RESUMO
OBJECTIVE: To determine the frequency of oral squamous cell carcinoma (OSCC) associated or not with oral potentially malignant disorders (OPMD), and the epidemiological profile and traditional risk factors in Latin America. METHODS: A retrospective observational study was conducted in 17 Latin American centres. There were included cases of OSCC, analysing age, gender, OSCC and their association with previous OPMD. Clinicopathological variables were retrieved. The condition of sequential-OSCC versus OSCC-de novo (OSCC-dn) was analysed concerning the aforementioned variables. Quantitative variables were analysed using Student's t-test, and qualitative variables with chi-square. RESULTS: In total, 2705 OSCC were included with a mean age of 62.8 years old. 55.8% were men. 53.75% of the patients were smokers and 38% were common drinkers. The lateral tongue border was the most affected site (24.65%). There were regional variations in OPMD, being leukoplakia the most frequent. Of the overall 2705 OSCC cases, 81.4% corresponded to OSCC-dn, while s-OSCC were 18.6%. Regarding lip vermillion SCC, 35.7% corresponded to de novo lip SCC and 64.3% were associated with previous OPMD. CONCLUSIONS: In Latin America, OSCC-dn seems to be more frequent with regional variations of some clinical and histopathological features. Further prospective studies are needed to analyse this phenomenon.
RESUMO
UNLABELLED: The activity of Nitric Oxide Synthase 2 (NOS2) was found in oral squamous cell carcinomas (OSCC) but not in normal mucosa. Molecular changes associated to early carcinogenesis have been found in mucosa near carcinomas, which is considered a model to study field cancerization. The aim of the present study is to analyze NOS2 expression at the histologically normal margins of OSCC. STUDY DESIGN: Eleven biopsy specimens of OSCC containing histologically normal margins (HNM) were analyzed. Ten biopsies of normal oral mucosa were used as controls. The activity of NOS2 was determined by immunohistochemistry. Salivary nitrate and nitrite as well as tobacco and alcohol consumption were also analyzed. The Chi-squared test was applied. RESULTS: Six out of the eleven HNM from carcinoma samples showed positive NOS2 activity whereas all the control group samples yielded negative (p=0.005). No statistically significant association between enzyme expression and tobacco and/or alcohol consumption and salivary nitrate and nitrite was found. CONCLUSION: NOS2 expression would be an additional evidence of alterations that may occur in a state of field cancerization before the appearance of potentially malignant morphological changes.
Assuntos
Carcinoma de Células Escamosas/enzimologia , Neoplasias Bucais/enzimologia , Óxido Nítrico Sintase Tipo II/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologiaRESUMO
OBJECTIVE: We compare the results of delay in oral cancer diagnosis before and after a campaign directed toward dentists and raising awareness of the population to achieve early diagnosis of oral cancer in Córdoba, Argentina. The campaign included training dentists in diagnostic skills and a public awareness program through media and networks. STUDY DESIGN: Clinical records (period 1: before intervention program, n = 70; period 2: after intervention program, n = 60) of patients presenting with oral squamous cell carcinoma treated in 2 referral centers were analyzed. Records included first symptoms, first consultation with a health professional, and the time when treatment was formulated. RESULTS: Oral cancer diagnosis at early stages increased from 27% (period 1) to 40% (period 2). Biopsy at first consultation was indicated in 6% of patients in period 1 and in 23.3% in period 2 (odds ratio = 4.68; 95% confidence interval, 1.87-11.73; P < .05). Professional delay at early stage decreased from 72% in period 1 to 36.8% in period 2. During period 1, for initial stage cancer, the average patient and professional delays were 2.7 and 2.9 months, respectively (P = .06); in period 2, patient delay was 2.67 months and professional delay was 1.34 months (P = .005). CONCLUSION: The intervention program helped to improve early-stage diagnosis from 27% to 40% by reducing professional delays.
