Clarissa Araújo Silva Gurgel

Activation of sonic hedgehog signaling in oral squamous cell carcinomas: A preliminary study

Sonic hedgehog signaling is important for human development, and aberrant regulation of this pathway can result in the development of tumors. The aim of this study was to examine the expression of sonic hedgehog signaling molecules in oral squamous cell carcinoma. By quantitative real-time polymerase chain reaction, the expression of SHH, SMO, PTCH-1, and GLI-1 was analyzed in 30 oral squamous cell carcinoma cases and 8 samples of nonneoplastic oral mucosa and associated to clinical pathologic features. The expression of β-catenin, cyclin D1, Wnt-1, and Egfr was evaluated by immunohistochemistry in 26 available cases of oral squamous cell carcinoma. Normal oral mucosa from healthy individuals was negative for all genes that were evaluated. SHH, PTCH-1, SMO, and GLI-1 were not expressed in nonneoplastic oral mucosa, and low levels of GLI-1 were observed in nonneoplastic oral mucosa that was adjacent to the tumor. All oral squamous cell carcinoma cases expressed high levels of PTCH-1, SMO, and GLI-1 and were devoid of SHH. The expression of SMO was associated with clinical stage (P = .022) and a borderline association in cervical lymph node metastasis (P = .053). PTCH-1 expression showed a strong correlation with SMO (rs = 0.64; P < .001) and GL-1 (rs = 0.70; P < .001); SMO and GLI-1 also correlated with each other (rs, 0.55; P < .001). All proteins evaluated were expressed as cyclin D1 (92% of samples), β-catenin (73%), Egfr (46%), or Wnt-1 (32%). Our data demonstrate that sonic hedgehog signaling is activated in oral squamous cell carcinoma and suggest that this pathway mediates its tumorigenesis.

Altered expression of cytokeratins in primary, recurrent and syndrome keratocystic odontogenic tumors.

Keratocystic odontogenic tumor (KOT) is a benign cystic tumor that affects the jaw bones and may be associated with the nevoid basal cell carcinoma syndrome (NBCCS). Twenty-five cases diagnosed as KOT, including primary and recurrent tumors and those associated with NBCCS, were submitted to immunohistochemical study for analysis of cytokeratins (CKs) 7, 8, 10, 13, 14, 18 and 19. The results showed CK13 immunostained on the intermediate layers and upper cells. CK14 was expressed in all epithelial layers and in those areas where inflammation and subepithelial splits were present; this protein was preserved within the basal cells. CK 18 was expressed mainly in the basal layer, whereas CK19 was expressed mainly on the intermediate and superficial layers. The remaining CKs tested were not immuoreactive. The status of maturation of cytokeratin seems to be altered on KOTs, and this is not distinct when different tumors are compared.

Oral mucoceles: A clinical, histopathological and immunohistochemical study

The aim of study was to evaluate the clinicopathological features of oral mucoceles and the immunohistochemical expression of cellular and extracellular matrix components in these lesions. One hundred cases of oral mucoceles were examined for clinicopathological features. The expression of mast cell tryptase, CD68, MMP-1 (matrix metalloproteinase-1), MMP-9 (matrix metalloproteinase-9) and CD34 was investigated immunohistochemically in 32 cases. The lesions arose as nodules or blisters of variable color. The mean age was 23.2 years and a higher male frequency was observed. The most common locations were the lower lip (92%), followed by the floor of the mouth (7%), and palate (1%). The lesion size ranged from 0.4 to 3.0cm. Unusual histopathological findings as superficial mucoceles (n=16, 16%), pseudopapillary projections (n=3, 3%), epithelioid histiocytes (n=4, 4%), multinucleated giant cells (n=1, 1%) and myxoglobulosis (n=9, 9%) were also seen. Mast cells and CD68-positive macrophages, MMP-1, MMP-9 and CD34-positive blood vessels were seen in all cases. A significant association was seen between mast cells and MMP-1 (p=0.03) and between macrophages and MMP-1 (p=0.01). This study provided important insight into the demographic and histopathological occurrence of oral mucoceles. The tissue remodeling seen in these lesions mainly involved the migration and interaction of mast cells, macrophages and MMP-1.

