Immunoexpression of p53 in Oral Squamous Cell Carcinoma and Oral Dysplastic Lesions in Patients with the Habit of Reverse Smoke / Inmunoexpresión de p53 en Carcinoma Bucal Escamo Celular y Displasias Orales en pacientes con el Hábito de Fumar Invertido

Molecular biological markers have been suggested to be of value in the diagnosis and prognostic evaluation of precancerous lesions. The purpose of the current study was to investigate the expression of p53 protein in normal oral mucosa, oral dysplastic lesions (DL), and oral squamous cell carcinoma (SCC), comparing patients with the habit of reverse smoking and conventional smokers. The patients were subjected to incisional biopsy and the soft tissue specimens were routinely fixed in 10% formalin and processed in the laboratory. Immunohistochemical technique was performed using the avidin-biotin-peroxidase protocol. The 102 patients included 42 reverse smokers and 60 conventional smokers. There were 79 cases of mild, 15 of moderate, and 3 of severe epithelial dysplasia. Five microinvasive oral SCC included one male and four females. The clinical characteristics of microinvasive tumors included patches, plaques or erosions; 100% showed positive nuclear staining for p53. It was found a significant association of p53 expression and exposure of reverse smoking among microinvasive oral SCC and oral DL patients in the population studied.

Marcadores biológicos moleculares se han sugerido para ser de valor en el diagnóstico y evaluación pronóstica de lesiones precancerosas. El propósito del presente estudio fue investigar la expresión de la proteína p53 en mucosa oral normal, lesiones displásicas orales (LD), y en el carcinoma oral de células escamosas (COCC), comparando pacientes con el hábito de fumar convencional y fumar invertido. Los pacientes fueron sometidos a biopsia por incisión y los especímenes de tejidos blandos fueron fijados en formalina al 10% y se procesaron en el laboratorio. La técnica inmunohistoquímica se realizó utilizando el protocolo de avidina-biotina-peroxidasa. De los 102 pacientes incluidos, 42 fueron fumadores invertidos y 60 fumadores convencionales. Hubo 79 casos de displasia epitelial leve, 15 moderada, y 3 severa. Cinco casos de COCC microinvasivo incluyeron un hombre y cuatro mujeres. Las características clínicas de los tumores microinvasores incluyen parches, placas o erosiones; el 100% mostró tinción nuclear positiva para p53. Se encontró una asociación significativa de la expresión de p53 y la exposición de los fumadores invertidos entre pacientes con COCC microinvasivo y DL en la población estudiada.

Revisión sistemática de los efectos del hábito de fumar invertido sobre la mucosa oral / Systematic revision of the effects of the reversed smoking habit on the oral mucosa

Fundamento: se ha postulado que el hábito de fumar invertido intensifica la severidad de las enfermedades de la mucosa bucal y expone a las personas a riesgos severos en la salud oral. Objetivo: revisar la literatura científica acerca de las enfermedades de la mucosa oral asociadas con el hábito de fumar invertido. Método: se realizó una revisión sistemática de investigaciones observacionales y experimentales publicadas en las bases de datos Medline-Pubmed y SCIELO desde 1960 hasta 2012. Se utilizaron términos en diferentes combinaciones: nicotinic stomatitis, reverse smoking, reverse smokers, oral cancer, oral premalignant lesions y tobacco. Se excluyeron las series de casos, resultados duplicados debido a las combinaciones de los términos de búsqueda, datos no disponibles, cartas al editor y revisiones históricas. Desarrollo: se detectó en todos los estudios revisados que el hábito de fumar invertido es más frecuente en mujeres que en hombres. Doce investigaciones mostraron asociación entre el hábito de fumar invertido y carcinoma del paladar duro o tumores microinvasivos. Se observó que los fumadores invertidos tienen muchas más probabilidades de presentar parches y áreas rojas en el paladar, además de leucoplasias y carcinomas. El riesgo estimado de presentar carcinoma del paladar duro fue 132 veces mayor en mujeres con el hábito de fumar invertido. Las tasas de mortalidad ajustadas por edad fueron casi dos veces más altas para los fumadores invertidos en comparación con aquellas personas que no fumaban. Conclusiones: el hábito de fumar invertido está asociado con el cáncer oral y con otras enfermedades avanzadas de la mucosa bucal. Se deben realizar estudios de intervención para tratar de persuadir a las poblaciones acerca del abandono de los hábitos de tabaquismo.

