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1.
Br J Cancer ; 111(10): 1955-64, 2014 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-25314064

RESUMEN

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.


Asunto(s)
Apoptosis/efectos de los fármacos , Compuestos Bicíclicos Heterocíclicos con Puentes/farmacología , Carcinoma de Células Escamosas/tratamiento farmacológico , Caspasa 10/metabolismo , Caspasa 8/metabolismo , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Ligando Inductor de Apoptosis Relacionado con TNF/farmacología , Triazoles/farmacología , Proteína Proapoptótica que Interacciona Mediante Dominios BH3/metabolismo , Biomimética , Western Blotting , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patología , Proliferación Celular/efectos de los fármacos , Ensayo de Inmunoadsorción Enzimática , Neoplasias de Cabeza y Cuello/metabolismo , Neoplasias de Cabeza y Cuello/patología , Humanos , Células Tumorales Cultivadas , Factor de Necrosis Tumoral alfa/metabolismo
2.
Br J Cancer ; 107(7): 1138-43, 2012 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-22918395

RESUMEN

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.


Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/genética , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/genética , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/genética , Patología Molecular/métodos , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/sangre , Biomarcadores de Tumor/genética , Carcinoma de Células Escamosas/sangre , Carcinoma de Células Escamosas/patología , Femenino , Genes p53 , Neoplasias de Cabeza y Cuello/sangre , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Mutación , Recurrencia Local de Neoplasia/sangre , Recurrencia Local de Neoplasia/patología , Estudios Prospectivos
3.
Apoptosis ; 17(8): 762-76, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22484480

RESUMEN

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.


Asunto(s)
Apoptosis , Proteínas de la Cápside/fisiología , Proteínas de Unión al ADN/metabolismo , Proteínas Nucleares/metabolismo , Proteínas Supresoras de Tumor/metabolismo , Ubiquitina-Proteína Ligasas/metabolismo , Proteínas Reguladoras de la Apoptosis/genética , Proteínas Reguladoras de la Apoptosis/metabolismo , Proteínas de la Cápside/biosíntesis , Línea Celular Tumoral , Proteínas de Unión al ADN/genética , Puntos de Control de la Fase G2 del Ciclo Celular , Semivida , Humanos , Proteínas Nucleares/genética , Poli(ADP-Ribosa) Polimerasa-1 , Poli(ADP-Ribosa) Polimerasas/metabolismo , Isoformas de Proteínas/metabolismo , Procesamiento Proteico-Postraduccional , Estabilidad Proteica , Proteolisis , Proteínas Proto-Oncogénicas/genética , Proteínas Proto-Oncogénicas/metabolismo , Proteína Tumoral p73 , Proteína p53 Supresora de Tumor/metabolismo , Proteínas Supresoras de Tumor/genética , Ubiquitinación
4.
J Oral Pathol Med ; 40(7): 533-40, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21501232

RESUMEN

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.


Asunto(s)
Neoplasias de la Boca/patología , Lesiones Precancerosas/patología , Carcinoma in Situ/patología , Adhesión Celular , Núcleo Celular/patología , Transformación Celular Neoplásica/patología , Cromatina/patología , Células Epiteliales/patología , Epitelio/patología , Femenino , Humanos , Queratinas , Leucoplasia Bucal/patología , Neoplasias de los Labios/patología , Masculino , Mitosis , Suelo de la Boca/patología , Mucosa Bucal/patología , Clasificación del Tumor , Neoplasias Palatinas/patología , Paladar Blando/patología , Reproducibilidad de los Resultados , Conductos Salivales/patología , Neoplasias de la Lengua/patología
5.
J Oral Pathol Med ; 40(9): 677-83, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21762430

RESUMEN

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.


Asunto(s)
Transformación Celular Neoplásica/patología , Neoplasias de la Boca/patología , Lesiones Precancerosas/patología , Factores de Edad , Anciano , Biopsia , Candidiasis Bucal/patología , Carcinoma de Células Escamosas/patología , Estudios de Cohortes , Epitelio/patología , Femenino , Estudios de Seguimiento , Predicción , Humanos , Hiperplasia , Leucoplasia Bucal/patología , Liquen Plano Oral/patología , Erupciones Liquenoides/patología , Londres , Lupus Eritematoso Discoide/patología , Masculino , Persona de Mediana Edad , Mucosa Bucal/patología , Sistema de Registros , Estudios Retrospectivos , Factores Sexuales , Neoplasias de la Lengua/patología
6.
Oral Dis ; 17(6): 564-71, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21332605

RESUMEN

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.


