Gustavo Pina Godoy

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.

Prevalence of oral mucosal lesions among patients with diabetes mellitus types 1 and 2

BACKGROUND Patients with diabetes mellitus have been associated with a number of changes in the oral cavity, such as gingivitis, periodontitis, mucosal diseases, salivary dysfunction, altered taste, and burning mouth. OBJECTIVES To determine the prevalence of oral mucosal lesions in patients with diabetes mellitus. METHODS A cross-sectional observational study between August and October 2012 with a convenience sampling was performed for 51 patients with diabetes mellitus (type 1 and type 2). The study consisted of two phases: 1) a questionnaire application; 2) intraoral clinical examination. For the analysis of data, we used descriptive statistics, Fishers exact test in bivariate analysis (significance level of 0.05), and Poisson Regression. RESULTS The prevalence of oral lesions was 78.4%. Traumatic ulcers (16.4%) and actinic cheilitis (12.7%) were the most prevalent lesions. The lips (35.3%) and tongue (23.5%) were the most common location. The bivariate analysis showed an association with the type of diabetes, and two variables (age and comorbidity) were quite close to the significance level. In the Poisson Regression analysis, only diabetes type 2 remained significant after adjusting the model. CONCLUSIONS The results of this study show a high prevalence of oral mucosal lesions in diabetic patients. The oral mucosal lesions are mostly associated with diabetes type 2.

Inmunohistochemical Expression of PCNA, p53 and bcl-2 in Pleomorphic Adenomas

El objetivo del estudio fue determinar la expresion inmmunohistoquimica de las proteinas PCNA, p53 y bcl-2 en adenomas pleomorficos. Fueron seleccionados 19 especimenes de adenomas pleomorficos para analisis a traves del metodo de la estreptavidina-biotina-peroxidasa con anticuerpos contra las proteinas p53, PCNA y bcl-2. Fue observada leve marcacion para p53 en 12 casos (63,1%) y para PCNA en 8 (42,1%). Con relacion al indice de marcacion para bcl-2,ono fue detectada en 12 casos (63,1%) expresion de esta proteina. En base a los resultados, se concluyo que las proteinas p53 y PCNA pueden favorecer la actividad proliferativa de adenomas pleomorficos, y por otro lado, la bcl-2 probablementeono participaria efectivamente de la patogenia de este tumor.

Epithelial-Myoepithelial Carcinoma of High Grade Transformation: The Case Report in the Buccal Mucosa

Epithelial-myoepithelial carcinoma was first described by Danath et al. in 1972 and is classified as a rare low-grade biphasic neoplasm of the salivary glands. This case report presents a male patient who had a lesion in the oral mucosa with a history of recurrence of the tumor. The outcome resulted in a profile consistent with an epithelial-myoepithelial carcinoma with a high degree of transformation. The case highlights the importance of histopathological evaluation of oral lesions, which occasionally may not present typical clinical aspects of malignant lesion.

Myofibroblasts and their relationship with oral squamous cell carcinoma

UNLABELLED Myofibroblasts are hybrid-phenotype differentiated cells in between fibroblasts and smooth muscle cells. Due to their contractile features and ability to synthesize extracellular matrix components, cytokines, proteases, and proangiogenic factors, myofibroblasts have been implicated in the pathogenesis of fibrocontractive diseases and in the progression of many tumors, including oral squamous cell carcinoma (SCC). OBJECTIVE To perform a literature review on the origin of myofibroblasts, their main morpho-physiological and immunohistochemical aspects, and to discuss the correlations with oral SCC. METHOD A search was made on the PubMed database to select the main papers in the literature in English related to the subject, published between January 1991 and December 2011. CONCLUSION Myofibroblasts are an important component of the stroma of oral SCCs, although they are not present in all tumors. Abundant presence of myofibroblasts may be associated with local disease recurrence and decreased patient survival. However, given the relatively limited number of studies on the subject, further research is needed to clarify the molecular mechanisms by which myofibroblasts influence the biological behavior of oral SCC.

