BubR1 and cyclin B1 immunoexpression in pleomorphic adenoma and polymorphous adenocarcinoma of minor salivary glands.

The immunoexpression of BubR1 and cyclin B1 in pleomorphic adenoma (PA) and polymorphic adenocarcinoma (PAC) in minor salivary glands is poorly studied. Thus, a retrospective and observational study was performed to provide a better understanding of the role and immunopositivity patterns of these proteins in these lesions. Sixteen cases of PA and 16 cases of PAC were selected. Parenchyma cells were submitted to quantitative immunohistochemical analysis through the labeling index. Cytoplasmic immunoexpression of BubR1 was observed in neoplastic cells from all analyzed PA and PAC cases. All PA cases and 93.7% of PAC exhibited nuclear immunoexpression of BubR1. Higher cytoplasmic and nuclear immunoexpression of BubR1 was observed in PAC (p = 0.001 and p = 0.122, respectively). Cytoplasmic immunoexpression of cyclin B1 was observed in all cases of PA and PAC, with a higher labeling index in the latter (p < 0.001). There was a significant positive correlation between nuclear and cytoplasmic BubR1 immunoexpressions (p < 0.001) in PA and a significant negative correlation between BubR1 and cyclin B1 cytoplasmic immunoexpressions (p = 0.014) in PAC. The higher cytoplasmic and nuclear immunoexpression of BubR1 in PACs suggests the continuous maintenance of neoplastic cells in the cell cycle and migration. Higher immunoexpression of cyclin B1 supports this lesion's enhanced proliferative and migration ability.

Oral mucoceles: A Brazillian Multicenter Study of 1,901 Cases.

Oral mucocele (OM) is the most common lesion of minor salivary glands. The present study aimed to report the clinical and demographic features of a large series of OMs and identify possible predictive variables associated with the recurrence rate of these lesions. A retrospective descriptive cross-sectional study was performed. A total of 43,754 biopsy records from four pathology services in Brazil were analyzed. All cases of OMs were reviewed, and clinical and demographic data were collected. The study comprised 1,002 females (56.2%) and 782 males (43.8%), with a mean age of 19.8±16.4 years (range: 01-87 years) and a 1.3:1 female-to-male ratio. The lower lip (n=1,160; 67.4%), and floor of the mouth (n=172; 10.0%), were the most common affected sites, presenting clinically as nodules (n=978; 79.4%) of smooth surface (n=428; 77.5%) and normal color (n=768, 46.7%). Excisional biopsy was the treatment in most cases (n=1,392; 78.0%). Recurrent OMs represented 6.2% of all diagnosed cases (n=117). OMs recurred more commonly in younger patients (aged<20 years) (p<0.0001), in lesions larger than 2 cm in diameter (p<0.0001), and in those located in the ventral tongue (p=0.0351). Also, recurrence rates were higher significantly in cases treated with laser surgery than in those with conventional surgery (p=0.0005). Patients with OMs should be carefully informed of its possible recurrence, especially when found on the ventral tongue of young patients.

Oral mucoceles: A Brazillian Multicenter Study of 1,901 Cases

Abstract Oral mucocele (OM) is the most common lesion of minor salivary glands. The present study aimed to report the clinical and demographic features of a large series of OMs and identify possible predictive variables associated with the recurrence rate of these lesions. A retrospective descriptive cross-sectional study was performed. A total of 43,754 biopsy records from four pathology services in Brazil were analyzed. All cases of OMs were reviewed, and clinical and demographic data were collected. The study comprised 1,002 females (56.2%) and 782 males (43.8%), with a mean age of 19.8±16.4 years (range: 01-87 years) and a 1.3:1 female-to-male ratio. The lower lip (n=1,160; 67.4%), and floor of the mouth (n=172; 10.0%), were the most common affected sites, presenting clinically as nodules (n=978; 79.4%) of smooth surface (n=428; 77.5%) and normal color (n=768, 46.7%). Excisional biopsy was the treatment in most cases (n=1,392; 78.0%). Recurrent OMs represented 6.2% of all diagnosed cases (n=117). OMs recurred more commonly in younger patients (aged<20 years) (p<0.0001), in lesions larger than 2 cm in diameter (p<0.0001), and in those located in the ventral tongue (p=0.0351). Also, recurrence rates were higher significantly in cases treated with laser surgery than in those with conventional surgery (p=0.0005). Patients with OMs should be carefully informed of its possible recurrence, especially when found on the ventral tongue of young patients.

