RESUMO
BACKGROUND: [(18)F]fluoro-2-deoxyglucose-positron emission tomography (FDG-PET) is widely used to evaluate tumor metabolic activity. The aim of this study was to evaluate the usefulness of FDG-PET in assessing the histopathological response to preoperative concurrent chemoradiotherapy (CRT) in patients with oral squamous cell carcinoma (OSCC). METHODS: Forty-five patients with resectable advanced OSCC who had received preoperative CRT followed by tumor ablative surgery between January 2004 and December 2011 were included in the study. All patients underwent FDG-PET before and after preoperative CRT. The maximum standardized uptake value (SUVmax) before (pre-SUV) and after preoperative CRT (post-SUV) and the SUVmax reduction rate (ΔSUV %) were used to evaluate the response to preoperative CRT. Correlations among SUVmax, histopathological response, and expression of cancer antigen Ki-67 and hypoxia-inducible factor-1α (HIF-1α) were analyzed. RESULTS: Preoperative CRT significantly reduced intratumoral FDG uptake (P < 0.001). The pre-SUV and post-SUV were significantly lower in patients with a pathological complete response (pCR) than in those with a non-pCR (pre-SUV P = 0.037; post-SUV P = 0.001). ΔSUV % was higher in patients with pCR than in those with non-pCR (P = 0.029). The pre-SUV was significantly correlated with Ki-67 and HIF-1α expression in pretreatment biopsy specimens (Ki-67 P = 0.046, R = 0.292; HIF-1α P = 0.007, R = 0.385). The expression of both Ki-67 and HIF-1α was significantly lower in patients with pCR than in those with non-pCR (Ki-67 P < 0.001; HIF-1α P < 0.001). CONCLUSIONS: Low pre-SUV and post-SUV and high ΔSUV % may predict a good histopathological response to preoperative CRT. Ki-67 and HIF-1α expression in pretreatment biopsy specimens were predictors of histopathological response to preoperative CRT.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/terapia , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/terapia , Tomografia por Emissão de Pósitrons , Adulto , Idoso , Carboplatina/administração & dosagem , Carcinoma de Células Escamosas/patologia , Quimiorradioterapia Adjuvante , Fracionamento da Dose de Radiação , Feminino , Fluordesoxiglucose F18 , Fluoruracila/administração & dosagem , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/análise , Antígeno Ki-67/análise , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Terapia Neoadjuvante , Cuidados Pré-Operatórios , Compostos RadiofarmacêuticosRESUMO
We report a case of advanced upper gingival carcinoma with a contralateral metastatic lymph node invading the maxillary sinus (T4aN2cM0). An 83-year-old man was treated concurrently with chemoradiotherapy and S-1. S-1 (80 mg/body/day) was administered for 2 weeks followed by a 1-week rest period as one course. Radiation therapy involved a total of 60 Gy (2 Gy/day; 5 days/week). There were side effects of mild leucopenia and a grade 2 stomatitis. After the completion of 2 courses and radiation therapy, the primary tumor disappeared, and the patient achieved a pathologically complete response. The metastatic lymph node also completely disappeared. S-1 was then administered in the same regimen for 1 year. Neither local recurrence nor distant metastasis has been detected 2 years after the completion of the concurrent chemoradiotherapy with S-1.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Gengivais/tratamento farmacológico , Ácido Oxônico/uso terapêutico , Tegafur/uso terapêutico , Idoso de 80 Anos ou mais , Biópsia , Terapia Combinada , Combinação de Medicamentos , Neoplasias Gengivais/diagnóstico por imagem , Neoplasias Gengivais/patologia , Neoplasias Gengivais/radioterapia , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Expression of ligands of natural killer group 2D (NKG2D) immunoreceptors, such as major histocompatibility complex class I-related chain A/B (MICA/B), has been proposed to play an important role in tumour immunosurveillance. Soluble forms of MICA/B are increased in sera of cancer patients and are postulated to impair antitumour immune response by downregulating expression of NKG2D immunoreceptors. Serum levels of soluble MICA have been shown to be of diagnostic significance in malignant diseases. AIMS: The potential of soluble MICB (sMICB) as a marker for oral squamous cell carcinoma (OSCC) was investigated. RESULTS: sMICB levels did not differ significantly from those in normal control individuals. However, the findings indicate that sMICB levels are significantly increased in stage IV OSCC and high sMICB levels are significantly associated with decreased survival rates in patients.
