Denise Tostes Oliveira

Tumour-associated tissue eosinophilia as a prognostic factor in oral squamous cell carcinomas

Tumour‐associated tissue eosinophilia as a prognostic factor in oral squamous cell carcinomas

Oral verrucous carcinoma: a retrospective study in São Paulo Region, Brazil

Oral verrucous carcinoma (OVC) is a rare variant of squamous cell carcinoma with a characteristic morphology and specific behavior. To date, few studies are available focusing the prevalence and clinicopathologic features of the oral verrucous carcinoma in Brazilian population. A total of 3,500 primary oral well-differentiated squamous cell carcinoma surgically excised in the A.C. Camargo Cancer Hospital and Amaral Carvalho Cancer Hospital, Brazil, from 1980 to 2000 were retrospectively reviewed. Twenty cases of verrucous carcinomas were identified, most of them occurring in older male with age above the sixth decade, the sites frequently affected being the lower lip and the hard palate. Microscopically, the tumor showed a heavily keratinized lesion with compressive invasion pattern, little atypia, and free surgical margins. The local recurrence was verified in 38.5% of the patients with oral verrucous carcinoma; however, regional recurrence and distant metastasis were not verified. The results suggest that, although it is less frequent and with excellent prognosis, the verrucous carcinoma presents a potential for local recurrence that should be considered during the surgical planning of this neoplasm in the oral cavity.

E-cadherin abnormalities resulting from CPG methylation promoter in metastatic and nonmetastatic oral cancer.

This study aims to compare the alterations in the methylation profiles of E‐cadherin in oral cancer, especially in tumors with lowest metatastic potential.

Expression of PCNA, p53, Bax, and Bcl-X in oral poorly differentiated and basaloid squamous cell carcinoma: Relationships with prognosis

The aim of this study was to compare the clinical features and proliferating cell nuclear antigen (PCNA), p53, Bcl‐X, and Bax expression in primary oral basaloid squamous cell carcinoma (BSCC) and poorly differentiated squamous cell carcinoma (PDSCC) matched by stage and site and to assess the possible prognostic significance of these variables.

Expression of CD44 variant exons by normal oral epithelia.

Altered expression of CD44H an CD44 splice variants is associated with metastasis in several malignancies but its analysis requires knowledge of the normal pattern of expression which is tissue specific. There are considerable regional variations in epithelial differentiation within the mouth, including differences in cell surface glycoproteins. The aim of this study was to determine whether there are regional variations in the expression of CD44 variants in oral epithelia. Frozen and formalin-fixed paraffin-embedded sections of lip vermilion border, buccal mucosa, dorsum and ventrum of tongue, floor of mouth, gingiva and hard palate were stained immunohistochemically for CD44H and the produce of variant exons v3, v4/5, v6 and v9. Paraffin sections were subjected to microwave antigen retrieval. All epithelia stained strongly for all variants in basal, suprabasal and prickle cells and cornified and surface layers and the basal surface of basal cells were negative. Patterns of staining were identical in frozen and formalin-fixed tissue. Despite the structural heterogeneity within oral epithelium, no regional variation was detected.

Tissue eosinophilia and its association with tumoral invasion of oral cancer

This study investigated if tumor-associated tissue eosinophilia (TATE) could be associated with the process of tissue invasion in oral squamous cell carcinomas (OSCCs) and its influence on patients prognosis. Forty-three patients treated for OSCCs with or without lymph nodes involvement, at A. C. Camargo Cancer Hospital, Brazil, were selected for TATE analysis. Two degrees of tissue eosinophilia were established in OSCC: absent/mild and intense. The TATE was evaluated in relation to the clinicopathological features and prognostic value using χ 2 test and the Kaplan—Meier method. Most of the patients with OSCC in advanced clinical stage presented muscular infiltration and significantly intense TATE whereas those with tumors in early stage frequently showed absent/mild eosinophilia (P = .009). The TATE showed no prognostic value for 5-year and 10-year survival rates of the OSCC. These findings suggest that intense TATE seems to reflect the stromal invasion of the OSCCs that occur in advanced clinical stage.