Asunto(s)
Apoptosis/genética , Proteínas de Unión al ADN/genética , ADN/genética , Proteínas Nucleares/genética , Oxidorreductasas/genética , Ploidias , Neoplasias de las Glándulas Salivales/genética , Proteína p53 Supresora de Tumor/genética , Proteínas Supresoras de Tumor/genética , Adolescente , Adulto , Anciano , Aneuploidia , Proliferación Celular , Metilación de ADN/genética , Diploidia , Exones/genética , Femenino , Regulación Neoplásica de la Expresión Génica/genética , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Fenotipo , Reacción en Cadena de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Transcripción Genética/genética , Proteína Tumoral p73 , Oxidorreductasa que Contiene Dominios WW , Adulto Joven
7.
Br J Cancer ; 103(9): 1432-42, 2010 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-20859287

RESUMEN

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.


Asunto(s)
ADN de Neoplasias/ultraestructura , Progresión de la Enfermedad , Mucosa Bucal/patología , Neoplasias de la Boca/genética , Lesiones Precancerosas/genética , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma/genética , Femenino , Humanos , Citometría de Imagen , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Mucosa Bucal/metabolismo , Riesgo
8.
Radiother Oncol ; 145: 146-153, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31981964

RESUMEN

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.


Asunto(s)
Neoplasias de Cabeza y Cuello , Neoplasias Orofaríngeas , Humanos , Estadificación de Neoplasias , Neoplasias Orofaríngeas/patología , Neoplasias Orofaríngeas/terapia , Pronóstico , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello
9.
Br J Oral Maxillofac Surg ; 57(10): 1039-1043, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31564483

RESUMEN

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.


Asunto(s)
Adenoma Pleomórfico , Carcinoma Adenoide Quístico , Disección del Cuello , Neoplasias de las Glándulas Salivales , Adenoma Pleomórfico/cirugía , Carcinoma Adenoide Quístico/cirugía , Humanos , Glándula Parótida/cirugía , Estudios Retrospectivos , Neoplasias de las Glándulas Salivales/cirugía
10.
Oral Oncol ; 44(3): 227-35, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-17604679

RESUMEN

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.


Asunto(s)
Carcinoma de Células Escamosas/metabolismo , Mucosa Bucal/metabolismo , Neoplasias de la Boca/metabolismo , Proteínas Tirosina Quinasas Receptoras/análisis , Adulto , Anciano , Carcinoma de Células Escamosas/genética , Receptores ErbB/análisis , Genes erbB , Humanos , Inmunohistoquímica , Persona de Mediana Edad , Mucosa Bucal/embriología , Mucosa Bucal/patología , Neoplasias de la Boca/genética , Ploidias , Lesiones Precancerosas/metabolismo , Lesiones Precancerosas/patología , ARN Mensajero/análisis , Proteínas Tirosina Quinasas Receptoras/genética , Proteínas Tirosina Quinasas Receptoras/metabolismo , Receptor ErbB-2/análisis , Receptor ErbB-3/análisis , Receptor ErbB-4 , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Coloración y Etiquetado , Estadísticas no Paramétricas
11.
Br J Oral Maxillofac Surg ; 56(7): 615-620, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30017578

RESUMEN

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.


Asunto(s)
Carcinoma de Células Escamosas/patología , Metástasis Linfática/patología , Errores Médicos/estadística & datos numéricos , Neoplasias de la Boca/patología , Biopsia del Ganglio Linfático Centinela/efectos adversos , Adulto , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/cirugía , Protocolos Clínicos , Femenino , Humanos , Masculino , Neoplasias de la Boca/diagnóstico por imagen , Neoplasias de la Boca/cirugía , Disección del Cuello , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Complicaciones Posoperatorias , Estudios Retrospectivos , Tomografía Computarizada de Emisión de Fotón Único , Tomografía Computarizada por Rayos X
12.
Oral Oncol ; 43(3): 310-6, 2007 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16931117

RESUMEN

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.


