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1.
Vestn Otorinolaringol ; 87(6): 14-18, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36580504

RESUMO

OBJECTIVE: To improve the diagnosis of laryngeal disease in patients with gastroesophageal reflux disease (GERD). MATERIAL AND METHODS: 171 patients (89 (52%) men, 82 (48%) women) with non-erosive (39 (23%) people) and erosive (132 (77%) people) forms of GERD were examined. None of the patients made active complaints about the condition of the larynx and pharynx. The examination included a questionnaire, examination by an otorhinolaryngologist, and videoendolaryngoscopy. RESULTS: The survey revealed the presence of symptoms of otorhinolaryngological pathology in 74% of patients. Videolaryngoscopy revealed no laryngeal pathology in 55 (32%) patients, and signs of GERD-associated laryngitis were detected in 116 (68%) patients. The most common pathology was pachydermia in interarytenoid region - in 89 people, laryngeal granuloma was detected in 7 patients, leukoplakia - in 2 patients, chronic edematous polypous laryngitis - in 2 patients, benign laryngeal formations - in 9 patients. In patients with GERD (erosive and non-erosive forms), an asymptomatic course of chronic laryngitis associated with this pathology was observed in 44% of cases. In 52% of patients, pachydermia in interarytenoid region was diagnosed, of which every second had pronounced hyperplasia and folding of the mucous membrane in interarytenoid region, which must be differentiated from laryngeal cancer (in this case, patients should be under the dynamic supervision of an otorhinolaryngologist). Other precancerous formations of the larynx (granulomas and leukoplakia) were found in 5% of patients. Benign neoplasms of the larynx (polyps and cysts) were also detected in 5% of cases. CONCLUSIONS: Despite the high frequency of detection of otorhinolaryngological diseases in the examined patients with gastroesophageal reflux disease, none of the patients presented complaints related to the pathology of the larynx, which indicates the need for active detection of this pathology in this category of patients by questioning, questioning, as well as examination by an otorhinolaryngologist.


Assuntos
Refluxo Gastroesofágico , Doenças da Laringe , Edema Laríngeo , Neoplasias Laríngeas , Laringite , Laringe , Masculino , Humanos , Feminino , Laringite/diagnóstico , Laringite/epidemiologia , Laringite/etiologia , Doenças da Laringe/diagnóstico , Doenças da Laringe/epidemiologia , Doenças da Laringe/etiologia , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/epidemiologia , Laringe/patologia , Neoplasias Laríngeas/diagnóstico , Leucoplasia/complicações , Leucoplasia/patologia
2.
Asian Pac J Cancer Prev ; 23(11): 3833-3842, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36444596

RESUMO

INTRODUCTION: Leukoplakia is one of the most frequently found lesions in the oral cavity, with a probability of 17 to 24% of becoming malignant cells in a period of 30 years. OBJECTIVE: To identify differentially expressed gene profiles of leukoplakia and its progression to oral squamous cell carcinoma, essential for the discovery of new biomarkers to predict and prevent the presence of diseases in the oral cavity. METHODS: Initially, gene profiles of GSE85514 and GSE160042 from the Gene Expression Omnibus database were used. Differentially expressed genes were identified using GEO2R. The CLUEGO plugin in Cytoscape was used for DEG functionality and enrichment analysis. Finally, a protein-protein interaction (PPI) network was constructed using Cytoscape from data collected online from the STRING server. RESULTS: According to the MCC algorithm, the 10 most found gene sequences were HNRNPU, SMC1A, PAFAH1B1, EHMT1, SPTBN4, OLFM1, NCAM1, SF3B3, FGF2, and UBE2I; with HNRNPU, SMC1A, and PAFAH1B1 being the most representative of the modules. CONCLUSIONS: We were able to describe the gene sequences that promote the progression from leukoplakia to oral squamous cell carcinoma. Within these genes, the HNRNPU, SMC1A, and PAFAH1B1 constitute the main promising therapeutic targets to counteract the progression of oral cancer, they could also be important biomarkers for the diagnosis and classification of the disease.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Humanos , Neoplasias Bucais/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço , Carcinoma de Células Escamosas/genética , Biologia Computacional , Leucoplasia , Expressão Gênica
3.
Stomatologiia (Mosk) ; 101(5): 11-16, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36268913

