BACKGROUND: DACT genes regulates Wnt as well TGF-ß pathway, and were already associated with hepatocellular and lung cancer. Alterations on Wnt/ß-catenin were associated with head and neck cancer through ß-catenin cytoplasmatic accumulation. OBJECTIVE: The aim of the study was to evaluate DACT1 and DACT2 expression and methylation on oral squamous cell cancer (OSCC). METHODS: 47 samples of salivary rinse and tissue were collected from 29 OSCC and 18 control patients. qMSP and RT-PCR reactions were performed in order to detect hypermethylation and expression of DACT1 and DACT2 genes. Statistical analysis was conducted to evaluate these genes as possible biomarkers for OSCC. RESULTS: As expected man over 60 years old with tobacco and alcohol consumption history were associated with OSCC. There was no statistical difference between groups concerning DACT1 and DACT2 either in promoter hypermethylation or transcript levels. Age was associated with DACT2 promoter hypermethylation, especially over 56 years old. CONCLUSION: Patients older than 56 years old were about 5 times more likely to have DACT2 promoter hypermethylation. These findings could partially explain why older subjects are more prone to carcinogenesis. Wnt/ß-catenin pathway plays an important role in carcinogenesis, and the study of their regulators may help understand malignant transformation.
Adaptor Proteins, Signal Transducing/genetics , Carcinoma, Squamous Cell/genetics , Carrier Proteins/genetics , Gene Expression Regulation, Neoplastic , Head and Neck Neoplasms/genetics , Mouth Neoplasms/genetics , Neoplasm Proteins/genetics , Nuclear Proteins/genetics , Adaptor Proteins, Signal Transducing/biosynthesis , Age Factors , Carcinoma, Squamous Cell/metabolism , Carrier Proteins/biosynthesis , Case-Control Studies , Cell Line, Tumor , DNA Methylation , Epigenesis, Genetic , Female , Head and Neck Neoplasms/metabolism , Humans , Male , Middle Aged , Mouth Neoplasms/metabolism , Neoplasm Proteins/biosynthesis , Nuclear Proteins/biosynthesis , Promoter Regions, Genetic , Prospective Studies , Squamous Cell Carcinoma of Head and Neck
Introdução: O carcinoma espinocelular (CEC) representa a neoplasia maligna bucal mais comum, a qual acomete preferencialmente homens acima de 50 anos, tendo como principais fatores de risco o tabagismo e o etilismo. A incidência dessa neoplasia em jovens com menos de 40 anos é rara (3 a 6% dos casos). Nesses pacientes, o curso da doença é ainda mais agressivo, apresentando maior risco de metastatização cervical com prognóstico desfavorável. Objetivo: O objetivo deste artigo foi descrever um caso clínico de câncer de boca agressivo e deevolução desfavorável em paciente jovem, tendo o tabagismo e o uso de maconha como possíveis fatores de risco. Fatores predisponentes são discutidos, bem como a revisão da literatura referente ao CEC em pacientes jovens. Relato de caso: Relatou-se um caso de CEC de boca em paciente do sexo masculino, 21 anos, leucoderma, tabagista e usuário de maconha. O paciente foi diagnosticado em estágios muito avançados da doença e tratado com quimioterapia e radioterapia concomitantes, pela irressecabilidade do tumor, porém ele abandonou o tratamento durante a radioterapia e evoluiu com óbito após dois meses do último contato. Conclusão: O caso ressalta a importância do diagnóstico precoce de lesões de câncer bucal, assim como o aumento de campanhas preventivas, enfocando também pacientes jovens usuários de maconha.
Introduction: Squamous cell carcinoma (SCC) is the most common oral malignant neoplasm, affecting mainly men over 50 years, with the main risk factors of smoking and alcoholism. The incidence of this neoplasm in young people under the age of 40 is rare (3 to 6% of cases).In these patients the course of the disease is even more aggressive,showing higher risk of cervical metastatization with unfavorable prognosis. Objective: The aim of this article was to describe a clinical case of aggressive cancer of the mouth and unfavorable developmentin a young patient, considering the use of marijuana and smoking as possible risk factors. Predisposing factors are discussed, as well asthe literature review related to SCC in young people. Case report: It was reported a case of SCC of the mouth in a 21-year-old male patient,who was leukoderma, smoker and user of marijuana. The patient was diagnosed in very advanced stages of the disease and treated with concurrent chemotherapy and radiotherapy, due to the unresectable tumor, but he left the treatment during radiotherapy and evolved todeath after two months of last contact. Conclusion: The case highlights the importance of early diagnosis of lesions of oral cancer, as well as the increase in prevention campaigns, focusing also young patients,users of marijuana.
OBJECTIVE: To assess the prognostic significance of several factors in oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with chemotherapy. DESIGN: Retrospective study. SETTING: Erasto Gaertner Hospital, Curitiba, Brazil, and A. C. Camargo Hospital, São Paulo, Brazil. PATIENTS: A total of 361 patients treated for squamous cell carcinoma from January 1, 1990, to December 31, 2001. INTERVENTIONS: Radiotherapy alone or with chemotherapy. MAIN OUTCOME MEASURES: Disease-free survival, overall survival, and treatment response. RESULTS: Most tumors were located at the tonsil (46.8%) or base of the tongue (28.0%) and were at clinical stage III or IV (92.8%). Treatment response was associated with Zubrod scale score, weight loss, number of comorbidities, symptom-severity and Piccirillo stages, hemoglobin level, tumor site, macroscopic appearance of the tumor, and clinical stage. The 5-year overall survival rate was 17.6% and disease-free survival rate was 16.2%. The significant prognostic variables were age; Zubrod scale score; weight loss; comorbidities; Berg, Piccirillo, and symptom-severity staging; involvement of adjacent soft-tissue areas and bone; lymph node mobility; clinical stage; and radiotherapy doses. The multivariate analysis showed Zubrod scale score, symptom-severity staging system, Berg staging system, comorbidities, and radiotherapy dose as independent prognostic factors. CONCLUSION: A combination of clinical factors, such as symptoms, patients' general status, weight loss, and comorbidities, leads to a relevant stage of clinical severity that can be associated with the TNM stage as predictors of survival in oropharyngeal carcinoma.
Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Oropharyngeal Neoplasms/drug therapy , Oropharyngeal Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Chemotherapy, Adjuvant , Combined Modality Therapy , Disease-Free Survival , Female , Humans , Male , Middle Aged , Neoplasm Staging , Oropharyngeal Neoplasms/mortality , Oropharyngeal Neoplasms/pathology , Prognosis , Radiotherapy Dosage , Retrospective Studies , Tongue Neoplasms/drug therapy , Tongue Neoplasms/mortality , Tongue Neoplasms/pathology , Tongue Neoplasms/radiotherapy , Tonsillar Neoplasms/drug therapy , Tonsillar Neoplasms/mortality , Tonsillar Neoplasms/pathology , Tonsillar Neoplasms/radiotherapy
Devido à importância do câncer de boca na regiäo de Curitiba, correspondendo ao sexto tumor de maior freqüência nos homens e oitavo nas mulheres, associado ao fato de que 60 por cento de todos os casos säo diagnosticados em estágios avançacos, foi criado o Centro de Diagnóstico de Lesöes Bucais - CDLB pela Secretaria Municipal da Saúde (SMS) de Curitiba. Este estudo apresenta os resultados iniciais das atividades deste centro
Mouth , Mouth Neoplasms , Wounds and Injuries
