study cohort comprised 50 patients. Most patients had tumors < 4 cm in size (64%) and no regional metastases (64%); no patients had distant metastases at the time of diagnosis. Most individuals had tumors with good (48%) and moderate (46%) degrees of malignancy. At the end of the follow-up period, only 14% of the patients were discharged, 42% died of the tumor, and 44% remained under observation owing to the presence of a potentially malignant disorder, relapse, or metastases. This analysis showed that traditional prognostic factors were not accurate in detecting subclinical changes or predicting the clinical evolution of patients.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Humanos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Seguimentos , Prognóstico , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/terapia , Recidiva Local de Neoplasia/patologiaRESUMO
This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.
Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Masculino , Humanos , Pessoa de Meia-Idade , Brasil/epidemiologia , Patologia Bucal , Estudos Transversais , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/epidemiologia , Carcinoma de Células Escamosas de Cabeça e PescoçoRESUMO
AIM: This study aimed to analyze the prevalence of diseases related to pericoronal follicles, and assess the rate of concordance between clinical and histopathological diagnoses. METHODS: Histologically, we analyzed 1,298 tissue samples surrounding the crowns of teeth that were diagnosed clinically as pericoronal follicles. In addition, we determined associations among histopathological diagnosis, patients' age and sex, tissue site, presence of nests of odontogenic epithelium, presence of reduced enamel epithelium, and presence of diffuse inflammation. RESULTS: Odontogenic pathologies were present in 35% of the samples, and rate of concordance between clinical and histopathological diagnoses was 0.54. Probability of developing odontogenic pathologies was high in the mandibular molars (odds ratio: 2.13) and in the tissues with odontogenic epithelial remnants (odds ratio: 1.2), reduced enamel epithelium (odds ratio: 1.3), and diffuse inflammation. (odds ratio: 10.5). CONCLUSIONS: The findings of this study highlight the clinical relevance of histopathological examination of the pericoronal tissue in unerupted and partially erupted teeth for early diagnosis of pathologies because this study demonstrated the odontogenic cysts and inflammatory lesions in tissues clinically diagnosed as pericoronal follicles.
Assuntos
Cisto Dentígero , Cistos Odontogênicos , Epitélio , Humanos , Microscopia , Dente Molar , Estudos RetrospectivosRESUMO
OBJECTIVE: the role of p53 expression in odontogenic lesions has not been fully determined, but has been associated with cell proliferation. The purpose of this study was to analyze p53 and proliferating cell nuclear antigen (PCNA) expression in 4 different odontogenic lesions. DESIGN: expression of p53 and PCNA was analyzed in radicular and dentigerous cysts, odontogenic keratocysts, and calcifying odontogenic cysts (Gorlin cysts) using monoclonal antibodies for detection of p53 and PCNA. RESULTS: PCNA expression was significantly greater in the basal layer of radicular cysts and in the suprabasal layer of odontogenic keratocysts; the percentage of p53 positive cells was significantly greater in the suprabasal layer of odontogenic keratocysts. CONCLUSIONS: The patterns of p53 and PCNA expression in dentigerous and radicular cysts were similar although the two lesions are of different origin. In odontogenic keratocysts and Gorlin cysts, results indicate a different pattern of tumor growth.
Assuntos
Cistos Odontogênicos/imunologia , Cistos Odontogênicos/patologia , Antígeno Nuclear de Célula em Proliferação/biossíntese , Proteína Supressora de Tumor p53/biossíntese , Humanos , Imuno-Histoquímica , Antígeno Nuclear de Célula em Proliferação/análise , Proteína Supressora de Tumor p53/análiseRESUMO
Carcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma (SCC). Only 27 cases have been published in English. A 50-year-old male, who presented a white nodule with erythematous areas, localized in the lateral border of the tongue with 2 months of duration. The patient presents oral lichen planus lesions on the tongue, commissure, and buccal mucosa. The microscopy evaluation of the nodular lesion of the tongue revealed a malignant epithelial neoplasia characterized by cuniculatum architecture, similar in appearance to "rabbit burrows" and the final diagnosis was of CC. The management of CC needs cooperation between surgeons and pathologists to establish a correct diagnosis and treatment. CC is a rare entity and must be recognized by oral pathologist so that it is not misdiagnosed as verrucous carcinoma or oral SCC (OSCC). Regarding prognosis, CC must be evaluated and distinguished from other variants of OSCC.