RESUMO

OBJECTIVE: The aim the study is to increase the effectiveness of the treatment of severe forms of leukoplakia with the use of photodynamic therapy. MATERIAL AND METHODS: 120 patients with severe forms of leukoplakia were examined. 30 patients were diagnosed with Cr and carcinoma in situ, and therefore they were excluded from the study. In 90 patients, the diagnosis was confirmed by histological and IHC studies. Before the use of photodynamic therapy, the degree of saturation of pathological foci with a photosensitizer was determined by the method of fluorescent diagnostics using the LED device «RFS-400¼. RESULTS: As a result of treatment with photodynamic therapy using a 2nd generation photosensitizer («Photoditazine¼ 0.5% gel penetrator), a significant improvement in the epithelization of lesion elements was observed: in 92% of patients with verrucous leukoplakia and in 83% of patients with erosive leukoplakia. CONCLUSION: The use of photodynamic therapy for the treatment of patients with complicated forms of leukoplakia is an effective method of treatment for this pathology.


Assuntos
Carcinoma in Situ , Fotoquimioterapia , Humanos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Leucoplasia Oral/tratamento farmacológico , Leucoplasia/tratamento farmacológico , Leucoplasia/induzido quimicamente
4.
J Cancer Res Ther ; 18(4): 1003-1008, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36149153

RESUMO

Background: Oral carcinogenesis is a multistage process with epithelial dysplasia as a premalignant condition. There is a significant inter-observer variation in diagnosing and grading the oral epithelial dysplasia. As human papillomavirus (HPV) is believed to have à strong relationship with oral carcinogenesis, using P16 as a biomarker may help in identifying the cells which may be undergoing the malignant transformation. However, due to the low specificity of P16, dual staining test P16INK4/Ki67 might be a better promising marker for identifying the transformed cells. This study was designed to evaluate the dual expression of P16 and Ki67 as a promising biomarker for dysplasia and their correlation with clinicopathological factors. Materials and Methods: Immunohistochemical analysis for p16 and ki67 was performed on 30 premalignant oral lesions and 36 oral squamous cell carcinoma (OSCC) by dual staining using the CINtec PLUS kit. Results: CINtec positivity was observed only in leukoplakia with dysplasia (46.7%) and squamous cell carcinoma (25%). None of the cases of leukoplakia without dysplasia or oral submucosal fibrosis stained positive for CINtec plus staining. In leukoplakia with dysplasia, there was no significant association with any of the clinicopathological parameters studied. In OSCC cases, alcohol intake showed statistically significant association with CINtec positivity. Conclusion: P16INK4/Ki67 assessment by dual staining is a promising biomarker for identifying dysplasia in cases with diagnostic dilemmas.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Bucais , Infecções por Papillomavirus , Lesões Pré-Cancerosas , Carcinogênese , Carcinoma de Células Escamosas/patologia , Inibidor p16 de Quinase Dependente de Ciclina , Humanos , Antígeno Ki-67/metabolismo , Leucoplasia , Neoplasias Bucais/patologia , Infecções por Papillomavirus/complicações , Lesões Pré-Cancerosas/patologia , Coloração e Rotulagem
5.
Cancer Lett ; 546: 215839, 2022 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-35961512

RESUMO

The characteristics of fibroblast cells in head and neck precancerous lesion and its ability to secrete inflammatory cytokines and affect CD8+T cell functions remain unclear. Herein, we reported the existence of fibroblasts in human-derived vocal fold leukoplakia (VFL) with positive staining of fibroblast activation protein (FAP) and α-smooth muscle actin (α-SMA). The fibroblasts from VFL and cancer-associated fibroblasts (CAFs) from head and neck squamous cell carcinoma (HNSCC) displayed similar cellular functions and robust inflammatory cytokine secretions. The effects of fibroblasts from VFL in inducing the apoptosis, depletion of CD8+ T cells and recruitment of regulatory T cells (Treg cells) were observed. We further assessed the autocrine loop within VFL fibroblasts to self-stimulate by secreting IL-6, TGF-ß through the IL-6/JAK2/STAT3 pathway. The synergistic stimulation of IL-6 and TGF-ß promoted Th17 cell differentiation and IL-17A secretion, which could result in fibroblast activation in another positive loop. Tocilizumab (TOC), a monoclonal antibody targeting IL-6R, managed to suppress the overexpression of both IL-6 and TGF-ß in VFL fibroblasts, and thus blocking IL-6 autocrine loop and CAF-Th17 loop in vitro. In a murine model of oral leukoplakia (OL), local injection of TOC inhibited the outgrowth of lesions and showed notable effect in control of OL progression in vivo. Our findings establish a novel rationale for blocking the IL-6/JAK2/STAT3 pathway to inhibit vocal fold (oral) leukoplakia progression and postpone HNSCC tumorigenesis.