Background: It is been said that the reversed smoking habit intensifies the seriousness of the diseases of the buccal mucosa and put people at serious risks regarding oral health. Objective: to revise the scientific literature related to the diseases of the oral mucosa associated to reversed smoking habit. Method: a systematic revision of observational and experimental investigations published in the Medline-PubMed and SciELO data bases from 1960 to 2012 was made. Terms were used in different combinations: nicotinic stomatitis, reverse smoking, reverse smokers, oral cancer, oral premalignant lesions y tobacco. Series of cases, duplicated results due to combinations of search terms, non-available data, letters to the editor and historical revisions were excluded. Results: in all the revised studies it was revealed that reversed smoking habit is more frequent in women than in men. Twelve investigations showed association between reversed smoking habit and carcinoma of the hard palate or microinvasive tumors. It was observed that inverted smokers are at more risk of presenting blotches and red areas in the palate, as well as leukoplakias and carcinomas. The estimated risk of presenting carcinoma of the hard palate was 132 times higher in women that have the reverse smoking habit. Mortality rates set by age were almost twice higher for reverse smokers compared to non-smokers. Conclusions: reversed smoking habit is associated to oral cancer and to other advanced diseases of the buccal mucosa. Intervention studies should be conducted in order to try to persuade populations to quit smoking.

Características clínicas e histopatológicas del carcinoma escamocelular bucal en el periodo 1990-2004 en Medellín, Colombia / Clinical and histopathological features of oral squamocellular carcinoma during 1990-2004 in Medellin, Colombia

El carcinoma escamocelular bucal es una neoplasia maligna frecuente en la cavidad bucal, sin embargo, no existe información sobre la incidencia y el comportamiento clínico e histológico de este tipo de cáncer en Antioquia, Colombia. Este estudio proveyó información acerca de las características clínicas e histopatológicas del carcinoma escamocelular bucal, proveniente de historias clínicas de 197 pacientes, con un total de 112 hombres (56,9 por ciento) y 85 mujeres (43,1 por ciento), atendidos en el Hospital Universitario San Vicente de Paúl, en Medellín, Colombia, durante un periodo de 14 años. La localización más frecuente del carcinoma escamocelular bucal fue la lengua (45,0 por ciento), seguido del paladar duro (17,1 por ciento), luego le siguió el paladar blando con el 9,0 por ciento y por último el piso de la boca con el 8,5 por ciento. La mayoría de estos carcinomas fueron diagnosticados en estadios tardíos III y IV (74,9 por ciento). En cuanto al grado de diferenciación predominaron los carcinomas bien y moderadamente diferenciados(AU)

The oral scamocellular carcinoma is a frequent malignant neoplasia located in the oral cavity; however, there is not information on the incidence and clinical behavior of this type of cancer in Antioquia, Colombia. Present study provides information on the clinical and histopathological features of the oral scamocellular carcinoma collected from the medical records of 197 persons, 112 men (56.9 percent) and 85 females (43.1 percent) seen in the "San Vicente de Paúl" University Hospital of Medellin for 14 years. The more frequent location of the oral scamocellular carcinoma was the tongue (45.0 percent), followed by the hard palate (17.1 percent), soft palate 9.0 percent and mouth floor (45 percent); most of these ones were diagnosed in late stages (III and IV) (74,9 percent), as regards the differentiation degree there was predominance of well and moderately differentiated carcinomas(AU)

Características clínico-histopatológicas del carcinoma escamocelular bucal, Colombia / Clinical-histopathology features of oral squamous cell carcinoma in Medellin, Colombia

El carcinoma escamocelular bucal (CEB), es una neoplasia maligna frecuente en cavidad oral. Objetivo: determinar la incidencia y el comportamiento clínico e histológico de este tipo de cáncer en Antioquia, Colombia. Métodos: éste estudio provee información acerca de las características clínicas e histopatológicas del CEB, proveniente de historias clínicas de 197 personas 112 (56,9 por ciento) hombres y 85 (43,1 por ciento) mujeres atendidas en el hospital Universitario San Vicente de Paúl de Medellín, durante un periodo de 14 años. Resultados: 197 historias fueron estudiadas, el 61,9 por ciento (122) de la población, era mayor de 60 años al momento del diagnóstico, 78,7 por ciento (157) fueron procedentes de Antioquia, el 78,6 por ciento (155), tenían antecedente tabaquismo, el 17,8 por ciento (35) de las personas, reportaron en la historia antecedentes familiares de cáncer. La localización más frecuente del CEB, fue la lengua 45 por ciento (90), seguido de paladar duro 17,1 por ciento (34), paladar blando 9 por ciento (17) y piso de boca 8,5 por ciento (17); la mayoría de estos (74,9 por ciento), fueron diagnosticados en estadios tardíos (III y IV), en cuanto al grado de diferenciación predominaron los carcinomas bien y moderadamente diferenciado, 45,2 por ciento (89) y 42,6 por ciento (84) respectivamente(AU)

