Prognostic value of lymphovascular and perineural invasion in squamous cell carcinoma of the tongue.

OBJECTIVE: The objective of this study was to investigate the association between survival rate and lymphovascular invasion (LVI) and perineural invasion (PNI) in the tumor invasive front (TIF) of squamous cell carcinoma of the tongue (TSCC). STUDY DESIGN: Seventy patients with TSCC were included. The retrospective analysis included demographic, clinical, and histopathologic data. Tissue blocks containing the TIF were stained with anti-α-smooth muscle actin and anti-S100 to detect LVI and PNI, respectively. Overall survival (OS) and disease-specific survival (DSS) were assessed using Pearson's chi-square test, Kaplan-Meier method, and Cox regression. RESULTS: LVI and PNI were detected in 61.4% and 78.6% of the TSCC samples at the TIF, respectively. LVI and PNI were present in 54.3% of the cases and were associated with advanced clinical stage, lymph node resection, metastatic nodes, and lower survival (P < .05). The 5-year OS and DSS rates were 44% and 52%, respectively. Multivariate analysis showed that primary tumors >3.0 cm (hazard ratio = 4.29; P = .004) and a concomitant presence of LVI and PNI at the TIF (hazard ratio = 4.0; P = .012) were independent predictors for worse DSS. CONCLUSION: LVI and PNI, identified by immunostaining at the TIF, are potential prognostic markers of TSCC.

Possible association of periodontal disease with oral cancer and oral potentially malignant disorders: a systematic review.

Background: Periodontitis has been associated with several systemic diseases and medical conditions, including oral cancer (OC). However, most studies reporting an association between OC and periodontal disease have used different clinical and radiographic criteria to define periodontal disease. This review aimed to evaluate the currently available evidence to determine an association between periodontal disease (extension and severity), OC, and oral potentially malignant disorders (OPMDs).Material and methods: A systematic search of studies published up to August 2018 was performed following the PRISMA guidelines in the electronic databases MEDLINE (PubMed) and COCHRANE (OVID). A methodological evaluation was made using the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist.Results: Eight studies (case-control, cross-sectional and cohort) were included. An increased clinical attachment loss, plaque index, bleeding on probing, and radiographic bone loss was found in patients with OC and OPMDs. Differences in the methodological characteristics, case definition used for periodontal diseases, and OC location did not allow estimating the odds ratio required to conduct a meta-analysis.Conclusion: Some studies suggest a positive relationship between periodontal disease, OC, and OPMDs; however, the currently available evidence is insufficient to draw solid conclusions.

Salivary glands: a clinical-histopathological study / Glándulas salivales: un estudio clínico-histopatológico / Glândulas salivares: um estudo clínico-histopatológico

Abstract Introduction and objective: The diseases that affect the salivary glands cover a wide range of conditions and etiologies, including infectious, inflammatory, immunological or neoplastic pathologies. The objective of this study was to identify the most frequent salivary gland diseases diagnosed in the School of Dentistry of Araraquara of the São Paulo State University (FOAr-UNESP). Materials and methods: This retrospective descriptive study included all cases of salivary gland diseases diagnosed between 2009 and 2013. In total, 2,236 clinical records of the Oral Medicine Service and 1,217 histopathological reports of the Histopathological Diagnosis Service were evaluated. Results: We identified 254 patients diagnosed with salivary gland disease, predominantly women (1.5 F / M). The most frequent diagnoses were mucocele (38.6%), sialolithiasis (6.7%), sialadenitis (5.1%), ranula (4.3%), Sjögren's syndrome (2.8%), pleomorphic adenoma (1.2%) and mucoepidermoid carcinoma (1.2%). The most frequent histopathological diagnosis was the phenomenon of extravasation of mucus (85.2%). A common clinical finding was xerostomia (39%), mainly in patients treated with antihypertensive (42.4%), psychiatric (35.3%), anti-inflammatory (20.2%) and drugs for the treatment of gastric ulcers (13.1%). Conclusions: Our findings show the importance of a careful diagnosis, not only for neoplastic lesions, but also for pathologies of autoimmune, inflammatory and traumatic origin, which make up a greater number of cases. In addition, oral health professionals should be aware of the high frequency of xerostomia and its association with the use of certain medications, due to its negative impact on the quality of life of those suffering from this condition.

Resumen Introducción y objetivo: Las enfermedades que afectan a las glándulas salivales abarcan una amplia gama de condiciones y etiologías, incluyendo patologías infecciosas, inflamatorias, inmunológicas o neoplásicas. El objetivo de este estudio fue identificar las enfermedades más frecuentes de las glándulas salivales diagnosticadas en la Facultad de Odontología de Araraquara de la Universidad Estatal Paulista (FOAr-UNESP). Materiales y métodos: Este estudio descriptivo retrospectivo, incluyó todos los casos de enfermedades de glándulas salivales diagnosticados entre los años 2009 a 2013. En total se evaluaron 2,236 registros clínicos del Servicio de Medicina Oral y 1,217 informes histopatológicos del Servicio de Diagnóstico Histopatológico. Resultados: Se identificaron 254 enfermedades de las glándulas salivales, predominantemente en mujeres (1.5 F / M). Los diagnósticos más frecuentes fueron mucocele (38,6%), sialolitiasis (6,7%), sialadenitis (5,1%), ránula (4,3%), síndrome de Sjögren (2,8%), adenoma pleomórfico (1,2%) y carcinoma mucoepidermoide (1.2%). El diagnóstico histopatológico más frecuente fue el fenómeno de extravasación de moco (85.2%). Un hallazgo clínico frecuente fue la xerostomía (39%), principalmente en pacientes en tratamiento con medicamentos antihipertensivos (42,4%), psiquiátricos (35,3%), antiinflamatorios (20,2%) y fármacos para el tratamiento de úlceras gástricas (13,1%). Conclusiones: Nuestros hallazgos muestran la importancia del diagnóstico cuidadoso, no sólo de las lesiones neoplásicas, sino también de las patologías de origen autoinmune, inflamatorio y traumático, que constituyen un mayor número de casos. Además, los profesionales de la salud bucal deben conocer la alta frecuencia de la xerostomía y su asociación con el uso de ciertos medicamentos, debido a su impacto negativo en la calidad de vida de las personas que padecen esta afección.