Assuntos
Fibroblastos Associados a Câncer , Neoplasias de Cabeça e Pescoço , Animais , Linfócitos T CD8-Positivos , Fibroblastos , Humanos , Interleucina-6 , Leucoplasia , Camundongos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Células Th17 , Fator de Crescimento Transformador beta , Prega Vocal
6.
Artigo em Chinês | MEDLINE | ID: mdl-35866281

RESUMO

Objective: To evaluate the clinical value of high-definition intelligent endoscopy (iSCAN) combined with stroboscopy in identifying vocal cord leukoplakia. Methods: Seventy-nine patients with vocal cord leukoplakia who underwent CO2 laser laryngeal microsurgery and diagnosed by histopathology were recruited between October 2020 to August 2021. The morphological features, microvascular morphology and mucosal waves were observed by stroboscope; SPSS 20.0 software was used for statistical analysis. Results: There were 79 patients with a total of 119 lesions (56 on left and 63 on right).Pathological examination showed that 51 sides of the vocal cords were malignant lesions (severe dysplasia, carcinoma in situ and invasive carcinoma), and 68 sides were benign lesions.Under stroboscopy, 69 sides of mucosal wave were normal or slightly decreased, and 50 sides were severely decreased or disappeared.The decrease degree of mucosal wave was positively correlated with malignant lesions (ρ=0.687, P<0.001).Under iSCAN endoscopy, there was a positive correlation between the morphological changes of microvessels at the lesion site (vertical) and the malignant lesion (ρ=0.687, P<0.001).Univariate analysis showed that lesion size, thickness, uneven color, granular elevation, peripheral erythema and asymmetry were positively correlated with malignant lesions (ρ=0.530, 0.401, 0.538, 0.315, 0.497, 0.281, P<0.05).Logistic regression analysis showed that the risk of pathological malignancy with large lesions was 5.437 times higher than those of small lesions, the vertical vascular changes under iSCAN were 8.711 times higher than that of normal vascular morphology, and the severe reduction or disappearance of mucosal waves was 9.12 times higher than that of normal or mild reduction of mucosal waves. Conclusion: ISCAN can be combined with staphyloscopy to comprehensively observe and evaluate the changes of vocal cord morphology, submucosal microvessels and mucosal wave of vocal cord in patients with vocal cord leukoplosis, thus improving the ability to distinguish benign and malignant lesions.


Assuntos
Doenças da Laringe , Prega Vocal , Endoscopia , Humanos , Doenças da Laringe/diagnóstico , Doenças da Laringe/patologia , Leucoplasia/diagnóstico , Leucoplasia/patologia , Estroboscopia , Prega Vocal/patologia
7.
Photodiagnosis Photodyn Ther ; 39: 102999, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35793782

RESUMO

Laryngeal leukoplakia is a common disorder in otolaryngology. Presently, the most widely accepted treatment is suspension laryngoscopic surgery under general anesthesia. The high recurrence rate and hoarse voice after surgery make it an intractable disease to treat. Here we report a case of a 67-year-old man who was diagnosed of laryngeal leukoplakia 15 years ago and underwent 5 surgeries because of its repeated recurrences. Two sessions of photodynamic therapy were performed with local application of 5-aminolevulinic acid and irradiation of 635 nm diode laser. Complete response was observed and no recurrence was detected during follow-up of 6 months. Photodynamic therapy with local 5-ALA application and 635 nm laser is safe and well-tolerated. It is a promising modality for laryngeal leukoplakia.


Assuntos
Terapia a Laser , Fotoquimioterapia , Idoso , Ácido Aminolevulínico/uso terapêutico , Humanos , Laringoscopia , Lasers , Leucoplasia/tratamento farmacológico , Masculino , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico
8.
Anaerobe ; 76: 102612, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35840013

RESUMO

We report a case with leukoplakia of the tongue as a manifestation of chronic graft versus host disease after allogeneic stem cell transplantation for acute promyelocytic leukemia treated with Clostridium butyricum tablets. His leukoplakia subsequently disappeared and his regulatory T cells increased after three months.