Buccal squamous cell carcinoma (SCC) is frequent malign neoplasm in oral cavity; however, there isn't information on its incidence and clinical and histological behavior of this type of cancer in Antioquia (Colombia). Methods: Present study supply information on the clinical and histological features of SCC from medical records of 197 persons (56.9 percent) (112 of male sex and 85 of female sex (43.1 percent) seen in "San Vicente de Paúl" University Hospital of Medellin for 13 years. Results: A total of 197 medical records were studied, the 61.9 percent (122) of population aged over 60 at diagnosis, 78.7 percent (157) from Antioquia, and the 78.6 percent (155) had smoking backgrounds, and the 17.8 percent (35) of persons had a family history of cancer. More frequent location of SCC was in tongue for a 45 percent (90), followed by hard palate for a 17.1 percent (17) and mouth floor for a 8.5 percent (17), most of them (7.9 percent) were diagnosed with late stages (III and IV) regards the differentiation degree the carcinoma were well and moderately differentiated, 45.2 percent (89) and 42.6 percent (84), respectively(AU)

Reverse smokers's and changes in oral mucosa. Department of Sucre, Colombia.

OBJECTIVES: This work is intended to establish the prevalence of reverse smokers at the villages of Hato Nuevo, San Francisco and Cayo de Palma, Department of Sucre, Colombia, characterizing their socio-culture conditions, clinical and histological changes in the oral mucosa. DESIGN OF STUDY: A descriptive study was done through a home to home inquiry to select the people with inclusion criteria for a posterior clinical test and a biopsy of the affected oral mucosa. RESULTS AND CONCLUSIONS: Reverse smokers's prevalence was from the 15%, mainly women (p<0.001) with an age average of 59.3 years. The lesions were classified clinically in mild, moderate and severe changes. Tongue moderate lesions presented the higher frequency (80%), followed by severe lesions on palate (74%). Oral cancer prevalence was 10.8% in the San Francisco village and 18.2% in Cayo de Palma village, no new cases were reported in Hato Nuevo village. This was the highest prevalence reported in comparison with other studies with similar population. The clinical and histological findings agree with the reported in literature, no relation was found between the degree of clinical severity and the dysplasia itself. Cases of oral submucous fibrosis-like lesions were found, which had never been reported in Latin America. Further studies are required in order to decrease the morbidity for this habit and to identify other related risk factors.

Reverse smokers’s and changes in oral mucosa. Department of Sucre, Colombia

No disponible

Objectives: This work is intended to establish the prevalence of reverse smokers at the villages of Hato Nuevo, San Francisco and Cayo de Palma, Department of Sucre, Colombia, characterizing their socio-culture conditions, clinical and histological changes in the oral mucosa.Design of study: A descriptive study was done through a home to home inquiry to select the people with inclusion criteria for a posterior clinical test and a biopsy of the affected oral mucosa.Results and conclusions: Reverse smokers’s prevalence was from the 15%, mainly women (p<0.001) with an ageaverage of 59.3 years. The lesions were classified clinically in mild, moderate and severe changes. Tongue moderate lesions presented the higher frequency (80%), followed by severe lesions on palate (74%). Oral cancer prevalence was 10.8% in the San Francisco village and 18.2% in Cayo de Palma village, no new cases were reported in Hato Nuevo village. This was the highest prevalence reported in comparison with other studies with similar population. The clinical and histological findings agree with the reported in literature, no relation was found between the degree of clinical severity and the dysplasia itself. Cases of oral submucous fibrosis-like lesions were found, which had never been reported in Latin America. Further studies are required in order to decrease the morbidity for this habit and to identify other related risk factors (AU)

Patologia oral y geriatrica / Oral and Geriatric Pathology

En este articulo se presentan las 17 entidades mas frecuentes diagnosticadas clinicamente, en un estudio epidemiologico realizado a 248 ancianos de Medellin, Colombia. Se hace enfasis en las caracteristicas sistemicas de la vejez y la aplicacion de ellas a la patologia estomatologica. Los resultados son comparados con hallazgos previos en escolares de Antioquia y con ancianos de EE.UU. y se presentan las deficiencias que para la codificacion en algunas enfermedades aplicada a odontologia y estomatologia (CIE-AO). Las entidades presentadas se consideran como tendencias epidemiologicas para estudios de este tipo en ancianos de nuestros paises. Sobre cada una de las entidades se presenta el criterio de diagnostico objetivo que es posible utilizar en estudios epidemiologicos en estomatologia