Immunohistochemical expression of TFIIH and XPF in oral tongue squamous cell carcinoma.

PURPOSE: The query for biomarkers that indicate tumor aggressiveness and the host's response to treatment is still one of the leading aims of cancer research. To investigate a possible role for DNA nucleotide repair proteins in oral cancer behavior, this study evaluated the immunoexpression of the proteins TFIIH and XPF and its association with clinical, histological, and survival parameters in oral tongue squamous-cell carcinoma (OTSCC). METHODS: TFIIH and XPF immunoexpressions were evaluated in 82 cases of oral tongue squamous-cell carcinoma. Tumor budding and depth of invasion were assessed for histopathological grading (BD model). RESULTS: Tumor cells exhibited high expression of TFIIH and XPF, which was associated to nodal status; both proteins were not associated with other clinical parameters, histopathological grading or survival. Tumor size, nodal status, tumor staging, and depth of invasion > 4 mm were significantly associated to disease-specific survival. CONCLUSIONS: We have demonstrated that the overexpression of TFIIH correlates positively with node metastasis, while XPF correlates negatively with node metastasis; therefore, the expression of XPF and TFIIH had a potential value for predicting the progression of OTSCC patients.

Increased SOX2 expression in salivary gland carcinoma ex pleomorphic adenoma progression: an association with adverse outcome.

SOX2 is a regulatory factor of embryonic stem cells that has been implicated in carcinogenesis and cancer progression. We aimed to investigate the potential role of SOX2 in the stepwise progression from pleomorphic adenoma (PA) to invasive carcinoma ex pleomorphic adenoma (CXPA), evaluating its prognostic significance as well. Thirty PAs without malignant transformation and 25 CXPAs presenting both luminal or myoepithelial differentiation (7 intracapsular and 18 extracapsular) were evaluated immunohistochemically for SOX2 expression. Of these, 24 CXPAs (96%) were positive to SOX2, being 6 intracapsular carcinomas (85.7%) and all the 18 extracapsular carcinomas (100%). Residual PA areas and PA without malignant transformation were negative. High SOX2 expression levels (> 50% of positive cells) were correlated with high histological grade (p = 0.02), brisk mitotic activity (p = 0.01), advanced pT stage (p = 0.01), tumor recurrence (p = 0.01), and development of distant metastasis (p = 0.004). Still, overall survival rates were shorter in patients with extracapsular CXPA exhibiting diffuse SOX2 expression. These results suggest that SOX2 may play an important role in carcinogenesis and progression of CXPA and is also related with prognostic indicators in CXPAs with extracapsular invasion. Although direct therapeutic intervention in SOX2 may result in unwanted complications due to its constitutive functions, strategic approach to SOX2-related pathways may provide new therapeutic opportunities for patients with invasive CXPA.

Imunoexpressão das proteínas APE-1 e XRCC-1 em carcinoma epidermoide de língua oral / Immunoreactivity of APE-1 and XRCC1 protein in squamous cell carcinoma of tongue

Os sistemas de reparo do DNA desempenham um papel crítico na proteção do genoma humano contra danos causados por agentes cancerígenos presentes no ambiente. Mutações em genes de reparo de DNA podem ser responsáveis pelo desenvolvimento de tumores e de resistência das células malignas a agentes quimioterapêuticos. A principal via de reparo de danos oxidativos do DNA é a via de reparo por excisão de bases. O objetivo deste estudo foi investigar a imunoexpressão da APE-1 e XRCC-1, que são proteínas envolvidas no reparo do DNA por excisão de bases, e sua associação com parâmetros clínicos e histopatológicos em carcinoma epidermoide de língua oral (CELO), a fim de investigar um possível valor prognóstico para essas proteínas. A expressão de APE-1 e XRCC-1 foi avaliada por meio de imuno-histoquímica em 50 casos de CELO. Os dados clínicos foram coletados no prontuário médico de cada paciente e a gradação histopatológica foi efetuada para cada caso. A análise estatística com os testes de Qui-quadrado e Exato de Fisher foi realizada para determinar a associação entre as expressões das proteínas e características clínico-patológicas; adotou-se um valor de significância de p<0,05. APE-1 foi altamente expressa no núcleo e no citoplasma em 56% dos casos. XRCC-1 mostrou alta expressão apenas no núcleo em 60% dos casos. A alta expressão de XRCC-1 foi significativamente associada aos estádios clínicos I e II (p = 0,02). Ambas as proteínas não foram associadas a outros parâmetros clínicos ou gradação histopatológica. Por fim, nossos resultados demonstraram que as proteínas de reparo do DNA por excisão de bases APE-1 e XRCC-1 estão positivamente expressas em CELO, no entanto, não estão relacionadas com parâmetros clínicos e histológicos, exceto a associação de XRCC-1 com melhor estadiamento clínico. Os resultados deste experimento indicam que a expressão imuno-histoquímica dessas proteínas não possui valor prognóstico para esta neoplasia. (AU)

