CYP1A2*1C, CYP2E1*5B, and GSTM1 polymorphisms are predictors of risk and poor outcome in head and neck squamous cell carcinoma patients

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo comparativo das alterações celulares no líquen plano e no carcinoma epidermóide bucal

Atualmente, muito se discute a respeito da natureza pré-maligna do líquen plano bucal. OBJETIVO: O presente trabalho tem como objetivo analisar as alterações das células epiteliais presentes no líquen plano bucal, comparando-as com aquelas observadas no carcinoma epidermóide. MATERIAL E MÉTODO: Cortes histológicos de líquen plano bucal e carcinoma epidermóide, corados com hematoxilina-eosina, foram analisados por meio da microscopia de luz. RESULTADO: As alterações mais frequentemente observadas no líquen plano bucal foram aumento da relação núcleo/citoplasma (93,33%), espessamento da membrana nuclear (86,67%) e bi-ou multinucleação (86,67%). O teste t de Student (alfa=5%) revelou haver diferença estatisticamente significante entre o número médio de alterações celulares no líquen plano bucal (5,87±1,57) e no carcinoma epidermóide (7,60±1,81). Quanto aos tipos de alterações, o teste de qui-quadrado também revelou haver diferença estatisticamente significante entre as lesões avaliadas em relação às seguintes alterações celulares: hipercromatismo nuclear, mitoses atípicas, pleomorfismo celular e diferenciação celular anormal (p<0,05). CONCLUSÃO: Apesar de que, em alguns casos, alguns patologistas possam fazer confusão no diagnóstico histopatológico do líquen plano bucal, os resultados obtidos neste estudo mostram que as alterações presentes no líquen plano bucal diferem consideravelmente daquelas observadas no carcinoma epidermóide, evidenciando o quão distintas são estas duas doenças.

Evaluation of Staining Methods for Cytologic Diagnosis of Oral Lesions

ObjectiveTo compare the efficacy of Papanicolaou, hematoxylin-eosin (H-E), Leishman and periodic acid-Schiff (PAS) staining for Cytologic diagnosis of oral lesions.Study DesignPatients from the Discipline of Stomatology, Sao Jose dos Campos Dental School, from the wards of Hospital Heliopolis and from the dentistry outpatient clinic of the University Hospital, University of São Paulo Medical School, with the following diseases, were selected: erythematous candidiasis (n = 9), pseudomembranous candidiasis (n = 10), squamous cell carcinoma In = 19), herpes simplex (n = 8), paracoccidioidomycosis In = 8) and pemphigus vulgaris (n = 1).ResultsThe different staining methods were compared regarding the quality of definition of cytoplasmic and nuclear morphologic characteristics and the identification of bacteria, fungi, inflammatory cells and secretions. Papanicolaou and H-E staining were considered better methods. In cases of fungal infections, PAS staining is useful and should be applied as a complementary method.ConclusionWithin the limitations of this study, it can be concluded that the cytologic diagnosis of oral lesions along with different staining methods is a useful tool for oral diagnosis. (Acta Cytol 2008;52:697-701)

Surgical treatment of squamous cell carcinoma of tongue with carbon dioxide laser radiation (CO2)

In this clinical study, we proposed to observe the efficacy of the treatment of squamous cell carcinoma of the tongue (SCCT) by carbon dioxide (CO2) laser surgery. Twelve patients with SCCT were treated with excisional surgery using the CO2 laser with a spot size of 0.8 mm, 10 W, power density of 2.5 W/cm(2) in continuous mode, and under constant vacuum removal of the plume. The post surgical clinical evaluations were done every day until the sutures were removed and then every 7 days up to 1 month postoperatively. Subjects were re-examined quarterly until the fifth year post surgery. After 5 yr of follow-up for all subjects, there was no recurrence of the SCCT at the involved sites. The functional and aesthetic results observed were excellent. It is concluded that CO2 laser ablation of SCCT is an extremely useful surgical technique that can provide a clean field and is capable of providing surgical results consistent with accepted principles of oncological surgery. (C) 2012 Laser Institute of America.

Fluorescence spectroscopy for the detection of tongue carcinoma - validation in an animal model

The efficacy of fluorescence spectroscopy to detect squamous cell carcinoma is evaluated in an animal model following laser excitation at 442 and 532 nm. Lesions are chemically induced with a topical DMBA application at the left lateral tongue of Golden Syrian hamsters. The animals are investigated every 2 weeks after the 4th week of induction until a total of 26 weeks. The right lateral tongue of each animal is considered as a control site (normal contralateral tissue) and the induced lesions are analyzed as a set of points covering the entire clinically detectable area. Based on fluorescence spectral differences, four indices are determined to discriminate normal and carcinoma tissues, based on intraspectral analysis. The spectral data are also analyzed using a multivariate data analysis and the results are compared with histology as the diagnostic gold standard. The best result achieved is for blue excitation using the KNN (K-nearest neighbor, a interspectral analysis) algorithm with a sensitivity of 95.7% and a specificity of 91.6%. These high indices indicate that fluorescence spectroscopy may constitute a fast noninvasive auxiliary tool for diagnostic of cancer within the oral cavity. (C) 2008 Society of Photo-Optical Instrumentation Engineers.

