Oral health related quality of life and determinant factors in patients with head and neck cancer.

BACKGROUND: The present study aimed to measure the impact of oral health on the quality of life of patients with head and neck cancer. MATERIAL AND METHODS: A cross-sectional study was conducted with 130 patients diagnosed with head and neck cancer at two medical centers. Participants answered a sociodemographic questionnaire and the Oral Health Impact Profile - 14 (OHIP-14). Clinical aspects, cancer staging, and treatment approach were also investigated. Mann-Whitney and Kruskal-Wallis non-parametric tests were used for statistical analysis, followed by Poisson regression analysis (with robust error variance), to associate the OHIP-14 scores with independent variables. RESULTS: The OHIP-14 presented good internal consistency (Cronbach's Alpha = 0.861). The mean score obtained was 19.52 (±11.79). Physical pain (3.70±2.44), physical disability (3.26±2.62) and functional limitation (3.24±2.45) were ranked as the main factors affecting the quality of life. Patients non-Caucasians (PR = 1.30; IC 95% = 1.07-1.58; p = 0.009), widowers (PR = 1.36; IC 95% = 1.13-1.64; p = 0.001), diagnosed with squamous cell carcinoma (PR = 1.28; IC 95% = 1.05-1.58; p = 0.017) and with temporomandibular pain (PR = 1.31; IC 95% = 1.08-1.60; p = 0.007) were more likely to exhibit lower rates of quality of life. CONCLUSIONS: The results showed a high impact of the oral health in the quality of life of patients with head and neck cancer was observed. Sociodemographic and clinical characteristics can exert influence on the quality of life of patients with head and neck cancer.

Identification of clonally rearranged T-cell receptor beta chain genes in HTLV-I carriers as a potential instrument for early detection of neoplasia.

We analyzed the genetic recombination pattern of the T-cell receptor beta-chain gene (TCR-beta) in order to identify clonal expansion of T-lymphocytes in 17 human T-lymphotropic virus type I (HTLV-I)-positive healthy carriers, 7 of them with abnormal features in the peripheral blood lymphocytes. Monoclonal or oligoclonal expansion of T-cells was detected in 5 of 7 HTLV-I-positive patients with abnormal lymphocytes and unconfirmed diagnosis by using PCR amplification of segments of TCR-beta gene, in a set of reactions that target 102 different variable (V) segments, covering all members of the 24 V families available in the gene bank, including the more recently identified segments of the Vbeta-5 and Vbeta-8 family and the two diversity beta segments. Southern blots, the gold standard method to detect T-lymphocyte clonality, were negative for all of these 7 patients, what highlights the low sensitivity of this method that requires a large amount of very high quality DNA. To evaluate the performance of PCR in the detection of clonality we also analyzed 18 leukemia patients, all of whom tested positive. Clonal expansion was not detected in any of the negative controls or healthy carriers without abnormal lymphocytes. In conclusion, PCR amplification of segments of rearranged TCR-beta is reliable and highly suitable for the detection of small populations of clonal T-cells in asymptomatic HTLV-I carriers who present abnormal peripheral blood lymphocytes providing an additional instrument for following up these patients with potentially higher risk of leukemia.

Identification of clonally rearranged T-cell receptor beta chain genes in HTLV-I carriers as a potential instrument for early detection of neoplasia

We analyzed the genetic recombination pattern of the T-cell receptor beta-chain gene (TCR-beta) in order to identify clonal expansion of T-lymphocytes in 17 human T-lymphotropic virus type I (HTLV-I)-positive healthy carriers, 7 of them with abnormal features in the peripheral blood lymphocytes. Monoclonal or oligoclonal expansion of T-cells was detected in 5 of 7 HTLV-I-positive patients with abnormal lymphocytes and unconfirmed diagnosis by using PCR amplification of segments of TCR-beta gene, in a set of reactions that target 102 different variable (V) segments, covering all members of the 24 V families available in the gene bank, including the more recently identified segments of the Vbeta-5 and Vbeta-8 family and the two diversity beta segments. Southern blots, the gold standard method to detect T-lymphocyte clonality, were negative for all of these 7 patients, what highlights the low sensitivity of this method that requires a large amount of very high quality DNA. To evaluate the performance of PCR in the detection of clonality we also analyzed 18 leukemia patients, all of whom tested positive. Clonal expansion was not detected in any of the negative controls or healthy carriers without abnormal lymphocytes. In conclusion, PCR amplification of segments of rearranged TCR-beta is reliable and highly suitable for the detection of small populations of clonal T-cells in asymptomatic HTLV-I carriers who present abnormal peripheral blood lymphocytes providing an additional instrument for following up these patients with potentially higher risk of leukemia.