Asunto(s)
Carcinoma Verrugoso/genética , ADN de Neoplasias/genética , Leucoplasia Bucal/genética , Ploidias , Anciano , Anciano de 80 o más Años , Aneuploidia , Carcinoma Verrugoso/patología , Transformación Celular Neoplásica/genética , Transformación Celular Neoplásica/patología , Diploidia , Femenino , Neoplasias Gingivales/genética , Neoplasias Gingivales/patología , Humanos , Leucoplasia Bucal/patología , Neoplasias de los Labios/genética , Neoplasias de los Labios/patología , Masculino , Persona de Mediana Edad , Neoplasias de la Lengua/genética , Neoplasias de la Lengua/patología
13.
Int J Oral Maxillofac Surg ; 36(12): 1183-92, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17822878

RESUMEN

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.


Asunto(s)
Proteínas Morfogenéticas Óseas/uso terapéutico , Regeneración Ósea/efectos de los fármacos , Mandíbula/cirugía , Músculos del Cuello/cirugía , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos , Factor de Crecimiento Transformador beta/uso terapéutico , Animales , Proteína Morfogenética Ósea 7 , Estudios de Factibilidad , Mandíbula/diagnóstico por imagen , Microrradiografía/métodos , Proteínas Recombinantes/uso terapéutico , Ovinos
14.
Biochim Biophys Acta ; 971(3): 266-74, 1988 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-2844290

RESUMEN

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.


Asunto(s)
Neutrófilos/fisiología , Consumo de Oxígeno , Peroxidasa/sangre , Fagocitosis , Membrana Celular/fisiología , Humanos , Técnicas In Vitro , Cinética , Microscopía Electrónica , Neutrófilos/enzimología , Neutrófilos/ultraestructura , Staphylococcus aureus , Superóxidos/sangre
15.
Oral Oncol ; 41(4): 416-22, 2005 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15792614

RESUMEN

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.


Asunto(s)
Carcinoma de Células Escamosas/genética , Heterogeneidad Genética , Neoplasias de la Boca/genética , Ploidias , Carcinoma de Células Escamosas/patología , ADN de Neoplasias/genética , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Neoplasias de la Boca/patología
16.
Int J Oral Maxillofac Surg ; 34(3): 287-93, 2005 May.
Artículo en Inglés | MEDLINE | ID: mdl-15741038

RESUMEN

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.


Asunto(s)
Receptores de Activinas Tipo I/farmacología , Proteínas Morfogenéticas Óseas/farmacología , Regeneración Ósea/efectos de los fármacos , Mandíbula/cirugía , Proteínas/farmacología , Factor de Crecimiento Transformador beta/farmacología , Animales , Fenómenos Biomecánicos , Proteína Morfogenética Ósea 7 , Análisis del Estrés Dental , Femenino , Humanos , Implantes Experimentales , Modelos Animales , Docilidad , Proteínas Recombinantes/farmacología , Ovinos , Oveja Doméstica , Resistencia a la Tracción
17.
Int J Surg Case Rep ; 13: 43-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26101054

RESUMEN

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.
Artículo en Inglés | MEDLINE | ID: mdl-26298095

RESUMEN

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.
Artículo en Inglés | MEDLINE | ID: mdl-1333417

RESUMEN

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.


Asunto(s)
Nitritos/metabolismo , Peroxidasa/metabolismo , Cloruros/metabolismo , Espectroscopía de Resonancia por Spin del Electrón , Compuestos Férricos/metabolismo , Humanos , Neutrófilos/enzimología , Espectrofotometría
20.
FEBS Lett ; 382(1-2): 175-8, 1996 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-8612745

RESUMEN

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.


Asunto(s)
Antibacterianos/farmacología , Escherichia coli/efectos de los fármacos , Lactoferrina/farmacología , Fragmentos de Péptidos/farmacología , Secuencia de Aminoácidos , Antibacterianos/química , Apoproteínas/química , Humanos , Lactoferrina/química , Datos de Secuencia Molecular , Fragmentos de Péptidos/síntesis química , Conformación Proteica , Homología de Secuencia de Aminoácido
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