Éricka Janine Dantas da Silveira

Correlation of Clinical, Histological, and Cytokeratin Profiles of Squamous Cell Carcinoma of the Oral Tongue With Prognosis

The aim of the present study was to clinically, morphologically, and immunohistochemically correlate the expression of cytokeratins (CKs) 7, 10, 13, 14, 16, and 19 in 30 cases of tongue squamous cell carcinoma (SCC) with disease outcome, metastases, clinical stage (tumor, node, metastasis [TNM]), and histological grade of malignancy proposed by Bryne. Statistical analysis (chi2 test) showed that only histological grading was not significantly correlated with the clinical variables. CK expression varied in the samples analyzed. CK 10 expression was significantly correlated with the presence of metastases, and the expression of CK 16 was related to disease outcome and also to TNM stages III and IV. These results indicate that metastases and TNM are effective prognostic indicators. The histological grading proposed by Bryne did not reflect the biological behavior of the tongue SCC cases studied. Analysis of some intermediate CK filaments can reflect the biological behavior and aggressiveness of some tongue SCCs.many aspects of this tumor, especially those related to prognosis, remain unknown. The aggressiveness of these tumors is related to different factors, including the histological degree, tumor size, level of involvement of neighboring tissues, presence of metastases at the time of diagnosis, and anatomical location of the tumor. With respect to anatomical location, cancer of the tongue shows a high potential of invasion and a high probability of developing metastases to the regional lymph nodes. Many studies have attempted to establish a correlation between the clinical and histological characteristics of oral cancer and its prognosis, but the results have been unsatisfactory. The objective of the present study was to correlate the outcome of the disease, clinical stage, and histological grade of malignancy proposed by Bryne with the expression of cytokeratins (CKs) in epidermoid carcinoma of the Introduction

Significance of galectins-1, -3, -4 and -7 in the progression of squamous cell carcinoma of the tongue

The aim of this study was to analyze the immunohistochemical expression of galectins-1, -3, -4, and -7 in 65 cases of squamous cell carcinoma of the tongue and to correlate this expression with clinical (disease outcome, metastasis, and clinical stage) and morphological parameters (histological grade of malignancy). Clinical data were obtained from the patient records. The histological grading system of malignancy proposed by Bryne (1998) [9] was used for the analysis of morphological parameters. The results were analyzed statistically by χ(2) test (p < 0.05). Galectin-1 expression was observed in 87.7% of cases and was significantly correlated with metastasis (p = 0.033) and clinical stage (p = 0.016). Immunoexpression of galectin-3 was observed in 87.7% of cases and was correlated with the presence of metastasis (p = 0.033) and histological grade of malignancy (p = 0.031). Galectin-4 showed no significant correlation with any of the parameters studied. Expression of galectin-7 was observed in 73.8% of cases and was significantly correlated with the histological grade of malignancy (p = 0.005). In conclusion, the intense immunoexpression of galectins-1, -3, and -7 suggests the participation of these proteins in oral carcinogenesis and their use as markers of biological behavior and tumor progression in squamous cell carcinoma of the tongue.

ANALYSIS OF INFLAMMATORY INFILTRATE, PERINEURAL INVASION, AND RISK SCORE CAN INDICATE CONCURRENT METASTASIS IN SQUAMOUS CELL CARCINOMA OF THE TONGUE

PURPOSE In this retrospective study, the aim was to compare individual histopathologic parameters of malignancy between nonmetastatic and metastatic squamous cell carcinoma of the tongue. MATERIALS AND METHODS Sixty-two cases of squamous cell carcinoma of the tongue were selected and examined according to the system established by Brandwein-Gensler et al (Am J Surg Pathol 29:167, 2005) and included the pattern of invasion (most to least favorable), lymphocytic infiltration, perineural invasion, risk score, keratinization, eosinophilia, perivascular invasion, and tumor thickness. RESULTS The least favorable pattern had no association with nodal metastasis (P > .05). The scarcity or density of the lymphocytic infiltration, perineural invasion, and a risk score ≥ 3 were associated with nodal metastasis (P < .05). Keratinization, eosinophilia, perivascular invasion, and tumor thickness had no association with nodal metastasis (P > .05). A significant positive correlation was found between the pattern of invasion and perineural invasion and between the pattern of invasion and tumor thickness (P < .05). CONCLUSIONS The scarcity or density of the lymphocytic infiltration, perineural invasion, and histopathologic risk score may be helpful as parameters of histologic malignancy for the evaluation of metastatic and nonmetastatic squamous cell carcinoma of the tongue.