Expression of vascular endothelial growth factor-C does not predict occult lymph-node metastasis in early oral squamous cell carcinoma

Strong vascular endothelial growth factor-C (VEGF-C) expression has been correlated to occurrence of lymph-node metastases in patients with oral squamous cell carcinoma (OSCC). The incidence of occult lymph-node metastasis remains a decisive factor in the prognosis of patients with early OSCC. The aim of this study was to evaluate VEGF-C expression as a predictor of occult lymph-node metastasis in OSCC. Eighty-seven patients with primary OSCC arising in the tongue or floor of mouth, clinically T1N0M0 or T2N0M0, with (pN+) and without (pN0) occult lymph-node metastases were analyzed for VEGF-C expression by malignant cells. Occult lymph-node metastases (pN+) were detected in 22% of the 64 patients who were submitted to elective neck dissection. No statistically significant difference was found between OSCC with and without occult lymph-node metastasis in regard to VEGF-C immunoexpression by malignant cells and clinicopathologic features. Independently of VEGF-C expression, lymph-node metastasis (pN+) was the most significant prognostic factor for overall survival of patients with OSCC (p=0.030). These findings indicate that isolated VEGF-C expression by malignant cells is not of predictive value for occult lymph-node metastasis in the early stages of OSCC.

Is podoplanin expression associated with the proliferative activity of ameloblastomas

OBJECTIVES The aim of this study was to investigate the relationship between podoplanin expression and proliferative activity of ameloblastomas and remnants of the odontogenic epithelium from dental follicles (DF) of unerupted teeth. SUBJECTS AND METHODS Thirty-three paraffin-embedded ameloblastomas and thirty-two DF obtained of unerupted teeth were analyzed by immunohistochemistry using anti-human podoplanin and anti-Ki-67 antibodies. Podoplanin expression in odontogenic epithelial cells was evaluated using a scoring method, and the Ki-67 labeling index was determined by the percentage of positive odontogenic cells. RESULTS All ameloblastomas displayed podoplanin expression in ameloblast-like cells of the epithelial islands. Membranous expression of podoplanin in ameloblastomas was stronger than in the remnants of odontogenic epithelium (P = 0.001). Statistically significant difference was observed between the cytoplasmic and membranous expression of podoplanin in the remnants of odontogenic epithelium (P = 0.001). The index of epithelial odontogenic proliferative activity, verified by Ki-67 expression, was higher in ameloblastomas vs remnants of odontogenic epithelium (P < 0.001). No statistically significant correlation was identified between podoplanin and the cellular odontogenic proliferative activity in meloblastomas and DF (P > 0.05). CONCLUSIONS These results provide evidence that there is no connection between podoplanin immunostaining and odontogenic cellular proliferative activity and suggest a role for membranous podoplanin expression in the local invasion of ameloblastomas.

Recurrent peripheral odontogenic keratocyst: a case report

A case of peripheral odontogenic keratocyst arising in a 57-year-old white female patient involving the posterior mandibular gingiva that recurred after 12 months of follow-up is presented. This reported case reinforces that patients presenting peripheral odontogenic keratocyst should be carefully followed up after conservative surgical treatment.

Immunolocalization of podoplanin in benign odontogenic tumours with and without ectomesenchyme.

OBJECTIVES To investigate podoplanin expression in epithelial odontogenic tumours with and without ectomesenchyme and verify the association between its immunoexpression and proliferative activity in keratocystic odontogenic tumours (KCOTS) and orthokeratinized odontogenic cysts (OOCs). DESIGN Eight ameloblastomas, nine adenomatoid odontogenic tumours, twenty KCOTS, five OOC, one calcifying epithelial odontogenic tumour, two ameloblastic fibromas, four ameloblastic fibro-odontomas and five calcifying cystic odontogenic tumours were immunohistochemically analysed with anti-podoplanin antibody. For KCOTS and OOC, the cell proliferation index was determined with Ki-67 immunostaining and compared by Spearman correlation coefficient. RESULTS Podoplanin was expressed in the peripheral odontogenic epithelium of most tumours. Ectomesenchyme was negative, except for odontoblasts. KCOTS exhibited positive podoplanin expression while in OOC it was absent/weak. There was statistically significant correlation (p=0.006) between podoplanin expression and cellular proliferation index of KCOTS and OOC. CONCLUSION Podoplanin seems to be related to the proliferative activity of KCOTS and may have a role in the process of local invasion of odontogenic tumours with and without ectomesenchyme.