Assuntos
Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Líquen Plano Bucal/complicações , Líquen Plano Bucal/patologia , Neoplasias da Língua/complicações , Neoplasias da Língua/patologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/ultraestrutura , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Humanos , Líquen Plano Bucal/diagnóstico , Masculino , Microscopia , Pessoa de Meia-Idade , Neoplasias da Língua/diagnóstico , Neoplasias da Língua/ultraestruturaRESUMO
Abstract Traditional guidelines for determining the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) are used to make therapeutic decisions. However, only 50% of the patients had lived for more than five years. The present study aimed to analyze the correlation of traditional prognostic factors such as tumor size, histological grading, regional metastases, and treatment with the survival of patients with HNSCC. A total of 78 patients diagnosed with HNSCC were followed up for 10 years after diagnosis and treatment. The health status of the patients was tracked at four time points, and according to the evolution of the patients and their final clinical status, we performed a prognostic analysis based on the clinical outcomes observed during the follow-up period. The final study cohort comprised 50 patients. Most patients had tumors < 4 cm in size (64%) and no regional metastases (64%); no patients had distant metastases at the time of diagnosis. Most individuals had tumors with good (48%) and moderate (46%) degrees of malignancy. At the end of the follow-up period, only 14% of the patients were discharged, 42% died of the tumor, and 44% remained under observation owing to the presence of a potentially malignant disorder, relapse, or metastases. This analysis showed that traditional prognostic factors were not accurate in detecting subclinical changes or predicting the clinical evolution of patients.
RESUMO
Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.
RESUMO
The aim of this study is to evaluate the immunohistochemical expression of E-cadherin, N-cadherin and Bmi-1, and their association with clinical parameters and with the degree of histopathological differentiation in oral squamous cell carcinomas. 65 squamous cell carcinoma samples were used for constructing a tissue microarray block, and then immunohistochemistry was performed for different markers. A semi-quantitative analysis of the amount of positive tumor cells was performed by two blind and calibrated observers (Kappa>0.75). The statistical Mann-Whitney and Kruskal-Wallis tests were used to evaluate the data. The correlation between variables was investigated by the Spearman test, and the significance level set at p<0.05. We observed higher expression of Bmi-1 in tumors located in the palate (p<0.0001). In addition, poorly differentiated tumors had a greater amount of Bmi-1 positive cells (p=0.0011). Regarding the other correlations between variables, no significant associations were detected. In conclusion, poorly differentiated squamous cell carcinomas located in the palate have higher immunostaining of Bmi-1, which can characterize activation of the Epithelial-Mesenchymal Transition process in these tumors.
Assuntos
Carcinoma de Células Escamosas/patologia , Transição Epitelial-Mesenquimal , Neoplasias Bucais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Caderinas/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Complexo Repressor Polycomb 1/metabolismo , Análise Serial de TecidosRESUMO
BACKGROUND: The aim of this research was to assess the expression of aldehyde dehydrogenase 1 (ALDH1) and epithelial-mesenchymal transition (EMT) markers in head and neck squamous cell carcinoma (HNSCC), and to correlate them with the clinical and histopathological parameters of a patient cohort with follow-up over an 8-year period. MATERIAL AND METHODS: For this, seventeen HNSCC and non-neoplastic adjacent epithelium (AE) samples were subjected to laser microdissection and real-time PCR to evaluate the mRNA expression of ALDH1, E-cadherin (E-CAD), N-cadherin (N-CAD), and vimentin (VIM). Also, immunohistochemistry was performed for ALDH1, E-CAD, N-CAD, and VIM in the tumor center (TC), invasion front (IF), and AE of the seventeen samples. Mann-Whitney, Kruskal-Wallis and Chi-square tests were used to correlate the mRNA and immunohistochemical ex-pression with different variables, considering p < 0.05. Kaplan-Meier curves were produced for local recurrence, regional metastasis and treatment. RESULTS: A mRNA overexpression of ALDH1 in primary tumors was associated with regional metastasis and a high ALDH1 immunostaining was related to metastasis and a worse patient outcome. Additionally, a favorable outcome was associated with the transition phase and an unfavorable outcome was associated with EMT event. An overall 26.9 months was observed with longer survival associated with surgery and radiotherapy. CONCLUSIONS: However, due to the intense variability inherent to the indicator proteins in the EMT process, the complete profile markers related to this biological process should be continuous investigated
No disponible
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/patologia , Aldeído Desidrogenase/análise , Transição Epitelial-Mesenquimal , Biomarcadores Tumorais/análise , Seguimentos , Imuno-Histoquímica , Carcinoma de Células Escamosas/mortalidade , Neoplasias de Cabeça e Pescoço/mortalidade , Estimativa de Kaplan-Meier , Recidiva Local de Neoplasia , Reação em Cadeia da Polimerase em Tempo RealRESUMO
Paracoccidioidomycosis (PCM) is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed.