Severe florid cemento-osseous dysplasia: a case report treated conservatively and literature review

BackgroundFlorid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. FCOD is usually asymptomatic. In severe cases, focal expansion may occur due to infection. Management of the symptomatic patient is more difficult due to the avascular nature of the lesion which contributes to susceptibility severe infection, bone sequestration, and osteomyelitis when surgery is performed.Case reportThis paper presents a rare case of severe FCOD; the black woman patient was diagnosed based on clinical and radiographic findings and treated conservatively. The examination of panoramic radiographs revealed a multiple sclerotic masses with radiolucent borders, found in the mandible and maxilla which were symmetrical at presentation. The patient continuous with the follow-up.DiscussionThis report confirms that a diagnosis can be made with accurate clinical and radiographic assessment. The correct selection of treatment for FCOD depends on this information.

Analysis of local immunity in squamous cell carcinoma of the tongue and lower lip.

Antitumor immunity plays an important role in the development of and protection against malignancy. In general, patients with cancer are known to be immunologically compromised. The objective of this study was to evaluate local immunity in squamous cell carcinomas (SCCs) of the tongue and lower lip by immunohistochemistry, using anti-CD3, -CD4, -CD8, -CD25 and -zeta antibodies. Immunoexpression at the invasive front was compared considering anatomical tumor location and metastasis. The CD4/CD8 ratio was calculated for each case and associated with the variables. CD3+, CD4+, CD8+ and CD25+ cell counts were higher in SCCs of the lower lip and anti-zeta immunostaining was more evident in non-metastatic cases. CD8+ and CD25+ cell counts were also significantly correlated with tumor location (p=0.004 and p=0.004, respectively), with the observation of a larger number of these cells in SCCs of the lower lip. The CD4/CD8 ratio showed no significant association with metastasis or anatomical location. In conclusion, the clinical behavior of the oral SCC cases studied might be partially related to the immunohistochemical profile of the inflammatory infiltrate present at the invasive front.

Glandular odontogenic cyst: case report and review of diagnostic criteria

The glandular odontogenic cyst (GOC) is an uncommon jaw bone cyst of odontogenic origin with unpredictable and potentially aggressive behaviour. It also has the propensity to grow to a large size and tendency towards recurrence. GOC can be easily misdiagnosed microscopically as a central mucoepidermoid carcinoma. This paper reports a case of GOC in a 56-year-old male and reviews the main criteria for accurate diagnosis. The diagnosis of GOC can be extremely difficult due to the rarity of the cyst and lack of clear diagnostic criteria.