DNA repair systems play a critical role in protecting the human genome from damage caused by carcinogens present in the environment. Mutations in DNA repair genes may be responsible for tumor development and resistance of malignant cells to chemotherapeutic agents. The major pathway for oxidative DNA damage repair is the base excision repair pathway. The objective of this study was to investigate the immunoexpression of APE-1 and XRCC-1, which are proteins involved in DNA base excision repair and its association with clinical and histopathological parameters in oral tongue squamous cell carcinoma (OTSCC), in order to investigate a possible prognostic value for those proteins. The expression of APE-1 and XRCC-1 was evaluated semi-quantitatively by immunohistochemistry in 50 OTSCC cases. Clinical data was collected from patients’ medical charts and histopathological grading was performed for each case. Statistical analysis (Chi-square and Fisher’s exact tests; significance of 5%) was performed to determine the association between protein expressions and clinico-pathological characteristics. APE-1 was highly expressed in nucleus and cytoplasm in 56% of cases. XRCC-1 showed overexpression only in nucleus in 60% of cases. High expression of XRCC-1 was significantly associated to clinical stages I and II (P=0.02). Both proteins were not associated to other clinical parameters or histopathological grading. Our findings demonstrate that DNA base excision repair proteins APE-1 and XRCC-1 are upregulated in OTSCC, however, they are not related to clinical and histologic parameters, except for XRCC-1 association to better clinical staging. Our results indicate that the immunohistochemical expression of these proteins has no association with prognostic parameters in this tumor. (AU)

Prevalence of Maxillofacial Trauma and use of Mouthguard by Student Athletes in São Luís, Northeastern Brazil

Objective:To estimate the prevalence of maxillofacial trauma (MT) during sporting activities and to compare the level of knowledge and use of mouthguard (MG) by athletes from the public andprivate school system of São Luís, MA, Brazil. Material and Methods:Cross-sectional study in which a target population composed of 416 competition student athletes aged between 10 and 20 years of both genders, basketball (n=100), handball (n=60), soccer (n=96), judo (n=11), karate (n=22) and volleyball (n=127) players were interviewed by a single examiner. A structured questionnaire containing six objective questions about history of MT, knowledge and use of MG was used. Data were statistically analyzed using the x2 test (α= 0.05). Results:A 26% prevalence of MT was observed in the study population. The knowledge of MG as a method for preventing injuries during sport practice was significant (p<0.05); however, its use by athletes was minimal. A difference in the use of MGby athletes from public and private schools was observed (p<0.05). Conclusion:It was concluded that more than one fourth of the study population was affected by some kind of MT, highlighting dichotomy between the knowledge of MG as prevention method and its non-use during sporting practice

Knowledge on oral cancer among dentistry students at Federal University of Maranhão / Conhecimento sobre o câncer oral entre estudantes de odontologia da Universidade Federal do Maranhão

Introduction: Oral cancer is a multifactorial disease of high incidence worldwide and considered a public health problem, in which prevention and early diagnosis are the best ways to reverse this situation. Purpose: To evaluate the level of knowledge on oral cancer in a population of dentistry students. Method: A questionnaire on oral cancer was applied to 150 students from six classes, divided into three groups according to their semesters. The variables studied were statistically analyzed by applying the chi-square test with confidence interval of 95% and significance level of 5%. Result: Eighty-eight students (60.61%) considered their level of knowledge on oral cancer good and regular, while 37.93% rated their knowledge as insufficient. Squamous cell carcinoma was listed as the most common cancer by only 38.25% of students, with the highest percentage of correct answers being observed for groups 2 (55.56%) and 3 (67.39%). The level of knowledge on the risk factors increased over the semesters; however, 77.85% considered their level of confidence to perform diagnostic procedures low. Conclusion: The level of knowledge on oral cancer was considered good or regular among dentistry students, and although they showed good level of knowledge on the risk factors and to specific issues of the disease, there is a clear need to implement continued educational measures throughout the course to consolidate learning on this disease. .