Assuntos
Carcinoma de Células Escamosas , Neoplasias Bucais , Argentina , Carcinoma de Células Escamosas/diagnóstico , Detecção Precoce de Câncer , Humanos , Neoplasias Bucais/diagnóstico , Encaminhamento e ConsultaRESUMO
Oral squamous cell carcinoma (OSCC) is one of the most frequent types of oral cancer in developing countries and its burden correlates with exposure to tobacco and excessive alcohol consumption. Toll like receptors (TLRs) are major sensors of inflammatory stimuli, from both microbial and sterile causes and as such, they have been related to tumor progression and metastasis. Here, we evaluated the expression of TLR2, 4 and 9 as well as CD3+, CD8+ and Granzyme B+ cell infiltration by immunohistochemistry in oral samples of 30 patients with OSCC, classified according to their consumption of alcohol. Our findings indicate that there is a significant association between heavy alcohol consumption and tumors with higher expression levels of TLR9. Moreover, patients with TLR9high tumors, as well as those who indicated high consumption of alcohol exhibited a diminished overall survival. TCGA data analysis indicated that TLR9high tumors express a significant increase in some genes related with the oral cavity itself, inflammation and tumor promotion. Our analysis of tumor infiltrating leukocytes demonstrated that the major differences perceived in heavy alcohol consumers was the location of CD8+ T cells infiltrating the tumor, which showed lower numbers intratumorally. Our data suggest the existence of a pathogenic loop that involves alcohol consumption, high TLR9 expression and the immunophenotype, which might have a profound impact on the progression of the disease.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Carcinoma de Células Escamosas/metabolismo , Humanos , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço , Receptor Toll-Like 9RESUMO
UNLABELLED: Malignant neoplasm (MN) mortality worldwide ranks among the first four causes of death, in the 1990 decade (1-4). The aim of this work is to study the eight most frequent MN mortality rates, and especially that one caused by oral cancer (OC) in the province of Cordoba, Argentine Republic, in the period between 1975 and 2000, in order to analyze its characteristics and compare with other populations in America and Europe. MATERIAL AND METHODS: The data were provided by the provincial and national Health Ministry and Globocan 2000. RESULTS: The highest male rates were those of Slovakia and France, prevailing lung and bronchus tumors; whereas in females the highest rate was that of breast cancer in the United Kingdom and Germany, and lung cancer in the United States. Regarding to OC in the populations under study, Slovakia and France held the highest rates for both sexes, being Cordoba and Argentina among the lowest values, especially in women. Tongue was the most frequent site in Cordoba (43.5%), followed by salivary glands (23.7%). Male prevailed over female and the oldest ages were observed in the period 1995-2000. The mortality rates by MN in all sites increased 6.6% in both sexes, and by OC 77% in women within the period under study in Cordoba. Oral cancer is a serious problem for public health causing great morbidity and mortality, a situation that has not improved in decades. Mortality rates are an important tool towards implementation and planning of health policies and programs for cancer prevention.
Assuntos
Neoplasias Bucais/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: The Human Papillomavirus (HPV) has different strategies for persist in the cells. This characteristic has led us to consider the presence of the virus in tissues of the oral cavity that had no clinical signs of infection. The aim of this study was to detect the presence of DNA-HPV at multiple sites of the oral cavity. MATERIAL AND METHODS: A case-control study was designed: Oral Squamous Carcinoma Group (OSCG), healthy n=72 and Control Group (CG), n=72, healthy volunteers paired by sex and age with OSCG. Four samples were taken from OSCG: saliva, biopsy, brush scraping of lesion and contralateral healthy side. In CG a saliva sample and a scratch of the posterior border of tongue were collected. HPV was detected by PCR using Bioneer Accuprep genomic DNA Extraction kit, and consensus primers MY09 and MY11. Chi square test was applied. RESULTS: 432 samples were obtained from 144 individuals. DNA-HPV was detected in 30 (42%) of OSCG subjects and 3 (4%) of CG. Two or more positive samples were obtained in 67% of the OSCG, 67% in saliva and 60% in biopsy; in CG 100% of the individuals were positive in the two samples. CONCLUSIONS: HPV is frequently present in oral cavity as a multifocal infection, even without the presence of clinical lesions
No disponible
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Boca/virologia , Papillomaviridae/isolamento & purificação , DNA Viral/isolamento & purificação , Carcinoma de Células Escamosas/virologia , Neoplasias Bucais/virologia , Infecções por Papillomavirus/virologia , Estudos de Casos e Controles , Saliva/virologia , Fatores de Risco , Reação em Cadeia da PolimeraseRESUMO
To analyze the effect of two mouthwashes on salivary pH and correlate it with age, buffer capacity and saliva flow rate in healthy volunteers, a crossover phase IV clinical study involving three age-based groups was designed. Two commercial mouthwashes (MW), Cool Mint ListerineR (MWa) and Periobacter R (MWb) were used. The unstimulated saliva of each individual was first characterized by measuring flow rate, pH, and buffer capacity. Salivary pH was evaluated before rinsing with a given MW, immediately after rinsing, 5 minutes later, and then every 10 min (at 15, 25, 35 min) until the baseline pH was recovered. Paired t-test, ANOVA with a randomized block design, and Pearson correlation tests were used. Averages were 0.63 mL/min, 7.06, and 0.87 for flow rate, pH, and buffer capacity, respectively. An immediate significant increase in salivary pH was observed after rinsing, reaching average values of 7.24 (MWb) and 7.30 (MWa), which declined to an almost stable value 15 minutes. The great increase in salivary pH, after MW use shows that saliva is a dynamic system, and that the organism is capable of responding to a stimulus with changes in its composition. It is thus evident that pH of the external agent alone is not a good indicator for its erosive potential because biological systems tend to neutralize it. The results of this study enhance the importance of in vivo measurements and reinforce the concept of the protective action of saliva.