Resumo Introdução e objetivo: As doenças que afetam as glândulas salivares cobrem uma ampla gama de condições e etiologias, incluindo patologias infecciosas, inflamatórias, imunológicas ou neoplásicas. O objetivo deste estudo foi identificar as doenças mais frequentes das glândulas salivares diagnosticadas na Faculdade de Odontologia de Araraquara da Universidade Estadual Paulista (FOAr-UNESP). Materiais e métodos: Este estudo retrospectivo descritivo incluiu todos os casos de doenças da glândula salivar diagnosticados entre 2009 e 2013. No total, foram avaliados 2,236 prontuários clínicos do Serviço de Medicina Oral e 1,217 laudos histopatológicos do Serviço de Diagnóstico Histopatológico. Resultados: Foram identificadas 254 doenças das glândulas salivares, predominantemente mulheres (1,5 F/M). Os diagnósticos mais frequentes foram mucocele (38,6%), sialolitíase (6,7%), sialadenite (5,1%), ranula (4,3%), síndrome de Sjögren (2,8%), adenoma pleomórfico (1,2%) e carcinoma mucoepidermóide (1,2%). O diagnóstico histopatológico mais freqüente foi o fenômeno de extravasamento de muco (85.2%). Um achado clínico comum foi a xerostomia (39%), principalmente em pacientes tratados com anti-hipertensivos (42,4%), psiquiátricos (35,3%), anti-inflamatórios (20,2%) e medicamentos para tratamento de úlceras gástricas (13,1%). Conclusões: Nossos achados mostram a importância de um diagnóstico cuidadoso, não só das lesões neoplásicas, mas também de patologias de origem autoimune, inflamatória e traumática, que compõem um maior número de casos. Além disso, os profissionais de saúde bucal devem estar cientes da alta frequência de xerostomia e sua associação com o uso de certos medicamentos, devido ao seu impacto negativo na qualidade de vida daqueles que sofrem dessa condição.

Eficacia del tratamiento de laenfermedad periodontal sobremarcadores de riesgo cardiovascular / Effectiveness of the treatment of periodontal disease on markersof cardiovascular risk

Los principales factores de riesgo relacionados con eventos cardiovasculares son: edad, género, hipertensión arterial, diabetes mellitus, tabaquismo, bajo nivel de lipoproteínas de alta densidad, genética, estrés, obesidad y sedentarismo; pero existen factores de riesgo no identificados aún para explicar el modelo cardiovascular. La enfermedad periodontal ha emergido en las últimas décadas como un posible factor de riesgo para el desarrollo de eventos cardiovasculares. Una revisión sistemática presenta un riesgo relativo (RR) de 1,19 (IC 95 %, 1,08 -1,32) para la asociación entre la enfermedad periodontal y las enfermedades cardiovasculares y de 2,85 (IC 95 %, 1,78-4,56) para accidentes cerebrovasculares. La periodontitis tiene un efecto sistémico al producir gran cantidad de mediadores inflamatorios (hipersecreción de citoquinas IL-1, IL-6, IL- 8, prostaglandina E2, PCR y fibrinógeno). Se realizó una revisión narrativa acerca del impacto de la terapia periodontal mecánica y farmacológica sobre la función endotelial y sobre la disminución de sustancias pro-inflamatorias marcadoras de riesgo cardiovascular como la PCR y los niveles séricos de IL-6. Se concluye que la enfermedad periodontal es un factor de riesgo modificable, susceptible de ser prevenido y tratado con procedimientos de bajo riesgo, por lo tanto su tratamiento puede ser un componente integral de la cardiología preventiva.

The main risk factors associated with cardiovascular events include age, gender, hypertension, diabetes mellitus, smoking, low high-density lipoprotein, genetics, stress, obesity and physical inactivity. There are no identified risk factors still to explain the cardiovascular model. Periodontal disease has emerged in recent decades as a possible risk factor for developing cardiovascular events. A systematic review presents a relative risk (RR) of 1.19 (95% CI, 1.08 to 1.32) for the association between periodontal disease and cardiovascular disease and 2.85 (95% CI, 1, 78 to 4.56) for stroke. Periodontitis has a systemic effect to produce large amounts of inflammatory mediators (hyper secretion of cytokines IL-1, IL-6, IL-8, prostaglandin E2, CRP and fibrinogen). We conducted a narrative review of the impact of mechanical and drug periodontal therapy on endothelial function and decreased pro-inflammatory substances cardiovascular risk markers such as CRP and serum IL-6. It is concluded that periodontal disease is a modifiable risk factor, which could be prevented and treated with low-risk procedures, so their treatment can be an integral component of preventive cardiology.