Clinical and Immunohistochemical epithelial profile of non-healing chronic traumatic ulcers.

BACKGROUND: Chronic wounds were previously related to cancer. Chronic Traumatic Ulcers (CTU) are lesions caused by chronic mechanical irritation (CMI) frequently diagnosed in Oral Medicine. Although these conditions may reflect a benign nature, some authors have proposed its relationship with malignant transformation. Currently, there are scarce investigations that evaluate biomarkers within CTU. The aim of this study was to evaluate cell differentiation and proliferation biomarkers patterns of CTU and OSCC through recognized markers such as cytokeratin 19 and Ki67 and correlate it with clinical features of both groups of patients. MATERIAL AND METHODS: A Cross-sectional study of adult patients (n=79), both sexes, attended at Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba. The patients were classified into two groups: CTU (n=41), and OSCC (n=38). A subset of specimens were immunolabeled with Ki67 and Ck19. RESULTS: The population consisted of 51.9% male and 48.1% female, with an average of 57.0 ± 13.9. years (OSCC group) and 60.9 ± 14.9 years (CTU group). OSCC group presented higher scores for both biomarkers (Ki67 and Ck19), but only there were differences statistically significant for Ki67 (p=0.032). 25% of non-healing CTU were positive with medium scores of Ck19 and showed an immunohistochemical profile similar to OSCC. The lateral tongue was the most frequent site in both groups. CONCLUSION: The altered immunohistochemical pattern found in many specimens of CTU was also observed in OSCC. The tongue border presents physiological conditions that could offer a suitable environment for the development of neoplastic events associated with CMI. Further studies are needed to understand the underlying mechanisms that could link oral non-healing ulcers with early malignant changes.

[Human papillomavirus detection in oral cancer lesions in the city of Córdoba]. / Detección del virus papiloma humano en lesiones cancerosas orales en la ciudad de Córdoba.

Oral cancer is a process that involves different etiological factors and mechanisms in the light of current view of viral cocarcinogenesis. Evidence from histology and DNA hybridization studies suggests that HPV is engaged in oral carcinogenesis. The Pathology Laboratory of the Dentistry School, National University of Córdoba, admits approximately 20% of all patients with cancerous lesions in this city. In the January 1992-December 1997 lapse, we examined 1950 biopsies with oral lesions, 4.77% (93/1950) of which were malignant neoplasms, 79.57% (74/93) were oral carcinomas. Thirty-three oral carcinomas (44.6%; 33/74) were selected at random and included in this study, 33 cells smears of normal oral mucosa of controls individuals were included. They were analyzed by conventional light microscopy and an in situ hybridization technique for the detection of HPV. Data were analyzed with chi square test. The prevalence of HPV among the 33 cancer samples studied was 27.27%, 9/33 tested positive for HPV in low stringent conditions. Only one was positive in high stringent condition for HPV16, a verrugous carcinoma. No HPV-DNA was detected in cells smears of controls. Among the HPV positive, 3/9 (33.33%) were squamous carcinomas and 5/9 (55.56%) were verrugous carcinomas. Only one was a melanoma. Verrugous carcinoma was the carcinoma most associated with the HPV infection (x2 = 20.5; 95% level of confidence). This would indicate a major role of HPV in the pathogenesis of verrucous carcinomas. The viral prevalence found in cancerous lesions reinforces the concept of heterogenic natures of oral cancer. HPV is a circumstance that increase the probability of malignancy, and when reducing, diminish the frequency of cancer.