Presence of Staphylococcus spp. and Candida spp. in the human oral cavity

A presença de leveduras do gênero Candida e Staphylococcus na cavidade bucal humana é de extrema importância, pois podem atuar como microbiota suplementar e em determinadas situações causar doença bucal ou sistêmica. O objetivo do presente trabalho foi estudar a prevalência de Candida spp. e Staphylococcus spp. na cavidade bucal humana. Enxagüe bucal foi coletado de 68 indivíduos segundo a técnica proposta por Samaranayake e MacFarlane e a seguir semeados em ágar Sabouraud dextrose com cloranfenicol e ágar Baird-Parker. Após crescimento, os microrganismos foram isolados e identificados através de provas bioquímicas. Os dados foram analisados através de análise de variância (ANOVA). Leveduras do gênero Candida foram encontradas em 61,76% dos indivíduos examinados, sendo C. albicans a mais frequentemente isolada. Staphylococcus spp. foram isolados em 95,60% das cavidades bucais, sendo 41 cepas (63%) coagulase-negativas. Das cepas coagulase-positivas, nove eram S. aureus, 11 S. hyicus, e quatro S. schleiferi subespécie coagulans. Não foi observada correlação entre as contagens (UFC) de Candida spp. e Staphylococcus spp. encontradas nos enxagües bucais dos indivíduos examinados.

Staphylococcus spp. in the oral cavity and periodontal pockets of chronic periodontitis patients

Staphylococcus spp. não são usualmente isolados a partir da cavidade bucal. Quando presentes, são considerados pertencentes à microbiota transitória. Indivíduos que apresentam doença periodontal representam possíveis reservatórios dessas bactérias oportunistas na cavidade bucal. O uso de antibióticos para o tratamento da doença periodontal ou outras infecções pode predispor o aumento do número de Staphylococcus spp. na boca, pois estes adquirem facilmente resistência aos antibióticos, podendo resultar em superinfecção. O objetivo deste estudo foi verificar a presença de Staphylococcus spp. na cavidade bucal e nas bolsas periodontais de pacientes com periodontite crônica; identificar as cepas isoladas; verificar a relação entre a presença de Staphylococcus spp. na cavidade bucal e presença de bolsa periodontal. Participaram deste estudo 88 pacientes, entre 25 e 60 anos de idade e apresentando periodontite crônica, com pelo menos dois sítios com profundidade de sondagem maior ou igual a 5mm. Após anamnese e exame clínico periodontal foram feitas coletas de material da bolsa periodontal com cones de papel e da cavidade bucal por meio de bochechos. do total de pacientes 37,50% apresentaram Staphylococcus spp. na bolsa periodontal e 61,36% na cavidade bucal, sendo que 27,27% apresentaram a bactéria nos 2 sítios. S. epidermidis foi a espécie mais prevalente para bolsa periodontal (15,9%) e cavidade bucal (27,27%). Não houve diferença estatística significante quanto à presença desses microrganismos entre as faixas etárias e aumento da profundidade de sondagem. A presença de bactérias oportunistas na cavidade bucal pode representar dificuldades para a manutenção do tratamento periodontal.

Effects of acetylsalicylic acid and acetic acid solutions on VX2 liver carcinoma in rabbits: in vivo analysis

OBJETIVO: Analisar os efeitos das soluções de aspirina e de ácido acético, in vivo, em fígado de coelhos portadores de tumor hepático VX2, verificando o efeito histolítico e anatomo-patológico das soluções e eventuais alterações bioquímicas hepáticas. MÉTODOS: Utilizou-se 48 coelhos, divididos em 2 protocolos experimentais(3 e 4), subdivididos em 3 grupos cada. Após 4 dias da implantação do tumor no fígado, procedeu-se a laparotomia mediana, com injeção de 0,4 ml da solução de aspirina (5,0%), de ácido acético (5,0%) e solução salina; o sacrifício ocorreu apos 24 horas (protocolo 3) e 11 dias (protocolo 4); avaliou-se o peso, evolução clinica, dosagens bioquímicas, cavidade abdominal e torácica e microscopia do fígado. RESULTADOS: Não foram observadas alterações na evolução clinica, peso e nas dosagens bioquímicas, apenas elevação da fosfatase alcalina no grupo controle do protocolo 4. Observamos desaparecimento do tumor em ambos os protocolos. CONCLUSÃO: As soluções de ácido acético e ácido acetilsalicílico acarretam destruição do tumor hepático experimental.