Immunohistochemical assessment of CD1a-positive Langerhans cells and their relationship with E-cadherin in minor salivary gland tumors.

OBJECTIVE The aim of this study was to investigate the presence of CD1a-positive Langerhans cells and their relationship with E-cadherin in minor salivary gland tumors. METHODS Twenty-seven minor salivary gland tumors were investigated using immunohistochemistry for CD1a and E-cadherin. RESULTS A significant difference regarding the mean density of CD1a-positive Langerhans cells was observed between pleomorphic adenomas and malignant tumors studied (P = 0.001). No CD1a-positive cells were detected in most cases (n = 5) of cystic adenoid carcinomas. CD1a-positive cells were detected in one mucoepidermoid carcinoma case, and six low-grade polymorphous adenocarcinomas cases. Comparison of the mean density of CD1a-positive cells between the three malignant tumors showed no significant difference (P = 0.127). No significant difference was observed in the presence of E-cadherin between tumors (P = 0.73), but it was detected in 24 cases. CONCLUSIONS The lack of CD1a-positive in malignant salivary gland tumors facilitates the neoplastic development and suggests that these cells might be useful as auxiliary diagnostic and prognostic tool in minor salivary gland tumors. Furthermore, it is suggested that E-cadherin mediates cell adhesion in these tumors although we did not demonstrate significance.

Tumor-Infiltrating Macrophage and Microvessel Density in Oral Squamous Cell Carcinoma

Tumor-associated macrophages (TAM) are the main cellular component in stroma of many tumors and participate in tumor angiogenesis. The aim of present study was to compare the microvascular density (MVD) and infiltrating macrophage density (IMD) in oral squamous cell carcinomas (OSCCs) with different histological grades. A histomorphometric analysis was performed after immunohistochemistry using antibodies such as von-Willebrand factor and CD68. A significant difference in MVD was found between well and moderately differentiated OSCCs (p<0.05). TAM were largely present in all studied tumors and the IMD was not different among OSCCs with different histological grades (p=0.381). Significant correlation between MVD and IMD was not observed (p=0.870). In conclusion, these results suggest that TAM and angiogenesis have an influence at different histological grades of OSCC. However, the lack of correlation between MVD and IMD could suggest that angiogenesis does not depend on the number of macrophages present in OSCC, but their predominant phenotype. Further studies involving distinct phenotypes of macrophages should be done to better understand the influence of TAM on the tumor angiogenesis.

Evaluation of the Effects of Polarized Light (λ400–200 nm) on the Healing of Third-Degree Burns in Induced Diabetic and Nondiabetic Rats

OBJECTIVE The study evaluated, by light microscopy, the repair process on third-degree burns on diabetic and nondiabetic rats, illuminated or not, with a polarized light (PL) source. BACKGROUND DATA Burns are severe injuries that result in the loss of fluid and destruction of tissue, infection, and shock that may result in death. Diabetes mellitus is a public health problem that, being uncontrolled, causes severe disturbance to the body metabolism, including on wound healing. PL sources have been shown to be effective in improving healing in many situations. MATERIALS AND METHODS Ninety male Wistar rats were divided into two groups (n=45): nondiabetic and diabetic. In one of the groups, diabetes mellitus was induced by streptozotocin. A third-degree burn, measuring 1.5×1.5 cm(2), was created in the dorsum of each animal. Phototherapy (λ400-2000 nm, 10.2 or 20.4 J/cm(2)) started immediately after burning and was repeated daily until animal death (7, 14, and 21 days). Specimens were taken, processed, and stained with H&E and Sirius red and immunomarked with cytokeratin (CK) AE1/AE3. Descriptive analysis was performed by light microscopy. RESULTS Animals subjected to phototherapy showed an acceleration of the repair, the dose of 10.2 J/cm(2) being the one that caused best results, including higher deposition of collagen, quicker inflammatory reaction, and improved revascularization. CONCLUSIONS Our results suggest that the use of PL (10.2 J/cm(2)) improves the healing of third-degree burns on both diabetic and nondiabetic animals.

Polarized light (λ400-2000 nm) on third-degree burns in diabetic rats: immunohistochemical study.