Resumo A mucocele oral (MO) é a lesão mais comum das glândulas salivares menores. O presente estudo teve como objetivo relatar as características clínicas e demográficas de uma grande série de MOs e identificar possíveis variáveis preditivas associadas à taxa de recorrência dessas lesões. Foi realizado um estudo transversal descritivo retrospectivo. Foram analisados 43.754 registros de biópsias de quatro serviços de patologia no Brasil. Todos os casos diagnosticados como MOs foram revisados e dados clínicos e demográficos foram coletados. Participaram do estudo 1.002 mulheres (56,2%) e 782 homens (43,8%), com média de idade de 19,8 ± 16,4 anos (variação: 01-87 anos) e proporção de mulheres para homens de 1,3:1. O lábio inferior (n=1.160; 67,4%) e assoalho da boca (n=172; 10,0%), foram os locais mais acometidos, apresentando-se clinicamente como nódulos (n=978; 79,4%) de superfície lisa (n =428; 77,5%) e coloração normal (n=768, 46,7%). A biópsia excisional foi o tratamento na maioria dos casos (n=1.392; 78,0%). As MOs recorrentes representaram 6,2% de todos os casos diagnosticados (n = 117). As recorrências recorreram mais comumente em pacientes mais jovens (idade < 20 anos) (p < 0,0001), em lesões maiores que 2 cm de diâmetro (p < 0,0001) e naquelas localizadas na superfície ventral da língua (p = 0,0351). Além disso, as taxas de recorrência foram significativamente maiores nos casos tratados com cirurgia a laser do que aqueles com cirurgia convencional utilizando bisturi (p = 0,0005). Pacientes com mucoceles devem ser informados sobre uma possível recorrência, principalmente quando encontrados no lábio ou assoalho bucal de pacientes jovens.

Imunoexpressão das proteínas e-caderina, snail1 e vimentina em neoplasias de glândula salivar / Immunoexpression of e-cadherin, snail1 and vimentin proteins in salivary gland neoplasms

Os tumores de glândula salivar (TGS) representam cerca de 3% a 6% das neoplasias da região de cabeça e pescoço e são caracterizados por sua diversidade morfológica e de comportamentos biológicos. Sabe-se que algumas das características de tumores malignos, como a invasão tumoral e metástases à distância, possuem envolvimento da transição epitélio-mesênquima (TEM), evento no qual proteínas como a E-caderina, Snail1 e Vimentina estão diretamente envolvidas. Esta pesquisa se propôs a analisar e relacionar a expressão imuno-histoquímica dessas proteínas com as características clínico-patológicas em adenomas pleomórficos (APs), carcinomas adenoides císticos (CACs) e carcinomas ex-adenomas pleomórficos (CaExAPs) de glândulas salivares maiores e menores. A análise da imunoexpressão dessas proteínas foi feita de forma semiquantitativa em 20 casos de APs, 20 de CACs e 10 de CaExAPs. Na avaliação de E-caderina, considerou-se a expressão em membrana e/ou citoplasma das células do parênquima tumoral. Para a Snail1, foi considerada a expressão nos compartimentos nuclear e/ou citoplasmático dessas células. A Vimentina foi analisada no citoplasma de células fusiformes presentes no estroma dos TGS. Os dados obtidos foram comparados e correlacionados utilizando o nível de significância de 5% (p ≤ 0,05). Observou-se imunopositividade para E-caderina principalmente em citoplasma das células neoplásicas nãoluminais; a marcação membranar, perceptível em células luminais, estava mais presente nas neoplasias malignas (p = 0,041). A expressão de Snail1 foi mais frequente no compartimento nuclear, sendo mais evidenciada em células não-luminais dos TGS e apresentou maior reatividade nuclear em tumores malignos (p = 0,012). A expressão nuclear dessa proteína também foi maior para CACs e CaExAPs ao compará-los, de forma separada, com os APs (p = 0,037 e p = 0,025, respectivamente). Não foram observadas diferenças estatisticamente significativas entre a expressão de E-caderina e Snail1 e outros parâmetros clinico-patológicos e os subtipos histopatológicos das lesões (p > 0,05). A positividade para Vimentina foi vista no estroma de todos os casos de TGS, sendo mais difusa e intensa em CACs. Não foram verificadas diferenças estatisticamente significativas entre a expressão desse biomarcador e os parâmetros clínico-patológicos e subtipos histopatológicos das lesões (p > 0,05). Houve correlações positivas entre as expressões membranar e citoplasmática de E-caderina em APs, CACs e CaExAPs (r = 0,645, p = 0,002; r = 0,781, p < 0,001; r = 0,677 p = 0,031), bem como entre a expressão nuclear e citoplasmática de Snail1 e a expressão citoplasmática de E-caderina e nuclear de Snail1 em APs (r = 0,569, p = 0,009; r = 0,481, p = 0,032). Foram verificadas correlações negativas entre a expressão membranar de E-caderina e citoplasmática de Snail1, bem como entre Snail1 nuclear e Vimentina em CACs (r = -0,471, p = 0,036; r = -0,514; p = 0,021). Essa última correlação, bem como correlação positiva entre a expressão membranar e citoplasmática de E-caderina, também foi vista entre os casos de CACs e CaExAPs quando agrupados (r = -0,457; p = 0,0011; r = 0,746, p < 0,001). Os resultados do presente estudo sugerem que a participação de E-caderina e Snail1 no processo da TEM pode estar relacionada ao estágio de diferenciação celular em APs e à progressão tumoral nas neoplasias malignas bem como é possível que a expressão dessas proteínas em neoplasias malignas seja indicativa da plasticidade presente na TEM. Ressalta-se, também, a expressão de Vimentina em células fusiformes presentes no estroma tumoral, provavelmente refletindo estágios tardios da TEM (AU).