Assuntos
Clostridium butyricum , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Administração Oral , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/tratamento farmacológico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Leucoplasia
9.
Auris Nasus Larynx ; 49(6): 1009-1018, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35513993

RESUMO

OBJECTIVE: Cancer-associated fibroblasts (CAFs) have been reported to play an essential role in tumor angiogenesis and progression. In this study, we aimed to investigate the impact of vocal fold leukoplakia-associated fibroblasts (VFLFs) on the angiogenesis process in vocal fold leukoplakia (VFL) and their potential secretions of proangiogenic factors. METHODS: A total of 160 lesions (86 laryngeal carcinoma, 67 vocal fold leukoplakia, 7 vocal fold polyp) were detected under narrow band imaging (NBI) mode to evaluate the relationship between pathology and intraepithelial papillary capillary loop (IPCL) grades. We characterized immortalized vocal fold CAFs, VFLFs, normal fibroblasts (NFs) cell lines using immunofluorescence cytochemistry and real-time quantitative polymerase chain reaction (RT-qPCR). The effects of fibroblast conditioned media (CM) on the proliferative, migrating and tube formation capacity of human umbilical vein endothelial cells (HUVEC) were investigated using the cell counting kit-8 (CCK-8) assay, wound healing assay, transwell migration experiment and Matrigel tube formation experiment. The expression levels of proangiogenic factors in CAFs, VFLFs, and NFs were evaluated by antibody microarray and RT-qPCR. RESULTS: NBI images depicted that angiogenesis was abnormally activated during laryngeal tumorigenesis. Both CAF and VFLF expressed Vimentin, alpha-smooth muscle actin (α-SMA) and fibroblast activation protein (FAP). NF expressed Vimentin and α-SMA, but not FAP. The PCR results showed that mRNA expression levels of Vimentin, α-SMA and FAP in CAFs and VFLFs were significantly increased than those in NFs. CAF-CM and VFLF-CM promoted the proliferative, migrating, and tube formation ability of HUVECs. Secretome profiling of fibroblasts by antibody microarray demonstrated that VFLFs secreted significantly more vascular endothelial growth factor (VEGF), angiogenin, bFGF and HGF than NFs. CONCLUSIONS: Overall, we demonstrated that VEGF, angiogenin, bFGF and HGF derived from VFLFs may play crucial roles in the angiogenesis process of laryngeal premalignant and malignant lesions. This may contribute to the exploitation of novel therapeutic strategies for VFL.


Assuntos
Neoplasias Laríngeas , Prega Vocal , Indutores da Angiogênese/metabolismo , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Fibroblastos/metabolismo , Humanos , Neoplasias Laríngeas/metabolismo , Leucoplasia , Neovascularização Patológica/metabolismo , Neovascularização Patológica/patologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Vimentina/metabolismo , Prega Vocal/patologia
10.
Acta Otolaryngol ; 142(3-4): 350-356, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35471144

RESUMO

BACKGROUND: Low-temperature plasma ablation (LTPA) is an emerging technique for laryngeal leukoplakia (LL). OBJECTIVE: To initially observe the healing process of trauma after LTPA for LL. MATERIALS AND METHODS: Seventeen patients who underwent LTPA for LL were collected, and the degrees of wound healing were analyzed. RESULTS: Only 1 patient in who dysbiosis of the pharyngeal flora was induced by self-administered hormone nebulization treatment during the follow-up period. In the remaining patients, the wound healing was characterized by a crater-shaped defect on the vocal folds surface with pseudo-membranes, congestion, and mild edema on postoperative day 1. These symptoms became worse on postoperative day 7. On postoperative day 15, the pseudo-membrane was fully formed and some patients had granulomatous swelling of the vocal cords. These symptoms became better and better on postoperative day 30 and day 45. On postoperative day 60, the mucosa of the vocal folds had essentially returned to normal. On postoperative day 90, the vocal folds morphology and function had recovered well. CONCLUSION: It takes 2-3 months for the wound to heal completely after LTPA for LL. SIGNIFICANCE: A proper understanding of the wound healing process can reduce unnecessary surgical and pharmacologic interventions and avoid excessive treatment.


Assuntos
Ablação por Cateter , Doenças da Laringe , Humanos , Doenças da Laringe/cirurgia , Leucoplasia/cirurgia , Temperatura , Prega Vocal , Cicatrização
11.
J Pathol ; 257(5): 593-606, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35358331