Fatores Sociodemográficos e Condições de Saúde Bucal em Droga-Dependentes

Objeti vo: Identi fi car clinicamente e por meio de questi onario anamnesico, as condicoes de saude bucal em individuos, causadas pelo uso de drogas e suas relacoes com fatores sociodemografi cos. Metodo: O estudo foi do ti po descriti vo transversal, com abordagem pelo metodo induti vo, sendo a amostra composta de 70 pacientes que buscaram atendimento no CAPS-ad (Centro de atencao psicossocial – alcool e outras drogas). Os dados foram coletados de forma sistemati ca por uma unica examinadora previamente calibrada, atraves de exame clinico e aplicacao de formulario especifi co para identi fi cacao e classifi cacao de provaveis alteracoes. Resultados: Os resultados encontrados mostraram que a idade media dos pacientes pesquisados foi de 40,44 anos; o genero masculino (90%) foi predominante na amostra; mais da metade dos pacientes eram da raca branca (57,1); o nivel de escolaridade encontrado nos mesmos e baixo; as drogas mais consumidas pelos mesmos foram respecti vamente o alcool (68,6%), maconha(17,1%), cocaina(7,1%), crack (4,3%) e farmacos psicotropicos (2,8%); a maioria dos dependentes apresentou saude bucal defi ciente; eram dependentes quimicos ha mais de cinco anos; a defi ciencia na saude bucal pode estar associada ao descaso com a higiene corporal provocado pelo uso abusivo de drogas. Observou-se ainda que quanto maior o periodo de dependencia mais precaria a saude bucal do usuario (p= 0,002) e que a precariedade da saude bucal dos mesmos, esta relacionada aos seus habitos de higiene bucal (p=0,029). Conclusao: Observou-se a necessidade da insercao do profi ssional de odontologia nos projetos de recuperacao oferecidos a estes pacientes, para a realizacao de programas de promocao e de recuperacao da saude bucal melhorando assim, a qualidade de vida desses pacientes. 1

Clinical and histopathological evidence of oral squamous cell carcinoma in young patients: systematized review

The oral squamous cell carcinoma (OSCC) very often affects subjects above the sixth decade of life. However an increasing incidence has been observed in younger individuals, below 40 years. We conducted a systematized review of the current clinical, histopathological and therapeutic aspects of OSCC in young patients. Our work included studies that addressed OSCC involving young patients in the period 2007 2012, and which were indexed in PubMed. Initially, 499 articles were obtained; after refinement, 340 articles had their titles and abstracts evaluated, with 17 included in the sample. The majority of studies reported male predominance (87.5%), association with tobacco and/ or alcohol use (66.6%), advanced clinical stages at diagnosis (77.7%) and, at histopathology, moderately differentiated tumors (72.7%). Based on the results, we believe there are differences in the factors associated with pathogenesis, biological behavior and prognosis in young patients, since most studies show more rapid and aggressive tumor progression in this age group. We suggest the conduction of research focusing on the pathogenesis and carcinogenesis of OSCC in young patients, thereby searching for better scientific evidence.

Aspectos demográficos e manifestações clínicas bucais de pacientes soropositivos para o HIV/Aids

INTRODUCTION: The oral and perioral lesions are common in patients infected with HIV, and may represent the first signs of the disease, even before the systemic manifestations. OBJECTIVE : This study aimed to estimate the prevalence of oral manifestations in HIV seropositive individuals, considering the aspects socio-demographic, immunological and therapeutic. MATERIAL AND METHOD: Was performed nature study clinical-epidemiological transverse, between October 2007 to April 2008, with a sample of 40 patients. Was used the technique of intensive direct observation through appropriate clinical exam. Data were recorded on data sheets pre-prepared and analyzed by descriptive and inferential statistics. RESULT: There was a prevalence of females (52.5%), aged 40-49 years (45%). Treatment with antiretroviral drugs was found in 85.0% of cases, all being with high power therapy (HAART). It was observed that 52.5% of patients had a TCD4+ lymphocyte count above 500cel/mm ³ and 50.0% had an undetectable viral load. The prevalence of oral manifestations was 42.5%, the most significant for pseudomembranous candidiasis (19.23%), followed necrotizing ulcerative periodontitis (15.38%), hairy leukoplakia (11.54%) and angular cheilitis (11.54%). No association was observed between oral lesions and viral load (p=0.1268) nor the TCD4 cell count (p=0.3458). CONCLUSION: Prevalence of some oral manifestations associated with HIV infection is still high, with pseudomembranous candidiasis infection more prevalent, mainly among people with low education levels and longer HIV infection, independent of the therapy and immune status of the patient.

Antimicrobial and Antiproliferative Potential of Anadenanthera colubrina (Vell.) Brenan

The aim of the present study was to perform an in vitro analysis of the antimicrobial and antiproliferative potential of an extract from Anadenanthera colubrina (Vell.) Brenan (angico) and chemically characterize the crude extract. Antimicrobial action was evaluated based on the minimum inhibitory concentration (MIC), minimum bactericidal/fungicidal concentration, and the inhibition of formation to oral biofilm. Cell morphology was determined through scanning electron microscopy (SEM). Six strains of tumor cells were used for the determination of antiproliferative potential. The extract demonstrated strong antifungal activity against Candida albicans ATCC 18804 (MIC = 0.031 mg/mL), with similar activity found regarding the ethyl acetate fraction. The extract and active fraction also demonstrated the capacity to inhibit the formation of Candida albicans to oral biofilm after 48 hours, with median values equal to or greater than the control group, but the difference did not achieve statistical significance (P > 0.05). SEM revealed alterations in the cell morphology of the yeast. Regarding antiproliferative activity, the extract demonstrated cytostatic potential in all strains tested. The present findings suggest strong antifungal potential for Anadenanthera colubrina (Vell.) Brenan as well as a tendency toward diminishing the growth of human tumor cells.