Immunohistochemical study of acinic cell carcinoma of minor salivary gland

Acinic cell carcinoma (ACC) is a rare salivary gland tumour, making up 4% of all minor salivary gland tumours. Typically, it is composed of acinic cells although transitional and duct-like cells are also identified. In the present study, a panel of antibodies was applied to eight minor salivary gland ACCs. Antibodies tested were: cytokeratins 7, 8, 13, 14, 18, 19, vimentin and actin (HHF35). Immunohistochemical staining revealed that cytokeratin 8, among the tested antibodies, was the more specific to neoplastic cells with a pattern of distribution quite variable and peculiar. This staining may be useful in the recognition of neoplastic acinic cells. (C) 1997 Elsevier B.V. Ltd.

Abnormal expression of bcl-2 and bax in rat tongue mucosa during the development of squamous cell carcinoma induced by 4-nitroquinoline 1-oxide

4-Nitroquinoline 1-oxide (4NQO)-induced rat tongue carcinogenesis is a useful model for studying oral squamous cell carcinoma. The aim of this study was to investigate the expression of bcl-2 and bax during tongue carcinogenesis induced by 4NQO. Male Wistar rats were distributed into three groups of 10 animals each and treated with 50 ppm 4NQO solution through their drinking water for 4, 12 or 20 weeks. Ten animals were used as negative control. Although no histological changes were induced in the epithelium after 4 weeks of carcinogen exposure, bcl-2 and bax were over-expressed (P < 0.01) in all layers of the 'normal' epithelium. The expression levels were the same in all layers of epithelium for both the antibodies used (bcl-2 or bax). In dysplastic lesions at 12 weeks following carcinogen administration, the levels of bcl-2 and bax expression did not increase when compared to negative control with the immunoreactivity for bcl-2 being restricted to the superficial layer of epithelium. In well-differentiated squamous cell carcinoma induced after 20 weeks of treatment with 4NQO, bcl-2 was expressed in some cells of tumour islands. on the other hand, immunostaining for bax was widely observed at the tumour nests. The labelling index for bcl-2 and bax showed an increase (P < 0.05) after only 4 weeks of 4NQO administration. In conclusion, our results suggest that abnormalities in the apoptosis pathways are associated with the development of persistent clones of mutated-epithelial cells in the oral mucosa. Bcl-2 and bax expression appears to be associated with a risk factor in the progression of oral cancer.

Computer-assisted analysis of cell proliferation markers in oral lesions

Abnormalities in any component of the cell cycle regulatory machine may result in oral. cancer, and markers of cell proliferation have been used to determine the prognosis of tumor progression. The aim of this study was to determine whether silver-stained nucleolar organizer region (AgNOR) and Ki-67 measurements could improve the assessment of growth rates in oral lesions. Eighty-three oral biopsies were studied, 20 of which were classified as fibrous inflammatory hyperplasia (FIH), 40 as leukoplakia (LKP) and 23 as oral. squamous cell carcinoma (OSCC). Within the LKP group, 22 out of 29 biopsies were diagnosed as non-dysplastic leukoplakia (LK) and 18 as dysplastic teukoptakia (DLK), presenting discrete, moderate and severe dysplasia. Ki-67 immunotabeting of the lesions increased steadily in the following order: FIH, DLK, LK and OSCC, indicating that Ki-67 is a good marker for predicting the protiferative fraction among benign, premalignant and malignant oral lesions. The median values of AgNOR parameters indicate that the morphometric index gives better results regarding the proliferative rate than the numerical one. A series of linear regressions between AgNOR parameters and Ki-67 showed positive associations. We conclude that a combination of Ki-67 and morphometric AgNOR analyses could be used as an aid in the determination of the protiferative status of oral epithelial. cells in oral cancer. (C) 2007 Elsevier GmbH. All rights reserved.

Oral health in renal transplant recipients administered cyclosporin A or tacrolimus

OBJECTIVE: the aim of this study was to determine the oral status of renal transplant recipients receiving cyclosporin A (CsA) or tacrolimus (FK-506) as immunosuppressant.SUBJECTS AND METHODS: A total of 88 renal transplant recipients receiving CsA (63 men and 25 women, mean age 51.4 years) and 67 receiving FK-506 (57 men and 10 women, mean age 33.5 years) were included in the study. Donor type, histocompatibility, cold ischemia time and prior delayed graft function were similar between the two groups. Demographics and pharmacological data were recorded for all subjects.RESULTS: the results demonstrated that CsA caused a greater number of oral diseases. A greater number of gingival overgrowth was present in patients treated with CsA. However, the combined use with calcium channel blockers increased the gingival overgrowth number. The occurrence of candida in saliva was observed in 80 renal recipients treated with CsA and 20 treated with FK-506. The presence of squamous oral carcinoma (n = 3) and herpes simplex (n = 10) was observed in patients treated with CsA. These alterations were not observed in renal recipients treated with FK-506.CONCLUSIONS: Renal recipients constitute a high-risk group for oral diseases, as they are immunocompromised. However, the FK-506 regime appears to ameliorate this effect, compared with CsA. Adequate pre- and post-transplant oral health care is recommended for these subjects, irrespective of the time interval for which the drug is administered.