RESUMO

A thickened, white patch - leukoplakia - in the oral cavity is usually benign, but sometimes (in ~9% of individuals) it progresses to malignant tumour. Because the genomic basis of this progression is poorly understood, we undertook this study and collected samples of four tissues - leukoplakia, tumour, adjacent normal, and blood - from each of 28 patients suffering from gingivobuccal oral cancer. We performed multiomics analysis of the 112 collected tissues (four tissues per patient from 28 patients) and integrated information on progressive changes in the mutational and transcriptional profiles of each patient to create this genomic narrative. Additionally, we generated and analysed whole-exome sequence data from leukoplakia tissues collected from 11 individuals not suffering from oral cancer. Nonsynonymous somatic mutations in the CASP8 gene were identified as the likely events to initiate malignant transformation, since these were frequently shared between tumour and co-occurring leukoplakia. CASP8 alterations were also shown to enhance expressions of genes that favour lateral spread of mutant cells. During malignant transformation, additional pathogenic mutations are acquired in key genes (TP53, NOTCH1, HRAS) (41% of patients); chromosomal-instability (arm-level deletions of 19p and q, focal-deletion of DNA-repair pathway genes and NOTCH1, amplification of EGFR) (77%), and increased APOBEC-activity (23%) are also observed. These additional alterations were present singly (18% of patients) or in combination (68%). Some of these alterations likely impact immune-dynamics of the evolving transformed tissue; progression to malignancy is associated with immune suppression through infiltration of regulatory T-cells (56%), depletion of cytotoxic T-cells (68%), and antigen-presenting dendritic cells (72%), with a concomitant increase in inflammation (92%). Patients can be grouped into three clusters by the estimated time to development of cancer from precancer by acquiring additional mutations (range: 4-10 years). Our findings provide deep molecular insights into the evolutionary processes and trajectories of oral cancer initiation and progression. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.


Assuntos
Neoplasias Bucais , Transcriptoma , Transformação Celular Neoplásica/genética , Exoma , Genômica , Humanos , Leucoplasia/genética , Neoplasias Bucais/genética , Neoplasias Bucais/patologia , Mutação
12.
Braz J Med Biol Res ; 55: e11920, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35293553

RESUMO

Vocal fold leukoplakia (VFL) has a risk of malignant transformation. Therefore, patients can have symptoms such as dysphonia, vocal strain, difficulty breathing, and dysphagia. Additionally, there is a genetic predisposition that can be associated with genetic polymorphisms. We aimed to evaluate the influence of genetic polymorphisms and protein levels in the etiology of VFL. Our study followed the PRISMA checklist and was registered on PROSPERO database. The questions were: "Are genetic polymorphisms involved in the etiology of VFL? Are protein levels altered in patients with VFL?". Eligibility criteria were case control studies that compared the presence of polymorphisms or/and protein levels of subjects diagnosed with VFL and healthy controls. Of the 905 articles retrieved, five articles with a total of 1038 participants were included in this study. The C allele of the single nucleotide polymorphisms (SNP)-819 T/C IL-10, A allele of the SNP -592 A/C IL-10, CT genotype of the SNP rs11886868 C/T BCL11A, GG genotype of the SNP rs4671393 A/G BCL11A, LL genotype, and L allele of (GT)n repeat polymorphisms of the HO-1 were risk factors for VFL development. Nevertheless, there was a lack of association between VFL and the -1082 A/G IL-10, rs14024 CK-1, and -309 T/G Mdm2 SNPs. The concentrations of the MDM2, BCL11A, and HO-1 proteins were modified, while IL-10 levels were normally expressed in these subjects. In conclusion, most markers evaluated in this review could be potential indicators to develop effective therapies, avoiding a malignant transformation of the lesion.


Assuntos
Leucoplasia , Prega Vocal , Predisposição Genética para Doença/genética , Genótipo , Humanos , Leucoplasia/genética , Polimorfismo de Nucleotídeo Único/genética
13.
Bull Tokyo Dent Coll ; 63(1): 1-12, 2022 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-35173082