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

OBJETIVOS: O objetivo desta pesquisa foi realizar uma analise clinica e morfologica em lesoes orais com potencial de malignizacao. MATERIAL E METODO: Os dados clinicos e morfologicos referentes a tais lesoes foram obtidos a partir das fichas clinicas e dos laudos histopatologicos, respectivamente. RESULTADOS: Dos 205 casos analisados, a lesao mais prevalente foi a leucoplasia (70,7%), seguida da queilite actinica (16,1%), eritroplasia (9,8%) e eritroleucoplasia (3,4%). Verificou-se uma associacao significativa entre o sexo e as lesoes (p 0,05), sendo mais frequentes nas quinta, sexta e setima decadas de vida. Observou-se que, na maioria dos casos de eritroplasias e eritroleucoplasias, os diagnosticos clinicos foram incompativeis com o morfologico. Verificou-se associacao significativa entre transformacao maligna e lesoes (p < 0,001), pois a eritroplasia apresentou uma taxa de malignizacao de 20%, enquanto na leucoplasia o indice foi de 2,1%. CONCLUSAO: A prevalencia das lesoes orais com potencial de malignizacao foi semelhante ao encontrado na literatura, mas com algumas diferencas em relacao ao perfil epidemiologico das mesmas, ressaltando-se que estas entidades merecem uma atencao especial por parte do clinico, especialmente as eritroplasias, que apresentaram um elevado percentual de malignizacao e o maior indice de equivocos no diagnostico clinico.Objective: The objective of this study was to perform a clinical and morphological analysis of potentially malignant oral lesions. Material and method: The clinical and morphological data related to these lesions were obtained from clinical and histopathological records, respectively. Results: Out of 205 cases, the most prevalent lesion was oral leukoplakia (70.7%), followed by actinic cheilitis (16.1%), erythroplakia (9.8%) and erythroleukoplakia (3.4%). There was a significant association between the lesions and gender (p 0.05), although they were more frequent in the 5th, 6th and 7th decades of life. In most cases of erythroplakias and erythroleukoplakias, it was observed that clinical and morphological diagnoses were incompatible. There was a significant association between malignant transformation and lesions (p < 0.001) as the erythroplakia presented a malignization rate of 20%, whereas in leukoplakias the rate was 2.1%. Conclusion: The prevalence of potentially malignant oral lesions was similar to other findings in the medical literature, but with some differences in their epidemiological profile. It is important to highlight that these entities require further medical investigation, mainly erythroplakias, which showed high risk of malignization and the highest rate of clinical misdiagnosis. key words Potentially malignant oral lesions

Actinic cheilitis: clinicopathologic profile and association with degree of dysplasia

Actinic cheilitis (AC) is a potentially malignant disorder of the lip caused by exposure to solar radiation.

O papel das proteínas da matriz extracelular e das metaloproteinases em carcinomas de cabeça e pescoço: uma atualização bibliográfica

Interactions involving tumor cells and the extracellular matrix (ECM) strongly influence tumor development, including head and neck tumors, affecting cell proliferation and survival as well as the ability to migrate beyond the original location into other tissues to form metastases. These cell migration is often facilitated by partial destruction of the surrounding ECM, which is catalyzed by matrix metalloproteinases (MMPs), a family of more than 20 endopeptidases that is controlled by regulated expression of specific inhibitors (TIMPs). Several studies of ECM and MMPs markers have provided additional diagnostic and prognostic information in head and neck carcinomas. In this review, we are considering the role of ECM and MMPs in tumor progression, emphasizing its proteolytic contributors to this process, and interactions between several members of ECM providing substrate to regulation of this process.

FoxP3(+) T regulatory cells in oral lichen planus and its correlation with the distinct clinical appearance of the lesions.

The aim of this study was to evaluate the presence of FoxP3+ cells in oral lichen planus (OLP) and to correlate the findings with clinical and histopathological features of these lesions. The sample consisted of 32 cases of OLP (17 reticular and 15 erosive cases) and 10 cases of inflammatory fibrous hyperplasia (IFH). Clinical examination, histopathological and histomorphometric analysis, and immunohistochemistry (anti‐FoxP3 antibody) were performed. Cells were counted in juxtaepithelial and intraepithelial regions of the lesions, and the results are expressed as the mean and range. Most erosive lesions were keratinized and exhibited epithelial atrophy, whereas most reticular lesions were hyperkeratinized. Mean epithelial thickness and mean density of the inflammatory infiltrate were higher in reticular lesions than in erosive OLP. Juxtaepithelial FoxP3+ cells were slightly more frequent in erosive lesions (mean: 1.7 and range: 0–9.4) than in reticular lesions (mean: 1.5 and range: 0–8.3). There was a significant difference in the frequency of these cells between OLP (mean: 1.6 and range: 0–9.4) and IFH (mean: 0.5 and range: 0–1.4) (P < 0.05). The number of intraepithelial FoxP3+ cells was higher in reticular OLP and IFH when compared with erosive lesions. The larger number of juxtaepithelial FoxP3+ cells in OLP compared to IFH might be related to the distinct etiopathogenesis of these lesions. High disease activity or action of the oral microbiota may explain the slightly higher frequency of FoxP3+ cells in erosive lesions.