Assuntos
Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/sangue , Antígenos de Histocompatibilidade Classe I/sangue , Neoplasias Bucais/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Ensaio de Imunoadsorção Enzimática , Feminino , Antígenos de Histocompatibilidade Classe I/biossíntese , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Estadiamento de NeoplasiasAssuntos
Transplante Ósseo/métodos , Fíbula/transplante , Mandíbula/cirurgia , Modelos Anatômicos , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos/irrigação sanguínea , Fíbula/irrigação sanguínea , Humanos , Imageamento Tridimensional , Osteotomia , Tomografia Computadorizada por Raios XRESUMO
UNLABELLED: Nonsyndromic cleft lip with or without cleft palate (NSCLP) is one of the most common birth defects. Despite its frequency, the etiology remains largely unknown. Most likely, both genetic and environmental factors contribute to this malformation. A polymorphic gene family, the major histocompatibility complex class I chain-related gene A (MICA), is located about 40 kb centromeric to the HLA-B gene. In this study, we analyzed the association between MICA gene polymorphisms and NSCLP in Japanese patients. METHODS: The (GCT)n polymorphism of the MICA gene was investigated in 94 patients with NSCLP and 180 normal controls using polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. RESULTS: Our results demonstrate that there are no differences in microsatellite allele frequency between NSCLP patients and controls. However, the microsatellite allele frequency of the MICA-A6 (p = 0.045) allele was increased in male patients, as compared with controls. Further, the MICA-A5 (p = 0.359) allele was also increased in female NSCLP patients. CONCLUSION: These results suggest that the microsatellite allele frequencies of the MICA-A6 allele increased in male NSCLP patients. Although the MICA-A5 allele increased in female NSCLP patients, the increase was not statistically significant. These results suggest that the MICA gene could be one of the candidate genes for NSCLP.
Assuntos
Fenda Labial/genética , Fissura Palatina/genética , Antígenos de Histocompatibilidade Classe I/genética , Adulto , Alelos , Fenda Labial/complicações , Fissura Palatina/complicações , Eletroforese em Gel de Poliacrilamida/métodos , Feminino , Frequência do Gene , Humanos , Japão , Masculino , Repetições de Microssatélites/genética , Reação em Cadeia da Polimerase/métodos , Adulto JovemRESUMO
PURPOSE: This study analyzed the changes in mandibular movement and occlusal condition after conservative treatment for unilateral condylar fractures by use of a sensitive occlusal pressure sheet (Dental Prescale; Fujifilm, Tokyo, Japan) for the evaluation of occlusal condition. PATIENTS AND METHODS: We compared 18 patients conservatively treated for unilateral condylar fracture with 23 control subjects. Mandibular movement and occlusal condition were evaluated at 3 and 6 months after conservative treatment. RESULTS: Maximal mouth opening over 40 mm was achieved at 6 months but was not improved to the control level. Recovery of lateral excursion, protrusion, or deviation on mouth opening was also limited at 6 months. Occlusal area, which was reduced at 3 months, had significantly improved at 6 months. The asymmetry index of the occlusal area was significantly improved at 6 months compared with that at 3 months. Mean pressure in the patient group was significantly greater than that in the control group. Total occlusal force, which was reduced at 3 months, was significantly improved at 6 months. The asymmetry index of occlusal force, which was significantly greater than that in the control group, was significantly improved at 6 months. CONCLUSIONS: Mandibular movement was increased at 6 months despite the slight disturbance in lateral excursion to the nonfractured side and the presence of deviation on mouth opening. Occlusal area and occlusal force improved at 6 months, although mean pressure remained slightly higher than that in the control group.
Assuntos
Força de Mordida , Má Oclusão/diagnóstico , Fraturas Mandibulares/terapia , Amplitude de Movimento Articular/fisiologia , Articulação Temporomandibular/lesões , Estudos de Casos e Controles , Oclusão Dentária , Feminino , Humanos , Registro da Relação Maxilomandibular/instrumentação , Masculino , Má Oclusão/etiologia , Côndilo Mandibular/lesões , Côndilo Mandibular/fisiopatologia , Fraturas Mandibulares/complicações , Fraturas Mandibulares/fisiopatologia , Recuperação de Função Fisiológica , Valores de Referência , Articulação Temporomandibular/fisiopatologia , Resultado do TratamentoRESUMO
NK and cytotoxic T cells play an important role in the elimination of virus-infected and tumor cells through NKG2D activating receptors, which can promote the lysis of target cells by binding to the major histocompatibility complex class I-related chain A (MICA) proteins. Polymorphisms in MICA may influence its binding to the NKG2D. The soluble form of MICA is released from the surface of tumor cells of epithelial origin. Whereas MICA expressed on the cell surface stimulates the immunoreceptor natural killer group 2, member D (NKG2D), the secreted form down-regulates NKG2D activity, thus allowing the tumor to escape immunosurveillance by NKG2D-expressing cells. In this study, we examined the association between MICA gene microsatellite polymorphisms and serum levels of soluble MICA in patients with oral squamous cell carcinoma (OSCC). We found that patients with OSCC were more likely to have the A5.1 allele when compared to healthy subjects and also more likely to be homozygous for this allele (p=0.041). Patients with the homozygous A5.1 genotype had higher levels of soluble MICA (p=0.031) and a lower survival rate (p=0.026).