Introdução: O câncer oral é uma doença multifatorial com alta incidência no mundo, que vem sendo considerado problema de saúde pública, sendo a prevenção e o diagnóstico precoce as melhores formas de reverter essa situação. Objetivo: Avaliar o nível de conhecimento sobre o câncer oral em uma população de estudantes de odontologia. Método: Um questionário sobre o câncer de boca foi aplicado a 150 alunos de seis turmas, divididos em três grupos de acordo com o semestre letivo. As variáveis estudadas foram analisadas estatisticamente aplicando-se o teste do Qui-quadrado com intervalo de confiança de 95%, e nível de significância de 5%. Resultado: Oitenta e oito alunos (60,61%) consideraram seu nível de conhecimento sobre câncer oral bom ou regular, enquanto 37,93% avaliaram seu conhecimento como insuficiente. O carcinoma espinocelular foi considerado o câncer mais comum por apenas 38,25% do total de estudantes, sendo o percentual maior de acerto para os grupos 2 (55,56%) e 3 (67,39%). O nível de conhecimento sobre os fatores de risco aumentou ao longo dos semestres, entretanto, 77,85% consideram baixo o seu nível de confiança para realizar procedimentos de diagnóstico. Conclusão: O nível de conhecimento sobre câncer oral foi considerado bom ou regular entre os estudantes de odontologia entrevistados; apesar de demonstrarem um bom nível de conhecimento em relação aos fatores de risco e a questões específicas da doença, ficou clara a necessidade de implementar medidas educativas continuadas ao longo do curso de forma a consolidar o ensino sobre essa patologia. .

Análise de prontuários de pacientes com câncer de mama em tratamento com bisfosfonatos: fator de risco para manifestações orais e osteonecrose induzida / Analysis of medical records of patients with breast cancer on treatment with bisphosphonates: risk factor for oral manifestations and induced osteonecrosis

JUSTIFICATIVA E OBJETIVOS: A terapêutica do câncer de mama (CM) merece ser avaliada com cuidado antes de ser prescrita, pois dentre as opções, existem os bisfosfonatos que mostram relação com a indução a osteonecrose dos maxilares.O objetivo deste estudo foi verificar o uso de bisfosfonato na terapêutica anticâncer e a sua relação com osteonecrose induzida através da análise de prontuários de portadoras do câncer de mama. MÉTODOS: Estudo longitudinal com dados coletados de pacientes que com diagnóstico de câncer de mama entre 2007 e 2008, internadas no Hospital Aldenora Belo, referência neste tipo de tratamento em São Luis/MA, usuárias de bisfosfonato há mais de um ano, sendo a amostra formada por 31 mulheres.RESULTADOS: Das 31 pacientes em tratamento que compuseram a amostra (20,6%), 3 (1,99%) vieram a óbito, 13 (8,63%) desistiram e 15 (9,96%) continuaram, com maioria pertencentes a faixa etária superior aos 40 anos e usuárias de pamidronato por via venosa, sendo, este dois fatores, por si só, fatores de risco.Observou-se apenas um caso de destruição óssea craniofacial com comprovada associação entre idade e uso prolongado do fármaco.CONCLUSÃO: Constatou-se que o pamidronato nunca é o fármaco de primeira escolha, seus efeitos colaterais são significantes.Quanto à osteonecrose induzida, não há nenhum caso confirmado nos prontuários, visto que o diagnóstico é complexo (acompanhamento clínico e radiográfico) além do Cirurgião Dentista não fazer parte da equipe multidisciplinar do hospital.

BACKGROUND AND OBJECTIVES: The treatment of breast cancer (BC) must be carefully evaluated before being prescribed, since there are, among the options, bisphosphonates that show a relation with the induction of osteonecrosis of the jaw. The aim of this study was to investigate the use of bisphosphonates in anticancer therapy, and its relationship to induced osteonecrosis by analyzing medical records of patients with breast cancer. METHODS: A longitudinal study with data collected from patients diagnosed with breast cancer between 2007 and 2008, admitted at Hospital Aldenora Belo, a reference in this type of treatment in the city of São Luis, in the state of Maranhão,who were bisphosphonate users for over a year, with the sample being comprised of 31 women. RESULTS: Of the 31 patients treated in the sample (20.6%), 3 (1.99%) died, 13 (8.63%) quit and 15 (9.96%) continued, with most of them aged over 40 years, and users of intravenous pamidronate, these two factors alone being risk factors. There was one case of craniofacial bone destruction with proven association with age and prolonged use of the drug. CONCLUSION: It was found that pamidronate is never the first-choice drug, its side effects are significant. Regarding induced osteonecrosis, there is no confirmed case in the records, since the diagnosis is complex (clinical and radiographic monitoring) and also because the Dentist is not part of the multidisciplinary team at the hospital.