RESUMO

Early identification of leukoplakic oral squamous cell carcinoma (OSCC) is difficult. The purpose of this study was to determine whether it was possible to detect change from normal epithelium to leukoplakic OSCC using a fluorescence visualization (FV) device in a 4-nitroquinoline 1-oxide (4NQO) -induced rat tongue cancer model. If successful, this would facilitate early detection of OSCC. The rats (3 groups of 5) were administered 50 ppm 4NQO in their drinking water over a period of 10, 15, or 20 weeks. Five non-treated rats were used as a control group. Images of their tongues obtained by FV were analyzed for change in fluorescence intensity (FI) using image analysis software. Immunoreaction for anti-CK13, anti-CK17, and anti-E-cadherin antibodies was also histopathologically evaluated. Receiver operating characteristic (ROC) analysis was used to calculate the cut-off values, sensitivity, specificity, and area under the curve. The most marked change in FI was found between the control and 10-week groups, with an increase observed in its average value and range in the latter. These findings differed from those characteristic of leukoplakia. No significant difference was observed in the positive cell rate for immunoreaction for anti-CK13 or anti-CK17 antibodies between the control and 10-week groups. A significant decrease was observed in the positive pixel ratio of immunoreaction for anti-E-cadherin antibody in the 10-week group in comparison with in the control group (p <0.05). These results showed that disruption of intercellular adhesion could be observed at 10 weeks. In the ROC analysis, the FI cut-off value in the 10-week and control groups was 51.9, sensitivity 95.5%, and specificity 96.9%. This indicated that normal epithelium could be accurately distinguished from low-grade dysplasia with high probability. These results demonstrate that analysis of change in FI as measured by FV could facilitate early detection of leukoplakic OSCC.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Neoplasias da Língua , Animais , Carcinoma de Células Escamosas/induzido quimicamente , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Fluorescência , Leucoplasia , Neoplasias Bucais/induzido quimicamente , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Ratos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Neoplasias da Língua/induzido quimicamente , Neoplasias da Língua/diagnóstico , Neoplasias da Língua/patologia
14.
Mol Carcinog ; 61(5): 472-480, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35040215

RESUMO

Severe dysplasia of vocal cord leukoplakia (VCL) is more likely to occur in laryngeal carcinoma. Alcohol dehydrogenase and acetaldehyde dehydrogenase are both important enzymes in alcohol metabolism. This study aimed to investigate the incidence rate of malignant transformation in patients with VCL and the role of drinking habits and ALDH2 and ADH1B genetic polymorphisms in the malignant transformation of VCL. From January 2007 to January 2017, 136 cases of VCL were included in this retrospective analysis. Information on medical history, alcohol and tobacco consumption habits, ALDH2 and ADH1B genotypes, gastroesophageal reflux, and clinical pathological characteristics of VCL was collected. As a result, patients had a median follow-up of 9.6 years (interquartile range: 7.5-12.5 years). Twenty-three of 136 VCL patients finally developed laryngeal carcinoma, resulting in a cumulative malignant transformation rate of 16.9%. Cox regression analysis demonstrated that the independent risk factors for the malignant transformation of VCL included age over 60 years (hazard ratio [HR]: 13.872, p < 0.001), ALDH2 *2 allele status (HR: 9.694, p < 0.001), alcohol (HR: 10.011, p < 0.001) and tobacco (HR: 8.869, p < 0.001) exposure after operation, and drinking frequency (HR: 2.178, p = 0.016). Therefore, among patients over 60 years old, an ALDH2-inactivating mutation and excessive ethanol and tobacco consumption are potential contributors to the malignant transformation of VCL.


Assuntos
Álcool Desidrogenase , Carcinoma , Álcool Desidrogenase/genética , Álcool Desidrogenase/metabolismo , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/genética , Aldeído Desidrogenase/metabolismo , Aldeído-Desidrogenase Mitocondrial/genética , Aldeído Oxirredutases , China , Etanol , Genótipo , Humanos , Leucoplasia/genética , Pessoa de Meia-Idade , Polimorfismo Genético , Estudos Retrospectivos , Prega Vocal/metabolismo
15.
Med. oral patol. oral cir. bucal (Internet) ; 27(1): e77-e84, jan. 2022. graf, tab, ilus
Artigo em Inglês | IBECS | ID: ibc-204337

RESUMO

Background: MiRNAs are small non-coding RNAs that regulate gene expression at the post-transcriptional level and have been associated with malignant transformation of oral epithelial precursor lesions such as oral leukoplakia. The aim was to perform a scoping review of the contemporary literature about the different roles of miRNAs during the malignant transformation of oral leukoplakia. Material and Methods: We conducted a systematic search with the following MeSH terms: ‘oral leukoplakia’, ‘carcinoma in situ’, ‘microRNAs’, ‘mouth neoplasms’ and ‘epithelial–mesenchymal transition’ in PubMed/MEDLINE, EMBASE and SpringerLink. Results: Fifteen articles were included for analysis, among which in vivo and in vitro articles were included. A total of 21 different miRNAs were found to be involved in the malignant transformation process of oral leukoplakia. Regarding their possible effects, 6 miRNAs were classified as oncogenic, 5 as tumour suppressors and 10 were related to epithelial–mesenchymal transition, invasion and migration. Conclusions: Based on the current review, we concluded that miRNAs-21, 345, 181-b and 31* seem to be potential markers of malignant transformation of oral leukoplakia. However, further clinical prospective studies are needed in order to validate their utility as prognostic biomarkers.(AU)