Salivary gland tumors (SGTs) comprise about 2% to 10% of head and neck tumors and are known for their morphologic diversity and biologic behavior. Some features of malignant neoplasms, such as tumor invasion and distant metastasis, might have the participation of epithelial-mesenchymal transition (EMT), event in which proteins like E-cadherin, Vimentin and Snail1 are directly involved. This study aimed to analyze, by means of immunohistochemistry, the expression of these proteins, as well as to relate their expressions to clinical-pathological features of pleomorphic adenomas (PAs), adenoid cystic carcinomas (ACCs) and carcinomas ex-pleomorphic adenomas (CXPAs) located in minor and major salivary glands. This was a semi-quantitatively analysis which comprised 20 PAs, 20 ACCs and 10 CXPAs. Analysis of E-cadherin was made considering membranar and/or cytoplasmatic expression in parenchymal cells. For Snail1, it was considered the positivity in nucleus and/or cytoplasm of parenchymal cells. Vimentin was evaluated in the cytoplasm of fusiform stromal cells. Data were compared and correlated adopting a level of significance of 5% (p ≤ 0,05). Marked immunoexpression for E-cadherin was mostly found in the cytoplasm of non-luminal neoplastic cells in SGTs; membrane reaction for the protein, seen in luminal cells, was higher in malignant tumors (p = 0,041). Snail1 was more expressed in the nucleus, mostly of nonluminal cells of SGTs, with this reactivity being higher in malignant tumors(p = 0,012). Nuclear positivity for this marker was also higher for ACCs and CXPAs when compared with PAs separately (p = 0,037 e p = 0,025, respectively). No significant differences between E-cadherin and Snail1 and other clinical-pathological parameters were found (p > 0,05). Vimentin was seen in the stroma of all cases, being more diffuse and intense in ACCs. No significant differences between this marker and clinical-pathological parameters were found (p > 0,05). Positive correlations between membranar and cytoplasmatic E-cadherin in PAs, ACCs and CXPAs were observed (r = 0,645, p = 0,002; r = 0,781, p < 0,001; r = 0,677 p = 0,031), as well as between nuclear and cytoplasmatic Snail1 and between cytoplasmatic E-cadherin and nuclear Snail1 in PAs APs (r = 0,569, p = 0,009; r = 0,481, p = 0,032). Negative correlations between membranar E-cadherin and cytoplasmatic Snail1 were observed, as well as between nuclear Snail1 and Vimentin in ACCs (r = -0,471, p = 0,036; r = -0,514; p = 0,021). This last correlation and a positive correlation between membranar and cytoplasmatic E-cadherin were also seen when ACCs and CXPAs were grouped (r = -0,457; p = 0,0011; r = 0,746, p < 0,001). These results suggest that the participation of these proteins in EMT might be related to cellular differentiation in PAs and to tumoral progression in malignant tumors. In addition, it can be infered that the expression of E-cadherin and Snail1 in malignant tumors might reflect the plasticity seen in EMT process. Furthermore, the expression of Vimentin in fusiform stromal cells, probably in later stages of EMT, in the stroma of SGTs, is highlighted (AU).