Assuntos
Antissépticos Bucais/farmacologia , Saliva/efeitos dos fármacos , Adulto , Soluções Tampão , Clorexidina/farmacologia , Estudos Cross-Over , Combinação de Medicamentos , Humanos , Concentração de Íons de Hidrogênio , Pessoa de Meia-Idade , Óleos Voláteis/farmacologia , Salicilatos/farmacologia , Saliva/metabolismo , Saliva/fisiologia , Taxa Secretória/efeitos dos fármacos , Terpenos/farmacologia , Fatores de Tempo , Adulto JovemRESUMO
La sífilis es una infección de transmisión sexual (ITS) curable, causada por una bacteria llamada Treponema pallidum. Es de transmisión sexual y vertical en el embarazo. Esta patología se presenta en diferentes estadios, y cada uno se manifiesta con lesiones bucales particulares. El objetivo del presente trabajo es caracterizar las diversas manifestaciones clínicas en el período secundario aportando con imágenes propias de la experiencia en la práctica diaria. Esta etapa secundaria se expresa con gran variabilidad y multiplicidad de lesiones, lo que desorienta y crea dificultades a lahora del diagnóstico. Es de interés también actualizar el conocimiento a los profesionales de la salud y al odontólogo general sobre las pruebas serológicas que lo ayudarán a complementar y confirmar el diagnóstico de certeza.
Syphilis is a curable sexually transmitted disease (STD), caused by a bacterium called Treponema pallidum.It is transmitted sexually and vertically in pregnancy. This pathology occurs in different stages, andeach of them manifests particular oral lesions.The objective of the present article is to characterize the various clinical manifestations in the secondary period contributing with images of the experience in daily practice. This secondary stage expresses great variability and multiplicity of lesions, which is disorienting and creates difficulties when it comes to diagnosis.It is also of interest to update the knowledge for health professionals and general dentists on the serological tests that will help to complement and confirm the firm diagnosis.
Assuntos
Masculino , Feminino , Humanos , Sorodiagnóstico da Sífilis , Sífilis/diagnóstico , Infecções Sexualmente Transmissíveis/classificação , Infecções Sexualmente Transmissíveis/diagnóstico , Manifestações Bucais , Treponema pallidum/patogenicidade , Sífilis/prevenção & controle , Sífilis/epidemiologiaRESUMO
The activity of Nitric Oxide Synthase 2 (NOS2) was found in oral squamous cell carcinomas (OSCC) but not in normal mucosa. Molecular changes associated to early carcinogenesis have been found in mucosa near carcinomas, which is considered a model to study field cancerization. The aim of the present study is to analyze NOS2 expression at the histologically normal margins of OSCC. Study DESIGN: Eleven biopsy specimens of OSCC containing histologically normal margins (HNM) were analyzed. Ten biopsies of normal oral mucosa were used as controls. The activity of NOS2 was determined by immunohistochemistry. Salivary nitrate and nitrite as well as tobacco and alcohol consumption were also analyzed. The Chi-squared test was applied. RESULTS: Six out of the eleven HNM from carcinoma samples showed positive NOS2 activity whereas all the control group samples yielded negative (p = 0.005). No statistically significant association between enzyme expression and tobacco and/or alcohol consumption and salivary nitrate and nitrite was found. CONCLUSIONS: NOS2 expression would be an additional evidence of alterations that may occur in a state of field cancerization before the appearance of potentially malignant morphological changes
Assuntos
Humanos , Óxido Nítrico Sintase Tipo II/análise , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Invasividade Neoplásica/patologia , Biomarcadores Tumorais/análise , Recidiva Local de Neoplasia/prevenção & controleRESUMO
Etários de adultos voluntarios sanos, para analizar el efecto de dos colutorios sobre el pH salival y relacionarlo con la edad la capacidad buffer y el flujo salival. Se utilizaron dos marcascomerciales de colutorios (MW), ListerineCoolMint® (MWa) y eriobacter® (MWb). Primero se caracterizó la saliva sin estimular de cada individuo, se le midió el volumen minuto, el pH y la capacidad buffer. El pH salival se evaluó antes del buche con cada MW, inmediatamente después del enjuague bucal, 5 minutos después y luego cada 10 minutos (a los 15,25, 35 min) hasta que el pH inicial se recuperó. Para el análisis estadístico de los datos se utilizaron: ANOVA en bloque,test t apareado y el test de correlación de Pearson. Al caracterizar la saliva, se obtuvieron los siguientes valores promedio: 0.63 mL/min, 7.06 y 0.87 de volumen minuto,pH, y capacidadbuffer. Luego del enjuague se observó un incremento inmediato y significativo del pH salival alcanzando valores de 7.24 (MWb) y 7.30 (MWa) para descender a un valor estable luegode 15 minutos. El importante incremento del pH salival luego del uso del colutorio, muestra que la saliva es un sistema dinámico y que el organismo es capaz de responder a estímulos con cambios en su composición. Se hace evidente que el pH del agente externo, no es un buen indicador de su potencialerosivo sobre los elementos dentarios ya que los sistemas biológicos tienden a neutralizarlo. Los presentes resultadosponen de manifiesto la importancia de las mediciones en vivo y refuerzan el concepto de la función protectora de la saliva...