Assuntos
Humanos , Transformação Celular Neoplásica , Leucoplasia/genética , MicroRNAs/genética , Neoplasias Bucais , Humanos , Estudos Prospectivos
16.
Ear Nose Throat J ; 101(9): NP403-NP408, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33213196

RESUMO

INTRODUCTION: Leukoplakia is a precancerous lesion considered to be within the spectrum of histopathological results from parakeratosis, through stages of dysplasia to invasive cancer. Narrow band imaging (NBI) endoscopy has been introduced to improve early diagnosis of benign and malignant laryngeal lesions. The aim of this literature review was to evaluate the accuracy of preoperative evaluation of vocal fold leukoplakia with NBI endoscopy in comparison with histology. METHODS: A systematic review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using 3 different databases: PubMed, Embase, and Scopus. The included articles in the systematic review were identified combining each of the following terms: "narrow band imaging" OR "NBI," [AND] with each of these terms: "laryngeal leukoplakia," OR "vocal fold leukoplakia," OR "vocal cord leukoplakia." RESULTS: The articles that fully met the inclusion criteria were 5 case series, conducted between January 2010 and February 2018, and published between 2017 and 2019. The selected articles included 312 patients (86% males and 14% females), affected by 382 vocal cord leukoplakia, evaluated with NBI endoscopy and that underwent surgical microlaryngoscopy with biopsy. Based on the studies included in the review, accuracy of NBI in predicting malignancy within leukoplakia ranged from 81% to 97.8%, demonstrating to be an accurate method to predict the risk of malignant transformation of vocal fold leukoplakia. CONCLUSION: Narrow band imaging can help otolaryngologists in the decision-making process on the necessity to perform a biopsy and transoral surgery or long-term follow-up. Larger studies are necessary to confirm the high association of NBI evaluation of the epithelium surrounding the leukoplakia with the histological diagnosis.


Assuntos
Neoplasias Laríngeas , Prega Vocal , Endoscopia , Endoscopia Gastrointestinal , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Laríngeas/cirurgia , Leucoplasia/diagnóstico por imagem , Leucoplasia/patologia , Masculino , Imagem de Banda Estreita/métodos , Prega Vocal/diagnóstico por imagem , Prega Vocal/patologia
17.
Auris Nasus Larynx ; 49(6): 1056-1059, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33965285

RESUMO

Lichen planus (LP) is an immune-mediated chronic inflammatory disease affecting the skin and mucosal membranes, either alone or in combination. LP rarely occurs in the larynx, where it presents as leukoplakia. Additionally, due to its responsiveness to corticosteroid drugs, differential diagnosis from other causes of laryngeal leukoplakia is needed (e.g., dysplasia and squamous cell carcinoma [SCC]). A 71 years old male smoker presented with progressive hoarseness and cough without fever. Vocal folds' motility was preserved. At fiberoptic laryngoscopy, he presented with bilateral cordal erythema and leukoplakia of the right true vocal fold. A sub-epithelial CO2 laser cordectomy was performed. Histological findings were consistent with mucosal LP. After surgical excision, the patient experienced symptomatic relief without medical treatment. A relapsing lesion became clinically evident six months later. A pinch biopsy was performed, and the histological examination confirmed the presence of laryngeal-LP. Hence, the patient underwent a 10-week corticosteroid-based treatment. After that, and during the subsequent 12 months of follow-up, the patient showed no signs of recurrence. LP is an exceedingly rare cause of leukoplakia in the larynx. Histological evaluation plays a key role in the diagnosis, in order to establish a proper therapeutic approach. Since LP is responsive to corticosteroid drugs and untreated disease tends to relapse, the medical treatment is advisable in such instances.


Assuntos
Laringe , Líquen Plano , Corticosteroides/uso terapêutico , Idoso , Humanos , Laringoscopia , Leucoplasia/cirurgia , Líquen Plano/patologia , Líquen Plano/cirurgia , Masculino , Recidiva Local de Neoplasia/cirurgia , Prega Vocal/cirurgia
18.
Ear Nose Throat J ; 101(4): NP158-NP163, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-32865459

