Expressão de mastócitos em quelite actínica e carcinoma epidermóide de lábio inferior

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo imunoistoquímico da queilite actínica, carcinoma epidermóide de lábio e carcinoma epidermóide intrabucal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo Imuno-histoquímico da Quelite Actínica, Carcinoma Epidermoide de Lábio e Carcinoma Epidermoide de Língua

Pós-graduação em Odontologia Restauradora - ICT

Expressão de HER-1 e HER-2 totais e fosforilados em queilite actínica e carcinoma epidermóide de lábio inferior

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise de queilite actínica por espectroscopia micro FT-IR

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Expressão de apoptose e óxido nítrico sintase indutiva em queilites actínicas e carcinomas espinocelulares do lábio inferior: correlação clínica, histológica e imunoistoquímica

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Análise da proteína EGFR em carcinoma espinocelular de lábio

Pós-graduação em Biopatologia Bucal - ICT

Estudo clínico-histológico da quelite actímica crônica tratada por dois protocolos de laser de CO2 de baixa morbidade

Objetivo: Este ensaio clínico-histológico teve por meta avaliar a resposta terapêutica de dois protocolos de reconhecida baixa morbidade em passagem única. Métodos: Pacientes com queilite actínica crônica multicêntrica (n=40) comprovada pela microscopia foram randomicamente submetidos a dois protocolos de laser de CO2 pulsátil através de modelo comparativo bilateral (protocolo de pulsos de 350 mJ, 3,5 W, amplitude de 0,1s versus protocolo de pulsos de 250 mJ, 5 W, amplitude de 0,05s). Realizou-se em 26 pacientes análise comparativa dos níveis de atipia epitelial de espécimes de biópsia entre o status quo e o período pós-operatório de ambos os protocolos e entre si. Foram avaliados outros fenômenos do espectro da doença. Resultados: Houve presença clínica pós-operatória de lesões em 10% dos pacientes para cada protocolo e uma significante redução dos níveis de atipia epitelial (p<0,001), por vezes completa. Conclusão: Não houve diferença de resultados entre os protocolos estudados (p> 0,05).

Queilitis actínica tratada con imiquimod 5%

Los inmunomoduladores tópicos han demostrado utilidad en las enfermedades orales inflamatorias resistentes a corticoesteroides tópicos, en enfermedades sistémicas con mucosa oral primeramente comprometida y en lesiones severas que involucren la mucosa oral. La queilitis actínica es una lesión potencialmente maligna, con riesgo de progresar a Carcinoma espinocelular, por ello es necesario su tratamiento temprano.

Análise comparativa da imunoexpressão do IMP-3 e Ki-67 em queilites actínicas e carcinoma epidermóide de lábio inferior

Epithelial changes observed in actinic cheilitis (AC) and squamous cell carcinoma of the lower lip (LLSCC) are mainly caused by chronic exposure to ultraviolet rays (UV) and are studied using different immunohistochemical markers trying to evaluate the process of carcinogenesis. The objective of this study was to comparatively evaluate the expression of Ki-67 proteins and IMP-3 in AC and LLSCC to contribute with additional information on carcinogenesis in lower lip. A total of 33 cases of AC and 33 cases of LLSCC were studied, analyzed the clinical and pathological features and immunostaining of Ki-67 and IMP-3. Immunohistochemical analysis of Ki-67 was made through the determination of the proliferation index (PI) and subsequent classification of the cases according to the scores: 0 (0% positive cells) +1 (≤30%) + 2 (> 30% and ≤60%) and +3 (> 60%). For statistical tests cases were classified as unmarked (score 0), low expression (score +1) and high expression (scores +2 and +3). For the expression of IMP-3, the percentage of immunostained epithelial cells was established, and assigned scores: 0 (corresponding to 0%), +1 (up to 30% of positive cells); +2 (From 30% to 60% of immunostained cells) and +3 (over 60% of positive cells). Statistical tests chi-square test, Mann-Whitney and Wilcoxon were used. The significance level was 5%. Most AC chaos was male (78.8%) with mean age of 50 years and cases of LLSCC also were male (69.89%) with an average of 62 years. The Ki-67 was expressed in all cases of AC and in cases of LLSCC, predominantly in the two injuries the score 2, corresponding to 81.8% of cases in ACs and 54.5% in the CELI. The expression of IMP-3 in ACs occurred in 72.7% of cases, predominantly in 36.3% of LLSCC cases score 1. Already in the IMP-3 was expressed in 60.6% of cases, especially in 27.3% of the score of the cases 3. These results allow us to conclude that the expression of IMP3 and proliferative activity are early events in carcinogenesis independently lower lip state of change.