Assuntos
Carcinoma de Células Escamosas/fisiopatologia , Antígenos de Histocompatibilidade Classe I/genética , Antígenos de Histocompatibilidade Classe I/metabolismo , Neoplasias Bucais/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/genética , Ensaio de Imunoadsorção Enzimática , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/genética , Estadiamento de Neoplasias , Polimorfismo Genético , SolubilidadeRESUMO
The soluble form of major histocompatibility complex class I-related chain A (MICA) is released from the surface of tumor cells of epithelial origin. Although MICA expressed on the cell surface stimulates the immunoreceptor natural killer (NK) group 2, member D (NKG2D), the secreted form downregulates NKG2D activity, thus allowing the tumor to escape immunosurveillance by NKG2D-expressing cells. In this study, we examined the association between serum levels of soluble MICA and the severity of disease in patients with oral squamous cell carcinoma (OSCC). We used enzyme-linked immunoabsorbent assay to measure serum levels of soluble MICA in OSCC patients and normal control individuals. Among patients categorized according to most disease parameters tested (tumor size, location, grade of differentiation, regional lymph node status, disease stage), soluble MICA levels in sera did not statistically differ from those in normal control individuals. Patients with stage IV disease and/or regional lymph node metastasis did, however, exhibit significantly higher serum levels of soluble MICA than control individuals (95% confidence interval (CI), 0.65-2.45, p = 0.021, and 95% CI, 0.62-4.42, p = 0.031, respectively). Overall survival rates were significantly higher for OSCC patients with low soluble MICA levels (<50 pg/ml) than for those with high soluble MICA levels (>50 pg/ml) (95% CI, 0.43-2.75, p = 0.03). Serum levels of soluble MICA may be useful in the diagnosis of advanced stage OSCC and as an indicator of regional lymph node metastasis.
Assuntos
Biomarcadores Tumorais , Carcinoma de Células Escamosas/imunologia , Antígenos de Histocompatibilidade Classe I/sangue , Neoplasias Bucais/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/patologia , Feminino , Antígenos de Histocompatibilidade Classe I/imunologia , Humanos , Japão , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/sangue , Neoplasias Bucais/patologia , Estadiamento de Neoplasias , PrognósticoRESUMO
A 52-year-old female, scheduled for rectal cancer resection, had no history of central nervous system abnormality. Anesthesia was maintained with general anesthesia combined with epidural anesthesia. Her only hemodynamic change was a rise in arterial pressure to 140 mmHg just after the start of the operation. However, postoperatively she failed to be aroused and she exhibited a positive Babinski's sign, anisocoria, an absent light reflex and paresis of the left lower extremity. Cerebral vascular accident was suspected and a CT scan revealed a cerebral hematoma which was immediately removed surgically. Upon exploration, abnormal vessels were recognized and we diagnosed an acute rupture of arteriovenous malformation. She fully recovered consciousness immediately after the operation. Her postoperative course was uneventful, except for a residual paresis of the left lower extremity.
Assuntos
Malformações Arteriovenosas Intracranianas/cirurgia , Complicações Intraoperatórias , Doença Aguda , Anestesia Epidural , Anestesia Geral , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/cirurgia , Transtornos da Consciência/etiologia , Feminino , Hematoma/diagnóstico , Hematoma/cirurgia , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Neoplasias Retais/cirurgiaRESUMO
Intravenous anesthetic, propofol (2,6-diisopropylphenol), is extensively used for general anesthesia without knowing the effects on cancer. We found here that clinically relevant concentrations of propofol (1-5 microg/ml) decreased the invasion ability of human cancer cells (HeLa, HT1080, HOS and RPMI-7951). In the HeLa cells treated with propofol, formation of actin stress fibers as well as focal adhesion were inhibited, and propofol had little effect on the invasion ability of the HeLa cells with active Rho A (Val(14)-Rho A). In addition, continuous infusion of propofol inhibited pulmonary metastasis of murine osteosarcoma (LM 8) cells in mice. These results suggest that propofol inhibits the invasion ability of cancer cells by modulating Rho A and this agent might be an ideal anesthetic for cancer surgery.
Assuntos
Anestésicos Intravenosos/farmacologia , Invasividade Neoplásica/prevenção & controle , Propofol/farmacologia , Actinas/metabolismo , Animais , Neoplasias Ósseas/patologia , Adesão Celular/efeitos dos fármacos , Células HeLa/efeitos dos fármacos , Células HeLa/patologia , Humanos , Neoplasias Pulmonares/prevenção & controle , Neoplasias Pulmonares/secundário , Camundongos , Osteossarcoma/patologia , Osteossarcoma/prevenção & controle , Osteossarcoma/secundário , Células Tumorais CultivadasRESUMO
In oral and maxillofacial surgery, epinephrine is routinely used for cancer resection and it is important to clarify the effects of this agent on cancer. We found here that the clinically relevant concentrations of epinephrine (10, 50 and 100 microg/ml) decreased the invasion ability of oral squamous carcinoma (Sa3) cells. In the Sa3 cells treated with epinephrine (10, 50 and 100 microg/ml), migration, morphological changes and formation of actin stress fibers were inhibited and intracellular cyclic adenosine monophosphate (cAMP) increased significantly. These findings suggest that epinephrine inhibits the invasion of cancer cells by modulating intracellular cAMP and that clinicians could use epinephrine effectively for the surgical resection of the cancer.