RESUMO

OBJECTIVES: To evaluate the characteristics of laryngopharyngeal reflux (LPR) in patients with different hypertrophic laryngeal diseases and to explore the relationship between LPR and these diseases. METHODS: A retrospective analysis was performed. The clinical data of 154 patients were collected. According to their diagnoses, patients were divided into 3 groups. Group 1 included 49 patients with vocal cord polyps. Group 2 contained 52 patients with vocal cord leukoplakia. Group 3 included 53 patients with laryngeal carcinoma. The reflux symptom indexes (RSIs), reflux finding scores (RFSs), and Ryan scores of all patients were evaluated and compared. RESULTS: Patients with vocal cord polyps were the youngest of the 3 groups, and those with laryngeal carcinoma were the oldest. A male preponderance emerged in each group. In total, 128 patients (83.12%) had positive RSI/RFS values and 60 (60/146, 41.1%) patients had positive Ryan scores. The positive RSI/RFS rates of both groups 1 and 2 (89.80% and 92.16%, respectively) were significantly higher than that of group 3 (69.81%). Moreover, the positive Ryan score rates in both groups 1 and 2 (39.58% and 53.85%, respectively) were significantly higher than that of group 3 (28.26%). CONCLUSIONS: Laryngopharyngeal reflux occurs in many patients with vocal cord polyps, vocal cord leukoplakia, and vocal cord carcinoma, indicating that LPR may be important in the pathogenesis of these diseases. Laryngopharyngeal reflux occurs more common in patients with vocal cord polyps and leukoplakia and less common in those with laryngeal carcinoma, suggesting the role of LPR on these diseases may be different.


Assuntos
Carcinoma , Doenças da Laringe , Neoplasias Laríngeas , Refluxo Laringofaríngeo , Pólipos , Carcinoma/patologia , Humanos , Doenças da Laringe/patologia , Neoplasias Laríngeas/patologia , Refluxo Laringofaríngeo/complicações , Leucoplasia/etiologia , Leucoplasia/patologia , Masculino , Pólipos/complicações , Pólipos/patologia , Estudos Retrospectivos , Prega Vocal/patologia
19.
Clin Otolaryngol ; 47(1): 153-159, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34662496

RESUMO

OBJECTIVE: To assess long-term outcomes of ALA-PDT in treating recalcitrant laryngeal leukoplakia. STUDY DESIGN: Retrospective Case-Control. METHODS: We reviewed all laryngeal leukoplakia patients treated with ALA-PDT compared with angiolytic laser treatment alone (585 nm PDL or 532 nm KTP laser) from 2000 to 2019. Patients with laryngeal cancer (or a history of laryngeal cancer), leukoplakia previously treated with radiation and no pathologic report were excluded. Patient demographics, procedure details and outcomes were examined including histopathologic diagnosis, procedures performed, ALA usage, recurrence of leukoplakia and the development of cancer. RESULTS: We identified 132 patients with laryngeal leukoplakia: 42 were treated with ALA-PDT and 90 were treated with an angiolytic laser alone (Laser group). The proportion of cases of high-grade dysplasia was 57.1% in the ALA-PDT group compared to 32.2% in the Laser group. In high-grade dysplasia cases, there was a statistically significant better recurrence-free survival (RFS) at 12 months and 60 months in those who underwent ALA-PDT 71.4% and 7.1% vs Laser 25% and 0% (p = .01). However, for overall groups, there was no difference in RFS (p = .25). Voice outcomes (patient subjective report) improved or were stable in 75% of subjects with no serious side effects reported. CONCLUSION: ALA-PDT for recalcitrant and high-grade dysplasia is highly effective with improved recurrence-free survival compared to laser alone. ALA-PDT may be an appropriate therapy in patients who have failed prior angiolytic laser alone.


Assuntos
Ácido Aminolevulínico/uso terapêutico , Neoplasias Laríngeas/terapia , Terapia a Laser/métodos , Leucoplasia/terapia , Fotoquimioterapia/métodos , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Retrospectivos , Qualidade da Voz
20.
Laryngoscope ; 132(8): 1641-1643, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34913490

RESUMO

Glycogenic acanthosis is a common benign lesion of the esophagus; however, reports of extra-esophageal manifestations are exceedingly rare. This case represents the first report of laryngeal glycogenic acanthosis found in a living patient, presenting as vocal fold leukoplakia. Glycogenic acanthosis may be considered among the differential diagnoses of conditions presenting as vocal fold leukoplakia. Laryngoscope, 132:1641-1643, 2022.


Assuntos
Doenças do Esôfago , Doenças da Laringe , Doenças do Esôfago/patologia , Glicogênio , Humanos , Doenças da Laringe/complicações , Doenças da Laringe/diagnóstico , Leucoplasia/diagnóstico , Leucoplasia/patologia , Prega Vocal/patologia
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