Queilite actínica: expressão imuno-histoquímica da cox-2 e avaliação do diclofenaco sódico gel como uma terapia alternativa

Actinic cheilitis (AC) is a potentially malignant disorder which affects the lip vermilion and results from chronic exposure to sunlight. Currently, it is not possible to predict which cases of AC may progress to squamous cell carcinoma, and therefore, some biomolecular markers have been researched. Cyclooxygenase 2 (COX-2) is an enzyme associated with inflammatory response which is overexpressed in oral cancer; however, little is known about the role of this protein in actinic cheilitis. About the treatment of this lesion, currently available therapeutic modalities to AC may cause cytotoxic effects and deleterious results to patients. Therefore, the aim of this study was to evaluate the immunoexpression of COX-2 in AC of different risks of malignant transformation and analyse, through clinical follow-up, the efficacy of diclofenac sodium 3% gel in the treatment of this condition. Epithelial immunoexpression of COX-2 was analysed semi-quantitatively in 90 cases of AC classified as low risk (n = 55) and high risk (n = 35) of malignant transformation, in which the scores were assigned: (0) 0 to 5% of positive cells - Negative; (1) 6 to 30% of positive cells - Low expression; (2) 31 to 100% of positive cells - High expression. The chi-square test of Pearson was conducted to verify possible associations between immunoexpression of COX-2 and histologic grade of actinic cheilitis. The weighted kappa coefficient denoted a good interobserver agreement (0.677). Nineteen patients diagnosed with AC were instructed to perform topical application of the gel three times a day for a period of 90 days. In each biweekly visit, a follow-up record was accomplished through digital photographs and after treatment was completed, two researchers analysed all the images to assess clinical aspects of the lip. Furthermore, tolerability to the drug and patient satisfaction after treatment were evaluated. COX-2 was overexpressed in 74.4% of AC cases. Both low and high-risk groups revealed predominance of score 3, followed by scores 2 and 1. There was no significant association (p = 0.315) between COX-2 expression and histological grading. Among the total number of participants of this clinical study, ten showed total remission of all clinical features of the lesion and three had partial improvement of these characteristics. One participant presented worsening of the clinical condition. In five cases, the treatment was discontinued due to development of mild adverse effects at the site of gel application. Regarding analysis of satisfaction and tolerability to the drug, most patients were fully satisfied with the therapy (n = 11) and reported that the drug was not irritating to the lips (n = 9). Our study demonstrates that high expression of COX-2 is common in AC; however, this protein was not associated with malignant transformation risk of the analysed cases. Topical application of diclofenac sodium 3% gel provided a convenient and well tolerated approach in most cases, and may be a promising alternative for the treatment of actinic cheilitis.

Lesões orais com potencial de malignização: análise clínica e morfológica de 205 casos

Silveira , E. J. D. et al. Lesões orais com potencial de malignização: análise clínica e morfológica de 205 casos. J. Bras. Patol. Med. Lab., v. 45, n. 3, p. 233-238, jun 2009. ISBN 1676-2444.

Lesões orais com potencial de malignização: análise clínica e morfológica de 205 casos

Silveira , E. J. D. et al. Lesões orais com potencial de malignização: análise clínica e morfológica de 205 casos. J. Bras. Patol. Med. Lab., v. 45, n. 3, p. 233-238, jun 2009. ISBN 1676-2444.

Markers of cutaneous human papillomavirus infection in individuals with tumor-free skin, actinic keratoses, and squamous cell carcinoma

Separately, actinic keratosis (AK) and cutaneous squamous cell carcinoma (SCC) have been associated with cutaneous human papillomavirus (HPV) infections. To further explore the association between HPV infection and SCC development, we determined markers of cutaneous HPV infection within a single population in persons with precursor lesions (AK), cancerous lesions (SCC), and without. Serum and plucked eyebrow hairs were collected from 57 tumor-free controls, 126 AK, and 64 SCC cases. Presence of HPV L1 and E6 seroreactivity and viral DNA were determined for HPV types 5, 8, 15, 16, 20, 24, and 38. Significant positive associations with increasing severity of the lesions (controls, AK, and SCC, respectively) were observed for overall HPV L1 seropositivity (13%, 26%, and 37%) and for HPV8 (4%, 17%, and 30%). In parallel, the proportion of L1 seropositive individuals against multiple HPV types increased from 14% to 39% and 45%. The overall E6 seroreactivity, however, tended to decline with AK and SCC, especially for HPV8 (21%, 11%, and 2%). HPV DNA positivity was most prevalent in the AK cases (54%) compared with the SCC cases (44%) and the tumor-free controls (40%). Among all participants, there was a positive trend between overall HPV DNA positivity and L1 seropositivity, but not E6 seropositivity. Taken together, our data suggest that cutaneous HPV infections accompanied by detectable HPV DNA in eyebrow hairs and HPV L1 seropositivity, but not E6 seropositivity, are associated with an increased risk of AK and SCC.

Teledermatology: Its use in the detection and management of actinic keratosis

Teledermatology can profoundly improve access to medical services for those who may have limited access to dermatology due to workforce shortages, distance to providers, or limitations in their mobility. Two common ways of teledermatology are differentiated: life synchronous, where patient and doctor communicate directly, or store and forward asynchronous methods, where the patient and doctor provide and assess the medical information independently. Teledermatology has been tested for its safety, feasibility and accuracy for a number of dermatological conditions, including the early detection of skin cancer and is usually safe, feasible and accurate. Studies reported somewhat better results for synchronous than asynchronous methods, possibly because of loss of information if no direct patient doctor contact is feasible. However asynchronous methods are easier to organize, require less sophisticated technology and are more widely accessible, and are more convenient for both patients and doctors. No study to date focused solely on teledermatology of actinic keratosis, but such lesions are typically found during teledermatology examinations for other main target lesions. In studies where such results were reported, actinic keratoses seemed to be readily identifiable for teledermatologists and adequate management and treatment can be suggested within remote consultations.