Assuntos
Humanos , Masculino , Adulto , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Antissépticos Bucais/farmacologia , Erosão Dentária/diagnóstico , Concentração de Íons de Hidrogênio , Saliva/química , Análise de Variância , Erosão Dentária/etiologia , Fatores de RiscoRESUMO
The aim of the present paper was to evaluate the effect of fenticonazole and to compare it with that of ketoconazole and nystatin in the topical treatment of oral chronic candidosis. Eighty patients diagnosed with erythematous chronic candidosis were divided into four groups, according to the cream they were provided with 3% fenticonazole, 2% fenticonazole, 100000UI nystatin, and 2% ketoconazole in orabase respectively. A clinical assessment was made at 7, 15, 30 and 45 days. Fifty-one of them finished the trial. ANOVA, Kruskall Wallis and Wilcoxon tests were applied for statistical analysis. There was a significative decrease of the oral lesions in all groups (p 0.0001). The remission grade was also analysed according to the localisation: lesions in the buccal mucosa and in the comissure all the patients achieved complete resolution, whereas tongue and palate lesions showed a significative decrease in all the treatments (p 0.00001). Fenticonazole proved to be as effective as nystatin and ketoconazole in topical treatment of oral candidosis.
Assuntos
Antifúngicos/uso terapêutico , Candidíase Bucal/tratamento farmacológico , Imidazóis/uso terapêutico , Cetoconazol/uso terapêutico , Nistatina/uso terapêutico , Administração Tópica , Análise de Variância , Doença Crônica , Método Duplo-Cego , Feminino , Humanos , MasculinoRESUMO
A nivel mundial la mortalidad por neoplasias malignas (NM), figura entre las cuatro primeras causas de muerte en la década del 90 (1-4). El objetivo del presente trabajo, es estudiar la tasa de mortalidad por las ocho NM más frecuentes y especialmente por cáncer bucal (CB) en la provincia de Córdoba, República Argentina en el período 1975-2000, analizar sus características y compararla con la de otras poblaciones de América y Europa. Material y Métodos: los datos se obtuvieron del Ministerio de Salud de Córdoba y Argentina y de Globocan 2000. Resultados: en el sexo masculino se observó que los países con más alta tasa fueron Eslovaquia y Francia, siendo los Tumores más prevalentes los de pulmón y bronquios. En las mujeres el Reino Unido, Alemania y EEUU fueron los países con tasa más alta y el Tumor más frecuente fue el de mama, excepto en EEUU donde el de pulmón lo antecede. En relación al CB en las poblaciones estudiadas, Eslovaquia y Francia fueron los países con tasa más alta para ambos sexos, estando los valores de Córdoba y Argentina entre los más bajos, especialmente en mujeres. En Córdoba la lengua fue el sitio más frecuente (43,5%), seguido de glándulas salivales mayores (23,7%); predominó el sexo masculino y las edades promedio más altas se observaron en el período 1995-2000. Al analizar el comportamiento de las tasas de mortalidad se destacó que las NM en ambos sexos en Córdoba aumentaron el 6,6%, y la mortalidad por CB en mujeres se incrementó un 77% en el período estudiado. El CB es un serio problema de salud pública que causa gran morbilidad y mortalidad no habiendo mejorado en décadas. Las tasas de mortalidad son un instrumento importante para la diagramación de políticas y programas de salud orientados a la prevención del cáncer
Malignant neoplasm (MN) mortality worldwide ranks among the first four causes of death, in the 1990 decade (1-4). The aim of this work is to study the eight most frequent MN mortality rates, and especially that one caused by oral cancer (OC) in the province of Cordoba, Argentine Republic, in the period between 1975 and 2000, in order to analyze its characteristics and compare with other populations in America and Europe. Material and Methods: The data were provided by the provincial and national Health Ministry and Globocan 2000. Results: The highest male rates were those of Slovakia and France, prevailing lung and bronchus tumors; whereas in females the highest rate was that of breast cancer in the United Kingdom and Germany, and lung cancer in the United States. Regarding to OC in the populations under