AIM The aim of this study was to evaluate with light microscopy the healing process of third-degree burns on diabetic rats treated with polarized light (λ400-2000 nm, 20 or 40 J/cm(2)/session, 40 mW/cm(2), 2.4 J/cm(2)/min, 5.5-cm beam diameter). BACKGROUND Uncontrolled diabetes mellitus causes severe disruption of the bodys metabolism, including healing. Polarized light sources have been shown to be effective in improving healing in many situations. ANIMALS AND METHODS Diabetes mellitus was induced with streptozotocin (60 mg/kg) in 45 male Wistar albino rats, and a third-degree burn (1.5 by 1.5 cm) was created on the dorsum of each animal under general anesthesia. The animals were randomly distributed into three groups: control, 20 J/cm(2), and 40 J/cm(2). Each group was then divided into three subgroups based on time of death (7, 14, 21 d). Phototherapy (20 or 40 J/cm(2) per session) was carried out immediately after the burning and repeated daily until the day before death. Following animal death, specimens were removed, embedded in paraffin, sectioned, and stained with hematoxylin and eosin (HE) or Sirius Red or immunomarked with CK AE1/AE3 antibody. Qualitative and semiquantitative analyses were performed under light microscopy. The results were statistically analyzed. RESULTS The animals treated with 20 J/cm(2) showed significant differences with regard to revascularization and re-epithelialization. Although the 40 J/cm(2) group showed stimulation of fibroblastic proliferation as an isolated feature, no other difference from the control was observed. CONCLUSION Our results suggest that the use of polarized light at 20 J/cm(2) effectively improves the healing of third-degree burns on diabetic animals at both early and late stages of repair.

Immunolocalisation of laminin-1 in keratocystic odontogenic tumors

Keratocystic odontogenic tumors (KOTs) are distinct odontogenic lesions frequently affecting the jawbones. They may be associated with nevoid basal cell carcinoma syndrome (NBCCS), and may exhibit disorders involving the extracellular matrix. The aim of this study was to investigate the immunolocalisation of laminin-1 in 20 cases of KOTs in order to contribute to the characterization of this protein, which is little studied in odontogenic tumors. Our results showed laminin-1 in all 20 KOTs studied; its labelling intensity was weak in three cases (15%), moderate in five (25%) and strong in 12 cases (60%). Laminin-1 immunolocalisation was predominantly continuous in 18 (90%) KOTs, including areas of acanthosis, subepithelial split and epithelial buds. Weak immunolabelling was observed in regions exhibiting an inflammatory process, especially in the case of intense inflammation. These findings suggest that laminin-1 does not participate in biological processes such as cystic epithelium-cystic wall separation or the formation of epithelial islands in KOTs. Furthermore, the discontinuous and weak labelling of this protein in the basement membrane of these tumors is probably a consequence of the inflammatory process in the tumor stroma.

Density of Langerhans cells in the keratocystic odontogenic tumor

INTRODUCTION: Keratocystic odontogenic tumors (KOTs) are distinct odontogenic lesions commonly affecting the mandible bones. Langerhans cells (LCs) are specialized dendritic cells responsible for the presentation of antigens to T lymphocytes in mucosal and cutaneous surfaces. OBJECTIVE: This study analyzed the immunohistochemical expression of LCs in KOTs. MATERIALS AND METHODS: Fifteen cases of KOTs were studied using the anti-CD1a marker. Results: LCs were observed in all 15 cases analyzed. They were found to be concentrated in areas of cystic epithelial hyperplasia, mainly in those areas presenting higher concentration of inflammatory cells. Furthermore, a significant association between the number of LCs and areas of cystic epithelium presenting hyperplasia (Mann-Whitney test, p = 0.0223) was observed. The shape and location of these cells in KOTs epithelium were variable. CONCLUSION: The lower number of LCs observed on atrophic cystic epithelium of KOTs may be due to decreased epithelial immunosurveillance and this may result in locally aggressive invasiveness.

Cystadenoma: a rare tumor originated in minor salivary gland

Cystadenoma of salivary glands is an uncommon benign neoplasm that presents intraluminal papillary projections. The authors describe one case of cystadenoma located in the buccal mucosa and highlight its histomorphological features and differential diagnosis.