RESUMO
Background: The present study attempted to provide information regarding non-muscle myosin II (MII) isoforms immunoreactivity in patients with head and neck squamous cell carcinoma (HNSCC) and analysis of the patients' clinical status after 5 years of monitoring. Material and Methods: A semiquantitative analysis of the immunoreactivity of the MII isoforms was performed in 54 surgical specimens and its correlation with clinical and pathological variables and prognosis was verified. Data were analyzed using chi-square, Mann-Whitney and Kruskal-Wallis tests. To evaluate the survival over the total monitoring time and any connection with the proteins studied, the Kaplan-Meier analysis was used. P values ≤0.05 were considered statistically significant. Results: In the advanced stages of pathological tumor-node-metastasis, the expression of MIIB in adjacent non-neoplastic epithelial tissues tended to increase (p = 0.057). In tumoral zones there was an association of high expression among the three isoforms (MIIA/MIIB p = 0,001, MIIB/MIIC p = 0,006 and MIIA/MIIC p = 0,012). Negative clinical evolution in patients was directly correlated to increased MIIC expression in the tumoral zone of invasion in HNSCC (p = 0.017). Based on clinical evolution after the monitoring period, patients with tumors expressing MIIC had poorer prognoses (p = 0.048). Conclusions: The present study suggests that MIIB expression in non-neoplastic adjacent epithelial tissues may indicate a potential for regional metastasis and that MIIC expression in the tumoral zone of invasion is predictive of negative evolution of the disease
No disponible
Assuntos
Humanos , Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Carcinoma de Células Escamosas de Cabeça e Pescoço , Biomarcadores Tumorais , Miosina Tipo II , PrognósticoRESUMO
Abstract The aim of this study is to evaluate the immunohistochemical expression of E-cadherin, N-cadherin and Bmi-1, and their association with clinical parameters and with the degree of histopathological differentiation in oral squamous cell carcinomas. 65 squamous cell carcinoma samples were used for constructing a tissue microarray block, and then immunohistochemistry was performed for different markers. A semi-quantitative analysis of the amount of positive tumor cells was performed by two blind and calibrated observers (Kappa>0.75). The statistical Mann-Whitney and Kruskal-Wallis tests were used to evaluate the data. The correlation between variables was investigated by the Spearman test, and the significance level set at p<0.05. We observed higher expression of Bmi-1 in tumors located in the palate (p<0.0001). In addition, poorly differentiated tumors had a greater amount of Bmi-1 positive cells (p=0.0011). Regarding the other correlations between variables, no significant associations were detected. In conclusion, poorly differentiated squamous cell carcinomas located in the palate have higher immunostaining of Bmi-1, which can characterize activation of the Epithelial-Mesenchymal Transition process in these tumors.
Resumo O objetivo deste estudo foi avaliar a associação entre a expressão imunoistoquímica de E-caderina, N-caderina e Bmi-1, com os parâmetros clínicos e o grau de diferenciação em carcinomas espinocelulares bucais. Sessenta e cinco amostras foram selecionadas para a construção de um bloco de microarranjo tecidual, e a técnica de imunoistoquímica foi realizada para os diferentes marcadores. Uma análise semi-quantitativa das células tumorais positivas foi realizada por dois observadores calibrados e cegos (Kappa>0.75). Os testes estatísticos Mann-Whitney e Kruskal-Wallis foram utilizados para a análise dos dados e a correlação entre as variáveis foi investigada com o teste de Spearman. O nível de significância foi determinado em p <0.05. Observamos maior expressão de Bmi-1 em tumores localizados em palato (p <0.0001). Além disso, tumores pobremente diferenciados apresentaram maior quantidade de células positivas para Bmi-1 (p=0.0011). Não encontramos outras correlações ou associações significativas. Em conclusão, carcinomas espinocelulares pobremente diferenciados e localizados no palato apresentam maior marcação imunoistoquímica de Bmi-1, o que pode caracterizar a ativação do processo de transição epitélio-mesênquima nesses tumores.