study, Slovakia and France held the highest rates for both sexes, being Cordoba and Argentina among the lowest values, especially in women. Tongue was the most frequent site in Cordoba (43.5%), followed by salivary glands (23.7%). Male prevailed over female and the oldest ages were observed in the period 1995-2000. The mortality rates by MN in all sites increased 6.6% in both sexes, and by OC 77% in women within the period under study in Cordoba. Oral cancer is a serious problem for public health causing great morbidity and mortality, a situation that has not improved in decades. Mortality rates are an important tool towards implementation and planning of health policies and programs for cancer prevention
Assuntos
Masculino , Feminino , Adulto , Idoso , Pessoa de Meia-Idade , Humanos , Neoplasias Bucais/mortalidade , Argentina/epidemiologia , Europa (Continente)/epidemiologia , Estados Unidos/epidemiologiaRESUMO
El objetivo del presente trabajo fue evaluar el efecto del fenticonazol en el tratamiento tópico de las candidosis crónicas bucales y compararlo con el del ketoconazol y la nistatina. Se incluyeron ochenta pacientes con candidosis crónica eritematosa, de los cuales cincuenta y uno finalizaron la prueba. Fueron divididos en cuatro grupos a los cuales se les administró: fenticonazol al 3 por ciento, fenticonazol al 2 por ciento, nistatina 100000 UI y ketoconazol al 2 por ciento, en orabase respectivamente. Se los controló a los 7, 15, 30 y 45 días. Los datos obtenidos se analizaron estadísticamente con el ANAVA y los test de Kruskall Wallis y Wilcoxon. Se encontró una disminución de las lesiones altamente significativa en todos los grupos de pacientes (p 0,0001). Se analizó el grado de remisión según la localización de las lesiones; se encontró que en todos los pacientes las localizadas en mucosa yugal y comisura alcanzaron la remisión total, mientras que las lesiones de lengua y paladar mostraron una disminución significativa de la intensidad de las mismas (p 0,00001) con todos los tratamientos. El fenticonazol demostró ser tan efectivo como la nistatina y el ketoconazol en el tratamiento tópico de las candidosis orales (AU)
Assuntos
Adolescente , Adulto , Feminino , Masculino , Pessoa de Meia-Idade , Humanos , Candidíase Bucal/diagnóstico , Candidíase Bucal/tratamento farmacológico , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Administração Tópica , Cetoconazol/administração & dosagem , Cetoconazol/uso terapêutico , Nistatina/administração & dosagem , Nistatina/uso terapêutico , Imidazóis/administração & dosagem , Imidazóis/uso terapêutico , Queilite/complicações , Queilite/diagnóstico , Boca/lesões , Boca/patologia , Língua/lesões , Língua/patologia , Doenças da Língua/patologia , Microscopia/métodosRESUMO
To analyze the effect of two mouthwashes on salivary pH and correlate it with age, buffer capacity and saliva flow rate in healthy volunteers, a crossover phase IV clinical study involving three age-based groups was designed. Two commercial mouthwashes (MW), Cool Mint ListerineR (MWa) and Periobacter R (MWb) were used. The unstimulated saliva of each individual was first characterized by measuring flow rate, pH, and buffer capacity. Salivary pH was evaluated before rinsing with a given MW, immediately after rinsing, 5 minutes later, and then every 10 min (at 15, 25, 35 min) until the baseline pH was recovered. Paired t-test, ANOVA with a randomized block design, and Pearson correlation tests were used. Averages were 0.63 mL/min, 7.06, and 0.87 for flow rate, pH, and buffer capacity, respectively. An immediate significant increase in salivary pH was observed after rinsing, reaching average values of 7.24 (MWb) and 7.30 (MWa), which declined to an almost stable value 15 minutes. The great increase in salivary pH, after MW use shows that saliva is a dynamic system, and that the organism is capable of responding to a stimulus with changes in its composition. It is thus evident that pH of the external agent alone is not a good indicator for its erosive potential because biological systems tend to neutralize it. The results of this study enhance the importance of in vivo measurements and reinforce the concept of the protective action of saliva.